Inadequate social support contributes to depression, disease impact in COPD

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Key takeaways:

  • Among those with COPD who lived with a loved one, nearly 20% reported inadequate social support.
  • Inadequate vs. adequate social support contributed to poorer clinical outcomes.

Perceived inadequate social support among patients with COPD living with a loved one was linked to more depression symptoms and greater disease impact, according to results published in Respiratory Medicine.

“This study underlines the importance of addressing social support in the care for patients with COPD, even if they have a resident loved one,” Anna L. Stoustrup, PT, MSc, PhD fellow at Aalborg University Hospital in Denmark, and colleagues wrote.

Data were derived from Stoustrup AL, et al. Respir Med. 2024;doi:10.1016/j.rmed.2024.107625.

In a cross-sectional study, Stoustrup and colleagues assessed 191 patients with COPD (mean age, 65.6 years; 53.4% men; mean FEV1 47.3% percent predicted) living with a loved one to determine how inadequate vs. adequate social support impacts eight clinical outcomes: lung function, dyspnea, health status, anxiety symptoms, depression symptoms, care dependency, functional status and mobility.

Researchers used the Medical Outcomes Study-Social Support Survey (MOS-SSS) to find out if patients perceived their social support as adequate or inadequate.

The most common relationship patients had with their resident loved one was spouse/partner (97.9%), with fewer patients living with their child (1.6%) or friend (0.5%).

Of the total cohort, more patients reported adequate vs. inadequate social support (81.7% vs. 18.3%). In the adequate social support group, the average overall support index score was 4.5 out of 5 points, whereas this score was 2.8 out of 5 points in the inadequate social support group.

Three of the eight assessed clinical outcomes significantly differed according to the level of perceived social support, with worse outcomes seen in the inadequate group, researchers wrote.

Use of the COPD Test Assessment revealed a higher disease impact among patients with inadequate vs. adequate social support (25 points vs. 21 points; P = .004).

To evaluate symptoms of depression and anxiety, researchers used the Hospital Anxiety and Depression Scale (HADS) and found scores signaling more depression symptoms in the group with perceived inadequate social support (8 points vs. 5 points; P = .004).

Lastly, inadequate social support was linked to an elevated Care Dependency Scale score, suggesting more care dependency, when compared with adequate social support (69 points vs. 71 points; P = .04) in this study population.

Lung function (FEV1 percent predicted), dyspnea (Modified Medical Research Council Dyspnea Scale score), anxiety symptoms (HADS-anxiety score), functional status (Instrumental Activity of Daily Living score) and mobility (Timed Up and Go test) did not significantly differ based on inadequate vs. adequate social support.

“The relationship between perceived level of social support and actual support needs is relevant to unravel further when using the MOS-SSS or otherwise assessing social support among patients with COPD,” Stoustrup and colleagues wrote.

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