Prevalence of anxiety and depression among Filipino patients with chronic obstructive pulmonary disease: A multi-center study

BACKGROUND: One under-explored area in chronic obstructive pulmonary disease (COPD) patients is anxiety and/or depression, which may have negative impact in the patients' condition. This is possibly the first study to possibly assess the burden of anxiety and depression in COPD patients in the Philippines. STUDY DESIGN: This is a prospective descriptive survey in three tertiary care hospitals in Manila, Philippines. PARTICIPANTS: A total of 204 patients were enrolled in the study with the following inclusion criteria: Filipino patients who are aged more than or equal to 40 years with a diagnosis of COPD (documented post-bronchodilator FEV1/FVC ratio less than 0.7) by a physician seen at the outpatient clinics of three tertiary care hospitals with no primary diagnosis of asthma, no previous lung volume reduction surgery, lung transplantation or pneumonectomy and at least finished Grade 2 education. Exclusion criteria include pregnant patients and patients previously diagnosed to have an anxiety, depression, or on any anti-depressant medications. METHODS: Descriptive statistics was obtained with frequency and percentages of the demographic and physiologic variables in the study by tabulation and graph. The prevalence of anxiety and depression was determined by calculating the percentage of each patient with a score of 8 or higher on the Hospital Anxiety and Depression Scale (HADS) with validated Tagalog version, respectively. RESULTS: The prevalence of anxiety in Filipino COPD patients is 47.55%. The prevalence of depression in Filipino COPD patients is 31.37%. CONCLUSION: The prevalence of depression in Filipino COPD patients is comparable to the prevalence of depression from other general medical conditions nationwide according to the study of Batar (31.37% vs. 31%). Anxiety is slightly more prevalent in COPD from other general medical conditions (47.55% vs. 36%). A study on the risk factors of anxiety and depression among Filipino COPD patients is recommended.

A survey of knowledge, attitudes and practices of sedation and analgesia among medical residents and pulmonary fellows-in-training at the University of the Philippines-Philippine General Hospital

BACKGROUND: Providing sedation and analgesia for patients especially in the intensive care units remains difficult and controversial for clinicians and many institutions.OBJECTIVE: The purpose of this study is to describe the knowledge, attitudes and practices on sedation and analgesia among medical residents and pulmonary fellows-in-training in a tertiary care hospital.METHODS: The research design is a prospective descriptive survey of 67 participants.RESULTS: Midazolam is the preferred sedative agent for continuous infusion. The top two reasons why sedation is used according to the knowledge of the study participants were agitation and patient comfort. Monitoring neurologic status is the primary reason why sedation is not used. Majority of the medical residents said that 50% of the mechanically ventilated patients require continuous intravenous sedation. On the other hand, pulmonary fellows-in-training said that 50-75% of mechanically ventilated patients require continuous intravenous sedation. Twenty three participants (34.32%) have used a sedation scale, of which majority uses Ramsay Sedation Scale. Morphine is the preferred analgesic agents of the study participants. Unavailability of analgesic agents is the top reason why analgesia is not used.CONCLUSION AND RECOMMENDATION: The medical residents and pulmonary fellows-in-training showed differences inknowledge, attitudes and practices with regard to use of sedation and analgesia. To increase their knowledge and improve their practice, they should be given medical education and training in sedation and analgesia.