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Internet-Based Cognitive Behavioural Therapy Programme Tailored to Patients with Cardiovascular Disease and Depression: A Randomised Controlled Trial

42 Pages Posted: 24 Jan 2019

See all articles by Peter Johansson

Peter Johansson

Linkoping University - Department of Social and Welfare Studies

Mats Westas

Linkoping University - Department of Social and Welfare Studies

Gerhard Andersson

Linkoping University - Department of Behavioural Sciences and Learning

Urban Alehagen

Linkoping University - Department of Medical and Health Sciences

Anders Broström

Jonkoping University - Department of Nursing Science

Tiny Jaarsma

Linkoping University - Department of Social and Welfare Studies

Ghassan Mourad

Linkoping University - Department of Social and Welfare Studies

Johan Lundgren

Linkoping University - Department of Social and Welfare Studies

More...

Abstract

Background: Depression is a common cause of poorer well-being and prognosis in patients with cardiovascular disease (CVD). Yet there is a lack of effective intervention strategies targeting depression. We therefore evaluated the effect of a nurse-delivered and tailored internet-based cognitive behavioural therapy (iCBT) programme aimed at reducing depression in patients with CVD.

Methods: A randomised controlled trial. Patients were recruited from medical or cardiology clinics at five hospitals in south-eastern Sweden. Patients were eligible if they were ≥18 years old, had CVD treatment, had not been hospitalised for CVD in the past four weeks, and had at least mild depressive symptoms. 144 patients were randomised 1.1 to nine-week iCBT (n=72) or an active control participating in an online discussion forum (ODF, n=72) with a block size of two. The primary outcome, depression, was measured by the Patient Health Questionnaire-9.

Outcomes: In total, 65 patients in the iCBT group and 62 patients in the ODF completed the outcome measure. Using intention to treat analysis, iCBT compared to ODF had a moderate treatment effect on depression (mean group difference -2·34 [95 % CI -3·58 to -1·10], p=0·0003, effect size d=0·62). No patients were discontinued from the study due to high risk of suicide or deterioration in depression.

Interpretation: Nurse-delivered iCBT can reduce depression in CVD patients enabling treatment for depression in their own homes and at their own preferences of time.

Trial Registration Number:The trial is registered at ClinicalTrials.gov, NCT02778074.

Funding Statement: This study received funding from the Swedish Research Council (2015-02600), ALF grants Region Östergötland (LIO-600321 and LIO-687531) and Region Östergötland, Strategic fund (LIO-719561).

Declaration of Interests: None of the authors declare any competing interest.

Ethics Approval Statement: The study was approved by the regional ethical review board in Linköping Sweden (no. 2016/72-31).

Suggested Citation

Johansson, Peter and Westas, Mats and Andersson, Gerhard and Alehagen, Urban and Broström, Anders and Jaarsma, Tiny and Mourad, Ghassan and Lundgren, Johan, Internet-Based Cognitive Behavioural Therapy Programme Tailored to Patients with Cardiovascular Disease and Depression: A Randomised Controlled Trial (January 16, 2019). Available at SSRN: https://ssrn.com/abstract=3320158

Peter Johansson (Contact Author)

Linkoping University - Department of Social and Welfare Studies ( email )

Överstegatan 30
Linköping, 58212
Sweden

Mats Westas

Linkoping University - Department of Social and Welfare Studies

Överstegatan 30
Linköping, 58212
Sweden

Gerhard Andersson

Linkoping University - Department of Behavioural Sciences and Learning ( email )

Linkoping
Sweden

Urban Alehagen

Linkoping University - Department of Medical and Health Sciences

Linkoping, 581 83
Sweden

Anders Broström

Jonkoping University - Department of Nursing Science

Barnarpsgatan 39
P.O. Box 1026, SE-551 11
Jonkoping
Sweden

Tiny Jaarsma

Linkoping University - Department of Social and Welfare Studies

Överstegatan 30
Linköping, 58212
Sweden

Ghassan Mourad

Linkoping University - Department of Social and Welfare Studies

Överstegatan 30
Linköping, 58212
Sweden

Johan Lundgren

Linkoping University - Department of Social and Welfare Studies

Överstegatan 30
Linköping, 58212
Sweden

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