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

Background: 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.