PSYCHOLOGICAL FACTORS AFFECTING THERAPY COMPLIANCE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A CROSS SECTIONAL ANALYSIS.

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous respiratory disorder associated with persistent airflow limitation, often complicated by psychological comorbidities like anxiety and depression. These mental health conditions are known to impair treatment adherence and worsen clinical outcomes.

Objective: To assess the prevalence of anxiety and depression among COPD patients and examine their impact on adherence to respiratory therapy and clinical outcomes.

Methods: A cross-sectional study was conducted over 1 year at the Department of Respiratory Medicine, Sree Balaji Medical College and Hospital, involving 100 COPD patients. The Hospital Anxiety and Depression Scale (HADS) was used to assess psychological distress, while adherence was evaluated using the Morisky Medication Adherence Scale-8 (MMAS-8). Clinical and demographic data were collected alongside spirometry, GOLD classification, and COPD Assessment Test (CAT) scores.

Results: Anxiety and depression were present in 48.5% and 41.2% of patients, respectively. A significant negative correlation was found between HADS scores and MMAS-8 adherence levels (p < 0.001). Patients with abnormal HADS scores exhibited significantly lower adherence. Most participants were male (79.4%) and aged 61–70 years (45.1%). Nearly 96.1% reported shortness of breath, with 46.1% classified in GOLD stage 3 and 30.4% in GOLD stage 4. CAT scores showed a high symptom burden in 45.1% of patients.

Conclusion: Psychological distress is prevalent among COPD patients and significantly impairs adherence to respiratory therapy. Routine screening and integration of mental health support into COPD management are essential for optimizing outcomes.