Internet-Based Cognitive Behavioral Therapy for Symptoms of Depression and Anxiety Among Patients With a Recent Myocardial Infarction: The U-CARE Heart Randomized Controlled Trial
Source: Norlund et al. 2018 - Pubmed ID: 29519777
Setting: Sweden, 25 hospitals
Study design:
RCT
Follow up: 14 weeks
Patient group:
Sample size:
Total: 239
IG: 117
CG: 122
Inclusion criteria:
- <75 years of age
- Myocardial infarction (MI) <3 months
- >7 on one or both of the 2 Hospital anxiety and depression subscales (HADS)
Type of technology:
Webpage
- Monitoring
- Feed-back
- Self-monitoring
- Education:
– Psychoeducation
– Participants chat
Video consultation
- Skills training
- Engagement in exercises
Intervention:
Intervention: Internet-based cognitive behavioral therapy iCBT to reduce the symptoms of depression and anxiety : The U-CARE Heart. Therapist guided 10 modules with different themes. 2 to 4 treatment steps, and 1 to 2 homework assignments (1 step per week). Therapist responses within 48 hours. Reminders for inactive patients
Duration: 14 weeks
Add on: NA
Control group: Usual care
Clinical effect:
- HADS-T→
- Depression MADRS-S→
- Self-reported symptoms of depression (BADS-SF)→
- Cardiac anxiety (CAQ)→
Patient safety:
- Two patients in the iCBT group and 3 patients in the control group reported severe depression (MADRS-S>34) or suicidal ideation (MADRS-S item 9 >3)
Patient experiences/
Staff experiences:
Patient experience:
- Treatment adherence was low
Staff experience: NA
Investment:
Equipment
- Web portal
Running:
Equipment
- Web portal
Staff
- Monitoring
- Guidance
- Technical support
Organization: NA
Health care utilization: NA