Communication About Sexuality (COSY) Encourages Physical Activity in COPD: A Randomised Trial

Kaba Dalla Lana,1,2 Anja Frei,1 Thomas Radtke,1 Julia Braun,1 Milo A Puhan,1 Claudia Steurer-Stey1,2 1Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland; 2mediX Gruppenpraxis Zurich, Zurich, SwitzerlandCorrespondence: Claudia Steurer-Stey, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, Zurich, 8001, Switzerland, Tel +41 44 634 43 60, Email [email protected]: Communication about sexuality is neglected in chronic obstructive pulmonary disease (COPD). This study evaluated the effectiveness of the Communication about Sexuality intervention (COSY) on quality of life (QoL) and physical activity (PA) and its acceptability in people with COPD.Methods: People with COPD (GOLD I–IV) were recruited from pulmonary rehabilitation and primary care settings and randomly allocated (1:1 ratio) to the COSY intervention group (IG) or usual care control group (CG). The primary endpoint was change in QoL, assessed with the Control, Autonomy, Self-realization and Pleasure scale (CASP- 12) between baseline and 3 months. The implementation of the intervention was assessed by review of study documents and questionnaires and acceptability by an interview with IG participants at study end.Results: Thirty-six persons (28% of target sample size), median age 72 years, 44% female, were included and randomized (CG, n=19, IG, n=17). 33 completed the 3-month-follow-up (CG, n=17, IG, n=16). There was no difference in change between the two groups in CASP-12 (mean difference 0.02, 95% CI − 2.01 to 2.06). The COSY intervention increased self-efficacy and adherence for PA. All IG participants appreciated the communication about the topic and study participation. Most participants expressed their need for closeness, intimacy and tenderness.Conclusion: Communication about sexual wellbeing using the COSY instruments was well received by people with COPD and enable healthcare professionals to comfortably address an often-ignored topic. Recruitment challenges limited study power, but the findings offer strong justification for further research into this promising and needed holistic care approach.Plain Language Summary: Health care providers and people with chronic obstructive lung disease (COPD) often have trouble talking about intimacy and sex, even though it’s an important part of life and well-being. This study looked at a new approach called the (COmmunication about SexualitY) COSY intervention, which helps healthcare providers talk to patients with COPD about sexuality and emotional needs.What was done:People with COPD were split into two groups: one got usual care, and the other got the COSY intervention. We wanted to see if COSY improved quality of life and the motivation for regular physical activity. We also wanted to know if patients found COSY helpful and acceptable.Although the study did not show changes in quality of life after 3 months, people who took part in the COSY programme said these conversations were helpful and meaningful. Many wanted closeness and affection, and the topic of sexual well-being may help motivate them to stay physically active-something that’s very important in COPD care. The COSY approach helped open up important conversations about sexuality that are usually overlooked in COPD care. More research is needed, but this study shows that talking about sexual well-being is both welcomed by patients and useful for more holistic care.Keywords: COPD, quality of life, holistic care, physical activity, sexuality