Development of the TANDEM intervention for Chronic Obstructive Pulmonary Disease: reporting on the p
Background:Â The importance of detailing the development phase of complex behavioural interventions is increasingly recognized but typically underperformed.
Aim:Â To describe the development, including pre-pilot, of a tailored intervention for individuals with COPD and mild/moderate depression and/or anxiety, based on cognitive behavioural approaches and leading onto routine pulmonary rehabilitation.
Methods:Â The TANDEM intervention, informed by previous interventions for this population (The Lung Manual and SPACE), combines both psychological and self-management approaches for individuals with comorbid COPD and anxiety and/or depression. It was presented to 8 health care professionals (HCPs) and 7 patients through interviews or focus groups to elicit reactions to the intervention, and challenges to be considered. A pre-pilot study including training 3 respiratory nurses and delivery to 6 patients was conducted before revision of the intervention.
Results:Â All participants endorsed the TANDEM approach. Improvements to patient facing materials were made following feedback. The need to assess HCPsâ€™ interpersonal skills and competency using video feedback was identified during training. Trialing intervention delivery highlighted minimizing the period between intervention training and delivery, and the importance of supervision.
Conclusions:Â The pre-pilot study has enabled significant refinement of the TANDEM intervention prior to piloting. This may prove key to successful, cost-effective, implementation within the larger planned randomized controlled trial.