The impact of telephone-delivered cognitive behaviour therapy and befriending on mood disorders in people with chronic obstructive pulmonary disease: A randomized controlled trial

Objectives: The main objectives of this pragmatic randomized controlled trial were to investigate the impact of cognitive behaviour therapy (CBT) and an active social control (befriending) on depression and anxiety symptoms in people with chronic obstructive pulmonary disease (COPD). Methods: Eligible participants were randomly allocated to receive eight weekly telephone interventions of CBT (n = 54) or befriending (n = 56). Repeated‐measures ANOVA was used to assess changes in scores and Cohen's d was used to assess effect sizes. Results: Significant improvement was observed in anxiety symptoms for the befriending group from baseline (T1) to post‐intervention assessment (T2) and to 8‐week follow‐up assessment (T3), with a small to medium effect size (Cohen's d = 0.3). Significant improvement was noted in depression symptoms from T1 to T2 for both groups, but only the CBT group had a significant difference at T3, with a small to medium effect size (Cohen's d = 0.4). For secondary outcomes, there was a significant change in COPD symptoms from T1 to T2 for the befriending group; however, at T3 this change was no longer significant. Finally, there was a significant change in general self‐efficacy for both groups between T1 and T2, and T1 and T3. Conclusion: Cognitive behaviour therapy reduced depression symptoms but not anxiety. Befriending reduced depression symptoms in the short term and anxiety symptoms in both the short term and long term. Further research is needed to demonstrate non‐inferiority of telephone delivery compared with other formats, and to understand the impact of befriending which has the potential to be a cost‐effective support for people with COPD.