Attitudes, confidence, barriers and current practice of managing depression in patients with COPD in Saudi Arabia: a national cross-sectional survey

Objective: To investigate physicians' perceptions and current practices of identifying and managing depression in patients with chronic obstructive pulmonary disease (COPD).

Design: A cross-sectional online survey was employed between March and September 2022.

Settings: Saudi Arabia.

Participants: 1015 physicians, including general practitioners and family, internal and pulmonary medicine specialists.

Primary outcome measures: Physicians' perceptions, confidence, practices and barriers to recognising and managing depression in patients with COPD.

Results: A total of 1015 physicians completed to the online survey. Only 31% of study participants received adequate training for managing depression. While 60% of physicians reported that depression interferes with self-management and worsens COPD symptoms, less than 50% viewed the importance of regular screening for depression. Only 414 (41%) physicians aim to identify depression. Of whom, 29% use depression screening tools, and 38% feel confident in discussing patients' feelings. Having adequate training to manage depression (OR: 2.89; 95% CI: 2.02 to 3.81; p<0.001) and more years of experience (OR: 1.25; 95% CI: 1.08 to 1.45; p=0.002) were associated with the intention to detect depression in COPD patients. The most common barriers linked to recognising depression are poor training (54%), absence of standard procedures (54%) and limited knowledge about depression (53%).

Conclusion: The prevalence of identifying and confidently managing depression in patients with COPD is suboptimal, owing to poor training, the absence of a standardised protocol and inadequate knowledge. Psychiatric training should be supported in addition to adopting a systematic approach to detect depression in clinical practice.