The association of depression and preferences for life-sustaining treatments in veterans with chronic obstructive pulmonary disease

Lynn F. Reinke, Christopher G. Slatore, Edmunds M. Udris, Brianna R. Moss, Eric A. Johnson, David H. Au

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Context: Depressive symptoms are common among patients with chronic obstructive pulmonary disease (COPD) and may modify patients' preferences for life-sustaining therapy. Examining the relationship between patient preferences for life-sustaining treatments and depressive symptoms is important for clinicians engaging in end-of-life care discussions. Objectives: To assess whether a history of depression or active depressive symptoms is associated with preferences for life-sustaining therapies among veterans with COPD. Methods: This was a cross-sectional study of 376 veterans who participated in a randomized trial to improve the occurrence and quality of end-of-life communication between providers and patients. Depressive symptoms were assessed by self-reported history and the Mental Health Index-5 survey. Preferences for mechanical ventilation (MV) and cardiopulmonary resuscitation (CPR) were assessed using standardized instruments. Multivariate logistic regression was conducted to adjust for potential confounding factors. Results: Participants were older men with severe COPD. A substantial proportion of participants noted that they would want MV (64.2%) or CPR (77.8%). Depressive history and active symptoms were not associated with preferences for MV and CPR either before or after adjusting for confounding variables. Conclusion: Depressive history and active symptoms among veterans with severe COPD were not associated with their decisions for life-sustaining treatments. Clinicians caring for patients with COPD should understand the importance of assessing and treating patients with depressive symptoms, yet recognize that depressive symptoms may not be predictive of a patient declining life-sustaining treatments.

Original languageEnglish (US)
Pages (from-to)402-411
Number of pages10
JournalJournal of Pain and Symptom Management
Volume41
Issue number2
DOIs
StatePublished - Feb 2011

Fingerprint

Veterans
Chronic Obstructive Pulmonary Disease
Depression
Cardiopulmonary Resuscitation
Artificial Respiration
Patient Preference
History
Therapeutics
Terminal Care
Confounding Factors (Epidemiology)
Mental Health
Cross-Sectional Studies
Logistic Models
Communication
Quality of Life

Keywords

  • cardiopulmonary resuscitation
  • Chronic obstructive pulmonary disease
  • COPD
  • CPR
  • depression
  • life-sustaining preferences

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology
  • Nursing(all)

Cite this

The association of depression and preferences for life-sustaining treatments in veterans with chronic obstructive pulmonary disease. / Reinke, Lynn F.; Slatore, Christopher G.; Udris, Edmunds M.; Moss, Brianna R.; Johnson, Eric A.; Au, David H.

In: Journal of Pain and Symptom Management, Vol. 41, No. 2, 02.2011, p. 402-411.

Research output: Contribution to journalArticle

Reinke, Lynn F. ; Slatore, Christopher G. ; Udris, Edmunds M. ; Moss, Brianna R. ; Johnson, Eric A. ; Au, David H. / The association of depression and preferences for life-sustaining treatments in veterans with chronic obstructive pulmonary disease. In: Journal of Pain and Symptom Management. 2011 ; Vol. 41, No. 2. pp. 402-411.
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