Adherence as a determinant of effectiveness of internet cognitive behavioural therapy for anxiety and depressive disorders
Since 2009, the Clinical Research Unit for Anxiety and Depression (CRUfAD) has been providing primary care clinicians with internet cognitive behaviour therapy (iCBT) courses to prescribe to patients. Although these courses have demonstrated efficacy in research trials, adherence in primary care is...
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| Veröffentlicht in: | Behaviour research and therapy 2012-08, Vol.50 (7-8), p.463-468 |
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| creator | Hilvert-Bruce, Zita Rossouw, Pieter J. Wong, Nora Sunderland, Matthew Andrews, Gavin |
| description | Since 2009, the Clinical Research Unit for Anxiety and Depression (CRUfAD) has been providing primary care clinicians with internet cognitive behaviour therapy (iCBT) courses to prescribe to patients. Although these courses have demonstrated efficacy in research trials, adherence in primary care is less than half that of the research trials. The present studies pose three questions: first, do course non-completers drop out because of lack of efficacy? Second, can changes in delivery (e.g. adding choice, reminders and financial cost) improve adherence? Last, does clinician contact improve adherence? The results showed that non-completers derive benefit before dropping out; that adding reminders, choice of course and timing, and financial cost can significantly improve adherence; and that clinician contact during the course is associated with increased adherence. It is concluded that improved adherence is an important determinant of effectiveness.
► Non-completers of internet CBT courses still benefit from partial completion. ► Adding choice, cost, and reminders increases adherence. ► Clinician contact during the course is associated with increased adherence. |
| doi_str_mv | 10.1016/j.brat.2012.04.001 |
| format | Article |
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► Non-completers of internet CBT courses still benefit from partial completion. ► Adding choice, cost, and reminders increases adherence. ► Clinician contact during the course is associated with increased adherence.</description><subject>Adherence</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Anxiety</subject><subject>Anxiety Disorders - therapy</subject><subject>Anxiety-Depression</subject><subject>Behavior modification</subject><subject>Behavior therapy. Cognitive therapy</subject><subject>Biological and medical sciences</subject><subject>Clinical trials</subject><subject>Cognitive ability</subject><subject>Cognitive behaviour therapy</subject><subject>Cognitive therapy</subject><subject>Cognitive Therapy - education</subject><subject>Cognitive Therapy - methods</subject><subject>Depression</subject><subject>Depressive Disorder - therapy</subject><subject>Effectiveness</subject><subject>Female</subject><subject>Humans</subject><subject>Internet</subject><subject>Internet cognitive behaviour therapy (iCBT)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mood disorders</subject><subject>Motivation</subject><subject>Patient Compliance</subject><subject>Physician-Patient Relations</subject><subject>Primary care</subject><subject>Primary health care</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Reminder</subject><subject>Reminders</subject><subject>Treatment Outcome</subject><subject>Treatments</subject><issn>0005-7967</issn><issn>1873-622X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkk2LFDEQhoMo7rj6BzxIQAQv3SbVnY8GL8viFyx4UfAW0knFzTCTHpOewfHXm3ZGBQ_qKST11EuSpwh5zFnLGZcv1u2Y7dwC49CyvmWM3yErrlXXSIBPd8mKMSYaNUh1QR6Usq7bTgO7Ty4ApBi4ECvy7crfYsbkkNpCLfU4Y97GZNNMp0AxBHRzPGDCUpaDmGo94Uzd9DnFpUJHvLWHOO2z3dC5htndkYYpU5u-RpyPdfU1dpdrwoL7WKbsMZeH5F6wm4KPzusl-fj61Yfrt83N-zfvrq9uGtdrNjcwcqmsdoNSvJeiG3AUymuhwUs_BAWdcH7ggQkduMLec2QSegvKd2Cl7y7J81PuLk9f9lhms43F4WZjE077YjgHAbrTgv8bZV2vudZ6-A8UOEgGg6zo0z_Qdf2tVN_8g1IgdM8qBSfK5amUjMHsctzafKyQWXybtVl8m8W3Yb2pvmvTk3P0ftyi_9XyU3AFnp0BW5zdhGyTi-U3J5kaeqUq9_LEYTVxiJhNcXEZCx9znQDjp_i3e3wHcVbIkw</recordid><startdate>20120801</startdate><enddate>20120801</enddate><creator>Hilvert-Bruce, Zita</creator><creator>Rossouw, Pieter J.