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A tailored, psychological intervention for mild to moderate anxiety or depression in people with chronic obstructive pulmonary disease(COPD). TANDEM (Tailored intervention for ANxiety and DEpression Management in COPD)

TANDEM: A Tailored intervention for ANxiety and DEpression Management in COPD


The prevalence of psychological comorbidities such as anxiety and depression are common in patients with Chronic Obstructive Pulmonary Disease (COPD). Patients with severe COPD have 2.5 times the risk of depression onset compared to those with mild disease. Anxiety is observed in 10-50% of COPD patients irrespective of their disease severity. Completion of the evidence-based treatment, pulmonary rehabilitation (PR) in this population reduces anxiety and depression. However, there is significant under-referral to PR and poor attendance and completion rates are seen among those referred which limit its benefits.
TANDEM is a randomised controlled trial (RCT) investigating whether a cognitive behavioural approach (CBA) intervention, delivered prior to PR can help to improve mild to moderate anxiety and/or depression in those with moderate to very severe COPD and consequently encourage PR uptake/completion.
Preliminary work:
The TANDEM study is funded by the National Institute of Health Research Health Technology Assessment Programme (NIHR HTA) and comprises three phases.
In Phase I we developed the TANDEM CBA intervention manual; refined the intervention as a result of focus groups/individual interviews with patients, carers, and health care professionals (HCPs); and conducted a pre-pilot study in which the intervention was delivered to six patients with mild to moderate depression and/or anxiety and their carers followed by a qualitative evaluation among those who received the intervention and those who delivered the intervention.
Phase I also comprised liaising and confirming recruitment of NHS Trusts and GP practices for the main trial.

The findings of Phase I have informed the refined TANDEM CBA intervention which will undergo evaluation in the internal pilot and feasibility study (Phase II) and main RCT (Phase III). Recruitment for the main trial is currently ongoing.

Our Patient and Carer advisors have contributed significantly to the design and implementation of the TANDEM study. The advisors will continue to be involved until study completion and results dissemination.

Living with COPD

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TANDEM PPI lead Chris Warburton explains in this new British Lung Foundation video

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Chris Warburton