Effectiveness of Text Messaging for the Management of Psychological and Somatic Distress in Depressed and Anxious Outpatients

Abstract

Background:Cognitive behavioral group therapy has developed several techniques in order to make the treatment of depressive and anxiety disorders more effective. Particularly, the “homework” is a tool in order to practice therapeutic skills in ecological settings. When working with this aim, it is often necessary to support patient compliance.Researches have shown the efficacy of sending a text to the patients in order to support the patient compliance, but only a few data are available on the effectiveness of sending text in the treatment of depression and anxiety.Objective:Verify the effectiveness of sending text in the treatment of depression and anxiety in order to support patient compliance.Methods:Participants were enrolled for cognitive behavioral group therapy. Once completed the treatment, a sub-group of participants (Yes SMS group) was reached by a weekly text message for the whole 3 months time between the end of the intervention and the scheduled follow-up session.All the participants were assessed for the overall psychopathological symptoms, depression, and anxiety before and after the group intervention, and at the 3 months follow up.Results:Both groups improved from pre to post-treatment in all the assessed dimensions; the enhancement endures up to the 3 months follow up.Comparing the two groups regardless of the diagnosis, the Yes SMS group shows significant better outcomes in depression at follow-up and in anxiety both at post-treatment and at follow-up.Conclusion:The weekly SMS as prompt seems to enhance the patient’s compliance.

Patient and economic benefits of psychological support for noncompliant patients

“…Self-referral to primary care has a nonattendance rate of 15% ( Parsons et al, 2021 ). Nonattendance rates at referrals into secondary and tertiary care depends on condition and treatment, and varies from 5 to 60% ( Binnie and Boden, 2016 ; Osborne et al, 2017a ; Shannon et al, 2018a ; Sheridan et al, 2019 ; Truzoli et al, 2019 ). Once an appointment has been kept and treatment suggested, nonadherence and/or nonconcordance rates can be high, irrespective of condition or treatment type, and varies from 30 to 75% ( Karasu et al, 2000 ; Partridge et al, 2002 ; Hauptman, 2008 ; Basra et al, 2012 ; Osborne et al, 2016 ; Truzoli et al, 2017 ; Yeowell et al, 2018 ; Shannon et al, 2018b ; Peddie et al, 2021 ).…”

“…A focus on different aspects of the psychological issues may be helpful in reducing noncompliance at specific pathway points ( Osborne et al, 2016 , 2017a , 2021 ; Shannon et al, 2018b ; Carty et al, 2019 ; Felsted and Supiano, 2019 ). One intervention was developed for telephone delivery, and was targeted motivation of patients on a PFMT waiting list ( Osborne et al, 2017a ; Truzoli et al, 2019 ). As depression and anxiety reduce behavioural activity and impair memory, a brief support call involving both a reminder of the appointment, and an explanation of the treatment and its possible benefits, was delivered.…”

“…The initial attendance for the control group was relatively low in this study, but it is in line with studies including many from disadvantaged groups ( Shannon et al, 2018a ). Other reports have demonstrated text messages can also help bolster treatment compliance for psychologically related somatic distress ( Truzoli et al, 2019 ).…”

“…Within these broad approaches, many specific techniques have been employed to tackle different aspects of the psychological and behavioural comorbidities. For example, coupled with enhancing memory through reminders ( Osborne et al, 2017a ; Truzoli et al, 2019 ), improving motivation to engage with treatment is likely to promote attendance. The positive effects of stronger motivation-to-change on treatments are well documented for many conditions ( Bean et al, 2018 ; Ankawi et al, 2019 ; Johansen et al, 2019 ; Reed et al, 2020b ).…”