</creator><creator>Wong, Nora</creator><creator>Sunderland, Matthew</creator><creator>Andrews, Gavin</creator><general>Elsevier Ltd</general><general>Elsevier</general><general>Elsevier Science Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>20120801</creationdate><title>Adherence as a determinant of effectiveness of internet cognitive behavioural therapy for anxiety and depressive disorders</title><author>Hilvert-Bruce, Zita ; Rossouw, Pieter J. ; Wong, Nora ; Sunderland, Matthew ; Andrews, Gavin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c480t-2b167a8c977146539eb57d8582d6d9f7235cd91f058f17e4d1e0624a27d32a6d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adherence</topic><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Anxiety</topic><topic>Anxiety Disorders - therapy</topic><topic>Anxiety-Depression</topic><topic>Behavior modification</topic><topic>Behavior therapy. Cognitive therapy</topic><topic>Biological and medical sciences</topic><topic>Clinical trials</topic><topic>Cognitive ability</topic><topic>Cognitive behaviour therapy</topic><topic>Cognitive therapy</topic><topic>Cognitive Therapy - education</topic><topic>Cognitive Therapy - methods</topic><topic>Depression</topic><topic>Depressive Disorder - therapy</topic><topic>Effectiveness</topic><topic>Female</topic><topic>Humans</topic><topic>Internet</topic><topic>Internet cognitive behaviour therapy (iCBT)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mood disorders</topic><topic>Motivation</topic><topic>Patient Compliance</topic><topic>Physician-Patient Relations</topic><topic>Primary care</topic><topic>Primary health care</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Reminder</topic><topic>Reminders</topic><topic>Treatment Outcome</topic><topic>Treatments</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hilvert-Bruce, Zita</creatorcontrib><creatorcontrib>Rossouw, Pieter J.</creatorcontrib><creatorcontrib>Wong, Nora</creatorcontrib><creatorcontrib>Sunderland, Matthew</creatorcontrib><creatorcontrib>Andrews, Gavin</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Behaviour research and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hilvert-Bruce, Zita</au><au>Rossouw, Pieter J.</au><au>Wong, Nora</au><au>Sunderland, Matthew</au><au>Andrews, Gavin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adherence as a determinant of effectiveness of internet cognitive behavioural therapy for anxiety and depressive disorders</atitle><jtitle>Behaviour research and therapy</jtitle><addtitle>Behav Res Ther</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>50</volume><issue>7-8</issue><spage>463</spage><epage>468</epage><pages>463-468</pages><issn>0005-7967</issn><eissn>1873-622X</eissn><coden>BRTHAA</coden><abstract>Since 2009, the Clinical Research Unit for Anxiety and Depression (CRUfAD) has been providing primary care clinicians with internet cognitive behaviour therapy (iCBT) courses to prescribe to patients. Although these courses have demonstrated efficacy in research trials, adherence in primary care is less than half that of the research trials. The present studies pose three questions: first, do course non-completers drop out because of lack of efficacy? Second, can changes in delivery (e.g. adding choice, reminders and financial cost) improve adherence? Last, does clinician contact improve adherence? The results showed that non-completers derive benefit before dropping out; that adding reminders, choice of course and timing, and financial cost can significantly improve adherence; and that clinician contact during the course is associated with increased adherence. It is concluded that improved adherence is an important determinant of effectiveness.
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| subjects | Adherence Adult Adult and adolescent clinical studies Anxiety Anxiety Disorders - therapy Anxiety-Depression Behavior modification Behavior therapy. Cognitive therapy Biological and medical sciences Clinical trials Cognitive ability Cognitive behaviour therapy Cognitive therapy Cognitive Therapy - education Cognitive Therapy - methods Depression Depressive Disorder - therapy Effectiveness Female Humans Internet Internet cognitive behaviour therapy (iCBT) Male Medical sciences Middle Aged Mood disorders Motivation Patient Compliance Physician-Patient Relations Primary care Primary health care Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Reminder Reminders Treatment Outcome Treatments |
| title | Adherence as a determinant of effectiveness of internet cognitive behavioural therapy for anxiety and depressive disorders |
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