Secondary outcomes
SECONDARY
No statistically significant differences between the two trial arms were seen in HADS-A and HADS-D scores at 12 months nor in the other secondary outcomes, BDI II, BAI and SGRQ total and subscale scores, at either time-point, and the limits of the confidence intervals ruled out any clinically important differences (Treatment effect on smoking at 6 and 12Data are presented as n (%), unless otherwise stated.In the intervention arm, 122 participants (50%) were referred to pulmonary rehabilitation by their usual healthcare providers, 112 (46%) attended at least one pulmonary rehabilitation session and 73 (30%) completed the course. In the control arm, 88 participants (49%) were referred to pulmonary rehabilitation, 77 (43%) attended at least one session and 54 (30%) completed the course. The mean±Intervention participants received on average 4.8 intervention sessions each. Most (196 (81%)) received what we had anticipated might be the minimal clinically effective dose (two sessions) of a cognitive behavioural approach and 136 (56%) completed a course (six or more sessions) (The results of the health economic analyses are presented in detail in the Based on the imputed sample with adjustment for baseline covariates, TANDEM participants accumulated marginally fewer QALYs over the 12-month follow-up compared with the control participants (mean difference −0.010 QALYs, 95% CI −0.042–0.021 QALYs, equivalent to 3.7 fewer days spent in full health) (Combining the incremental cost and incremental QALYs between the intervention and control arms, the TANDEM intervention was more expensive and less effective. The incremental net health benefit of TANDEM at the GBP 20 000 cost-effectiveness threshold was negative (−0.0489 QALYs, 95% CI −0.0512– −0.0477 QALYs) with a low probability (0.037) that TANDEM was a cost-effective alternative to usual care (