Patients suffering from chronic obstructive pulmonary disease (COPD) are stuck in a vicious circle: their disease leads to shortness of breath, even with limited effort, causing patients to reduce their physical activity and become inactive, which then worsens their physical fitness, resulting in worse shortness of breath and lower quality of life. In the last 20 years, pulmonary rehabilitation (PR) has become a key part of the treatment programs available to patients suffering from COPD.
PR programs are built upon 3 main parts: exercise training, education in disease self-management, and psychological support. These programs are effective in improving patients' exercise tolerance short-term, but the benefits are often lost during the months after the PR program ends, especially after an acute crisis of COPD symptoms. The behavioral changes that benefit health in the long term, such as exercising on a regular basis can be very difficult to maintain, especially for patients who are used to an inactive lifestyle and who find it difficult to tolerate shortness of breath. What is not yet clear is the impact that psychological disorders may have on staying physically active after a PR program. This research program will first evaluate how anxiety and depression can affect the long-term maintenance of functional benefits gained from rehabilitation programs. A second study will evaluate how anxiety and depression can affect another health behavior, the adherence to medication.
Finally, the findings will guide us in developing and testing a new community-based follow-up intervention targeting the psychological health of COPD patients so they can better maintain an active healthy lifestyle and enjoy a better quality of life.