Scheduled Telephone Support for Internet Cognitive Behavioral Therapy for Depression in Patients at Risk for Dropout : Pragmatic Randomized Controlled Trial

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Pihlaja , S , Lahti , J , Lipsanen , J O , Ritola , V , Gummerus , E-M , Stenberg , J-H & Joffe , G 2020 , ' Scheduled Telephone Support for Internet Cognitive Behavioral Therapy for Depression in Patients at Risk for Dropout : Pragmatic Randomized Controlled Trial ' , Journal of Medical Internet Research , vol. 22 , no. 7 , 15732 . https://doi.org/10.2196/15732

Title: Scheduled Telephone Support for Internet Cognitive Behavioral Therapy for Depression in Patients at Risk for Dropout : Pragmatic Randomized Controlled Trial
Author: Pihlaja, Satu; Lahti, Jari; Lipsanen, Jari Olavi; Ritola, Ville; Gummerus, Eero-Matti; Stenberg, Jan-Henry; Joffe, Grigori
Contributor organization: Department of Psychiatry
HUS Psychiatry
University of Helsinki
Helsinki University Hospital Area
Department of Psychology and Logopedics
Faculty of Medicine
Doctoral Programme in Cognition, Learning, Instruction and Communication
Teachers' Academy
Clinicum
Date: 2020-07-23
Language: eng
Number of pages: 12
Belongs to series: Journal of Medical Internet Research
ISSN: 1438-8871
DOI: https://doi.org/10.2196/15732
URI: http://hdl.handle.net/10138/320561
Abstract: Background: Therapist-supported, internet-delivered cognitive behavioral therapy (iCBT) is efficient in the treatment of depression. However, the optimal mode and intensity of therapist support remain to be identified. Scheduled telephone support (STS) may improve adherence and outcomes but, as it is time- and resource-consuming, should be reserved for patients for whom the usual support may be insufficient. Objective: This paper aims to reveal whether add-on STS for patients at risk of dropping out improves treatment adherence and symptoms in iCBT for depression. Methods: Among patients participating in an ongoing large observational routine clinical practice study of iCBT for depression delivered nationwide by Helsinki University Hospital (HUS-iCBT), those demonstrating a >= 14-day delay in initiation of treatment received invitations to this subsidiary STS study. A total of 100 consenting patients were randomly allocated to either HUS-iCBT as usual (control group, n=50) or HUS-iCBT plus add-on STS (intervention group, n=50). Proportions of those reaching midtreatment and treatment end point served as the primary outcome; secondary outcomes were change in Beck Depression Inventory (BDI)-measured depressive symptoms and time spent in treatment. Results: Add-on STS raised the proportion of patients reaching midtreatment compared with HUS-iCBT as usual (29/50, 58% vs 18/50, 36%; P=.045) and treatment end point (12/50, 24% vs 3/50, 6%; P=.02). Change in BDI score also favored add-on STS (3.63 points vs 1.1 points; P=.049), whereas duration of treatment did not differ. Conclusions: Add-on STS enhances adherence and symptom improvement of patients at risk of dropping out of iCBT for depression in routine clinical practice.
Subject: internet CBT
depression
scheduled telephone support
adherence
routine clinical practice
ANXIETY
DISORDERS
PSYCHOTHERAPY
PREFERENCES
ADHERENCE
SYMPTOMS
HELP
3141 Health care science
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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