JMIR Publications

ABSTRACT

Background:

Co-morbid anxiety and depression can add to the complexity of managing treatment for people living with chronic obstructive pulmonary disease (COPD). Monitoring mood has potential to identify individuals who might benefit from additional support and treatment.

Objective:

We used data from the sElf-management anD support programme (EDGE) trial to examine (i) the extent to which the mood-monitoring components of an mHealth system for patients with COPD were used by participants, (ii) the levels of anxiety and depression symptoms among study participants, (iii) the extent to which videos providing advice about coping with low mood were viewed, and (iv) the characteristics of participants with differing levels of mood and utilisation of mood monitoring.

Methods:

107 men and women with a clinical diagnosis of COPD, aged ≥40 years were recruited to the intervention arm of EDGE trial. Participants were invited to complete the Patient Health Questionnaire-8, PHQ-8 and the Generalised Anxiety Disorder-7, GAD-7 at 4-weekly intervals using a tablet computer. Mood disturbance based on these measures was defined as a score ≥5 on either scale. Participants reporting a mood disturbance were automatically directed (signposted) to a stress or mood management video. Study outcomes included measures of health status, respiratory quality of life, and symptoms of anxiety and depression.

Results:

Ninety-four (87.9%) participants completed the 12-month study. Eighty participants entered at least one response each month for at least ten months. On average, 16 participants (range: 8 to 38 participants) entered ≥2 responses each month. Forty-seven participants (50%) gave responses indicating a mood disturbance. Participants with a mood disturbance score for both scales (n=47) compared with those without (n=20) had lower health status, lower quality of life, and greater anxiety and increased depression symptoms (P<0.05). Videos were viewed by 64 (68%) people over 12 months. Of the 220 viewing visualisations, 70 (34.7%) began after being signposted. Participants signposted to the stress management video watched a greater proportion of it, compared to those not signposted (100% (23.3-100%) versus 38.4% (16.0-68.1%), P=0.03) whereas duration of viewing was not significantly different for the mood management video.

Conclusions:

Monitoring of anxiety and depression symptoms for people with COPD is feasible. More than half of trial participants reported scores indicating a mood disturbance during the study. Signposting participants to an advisory video when reporting increased symptoms of a mood disturbance resulted in a longer view-time for the stress management video. The opportunity to elicit measures of mood regularly as part of a health monitoring system could contribute to better care for people with COPD.