Please select the eligibility criteria that correspond to the clinical trial below.
Title: Telephone-based Intervention for Patients With COPD and Their Caregivers
Brief Summary: This study is an NIH-funded clinical trial conducted at Duke University Medical Center and Ohio State University. The purpose of this study is to examine the effects of a telephone-based, care-giver assisted, coping skills training (CST) program in patients with Chronic Obstructive Pulmonary Disease (COPD) and their caregivers. This may help COPD patients and their caregivers to deal better with the stress of lung disease. This study will test 3 primary hypotheses: 1) That enhanced CST will be more effective in improving quality of life compared to a Usual Medical Care plus COPD education and symptom management control group; 2) That enhanced CST will be associated with better medical outcomes (i.e., greater survival and fewer COPD-related physician visits or hospitalizations) compared to Controls over a follow-up period of up to 4 years; and 3) That improvements in quality of life and survival will be mediated by increased functional capacity and better coping.

This proposed study builds upon our prior research by: a) adapting and refining our CST protocol, which was effective in improving psychosocial adjustment in patients awaiting lung transplantation, to a broader population of patients with COPD who are not immediate candidates for lung transplantation; b) enhancing our intervention to improve functional capacity, reduce somatic symptoms, and improve survival; c) examining the impact of CST on medical expenditures; and d) including caregivers in an enhanced CST intervention.


Options:
A: Inclusion Criteria:

* African-American
* Female
* Ages 25-44
* BMI between 25-34.9 kg/m2
* Patients with at least 1 visit in the previous 24 months to a participating Community Health Center

Exclusion Criteria:

* Not currently pregnant
* Not given birth within the past 12 months
* No history of myocardial infarction or stroke in last 2 years
B: Inclusion Criteria:

* 18 years of age or older
* have diagnosed but uncontrolled hypertension
* Most recent measurement and one other measurement of the 3 most recent blood pressure measurements in the past 2 years have a systolic pressure \>140mmHg or a diastolic pressure \>90mmHg. For patients with a diagnosis of diabetes or chronic kidney disease the blood pressure cut-offs will be systolic \>130 mm Hg or a diastolic pressure \> 80 mm Hg
* not on organizational "do not call" lists or deceased lists
* have been approved for invitation into the study by their physician
* do not have a life-threatening illness
* are not on more than 4 antihypertensive medications
* can use a telephone
* speak either English or Spanish

Exclusion Criteria:

* on organizational "Do Not Call" list or deceased list
* physician does not give permission for them to be included in the study
* younger than 18 years of age
* has a life-threatening illness
* currently takes more than 4 anti-hypertension medications
* does not have or cannot use a phone
* does not speak English or Spanish (languages available in IVR)
* does not want to participate
C: Inclusion Criteria:: 1) men and women aged \>40 years participating in supervised Phase II CR. The CR population tends to be older (mean age: 64.5+11.9, range 38-83 years, Preliminary Studies C.6.) and by including adults as young as 40 years, we expect to offer the program to the majority of Phase II CR patients. (2) scheduled to complete Phase II CR in the next 4 weeks, 3) able to read and speak English, 4) provide consent for medical chart review to extract disease and treatment variables, 5) able to walk unassisted. 6) We plan to include patients who participated in Phase II CR due to a diagnosis of coronary heart disease (e.g., post- MI, CABG, chronic angina pectoris) or chronic heart failure.

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Exclusion Criteria:1) Prior neurological brain disorder (e.g., Seizure Disorder, Traumatic Brain Injury. Patients with prior neurological disease, including large vessel stroke and Alzheimer's Disease will be excluded. 2) An arbitrary Mini-Mental Status Examination (MMSE) cutoff score of \>10 will be set to exclude patients whose scores suggest dementia or cognitive impairments that will interfere with ability to provide informed consent and complete research demands.

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D: Inclusion Criteria:

* male or female outpatients 21 years of age or older
* a diagnosis of COPD
* FEV1 25%-80% of predicted value
* FEV1/FVC \<70%
* capacity to give informed consent and follow study procedures

Exclusion Criteria:

* dementia
* psychotic features including delusions or hallucinations
* acute suicide or homicide risk
* other illness (e.g., cancer) that is likely to cause death within 3 years
* unstable angina
* congestive heart failure stage III - IV by NYHA classification
* active involvement in pulmonary rehabilitation or a formal exercise program

Answer: D