Internet-Based Cognitive Behavioral Therapy for Patients With Chronic Somatic Conditions: A Meta-Analytic Review

Beugen, Sylvia van; Ferwerda, M.; Hoeve, D.; Rovers, Maroeska M.; Koulil, Saskia Spillekom‐van; Middendorp, Henriët van; Evers, Andrea W M

doi:10.2196/jmir.2777

Cited by 167 publications

(165 citation statements)

References 72 publications

(72 reference statements)

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“…The number of studies on ehealth interventions has grown rapidly in the last few years. Studies among patient or general populations have shown that e-health interventions enhance health and wellbeing, improve lifestyle and increase self-management for a broad range of diseases or risk factors (16)(17)(18)(19)(20)(21). In occupational health, however, articles on e-health interventions are relatively scarce.…”

Section: Introductionmentioning

confidence: 99%

Effect of an eHealth Intervention to Reduce Sickness Absence Frequency Among Employees With Frequent Sickness Absence: Randomized Controlled Trial (Preprint)

Notenbomer¹,

Roelen²,

Groothoff³

et al. 2018

Preprint

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Effect of an e-health intervention to reduce sickness absence frequency among employees with frequent sickness absence: a randomized-controlled trial Effect of an e-health intervention to reduce sickness absence frequency among employees with frequent sickness absence: a randomized-controlled trial. AbstractBackground: Frequent sickness absence (SA), i.e., ≥3 episodes of SA in one year, is a problem for employers and employees. A high percentage of employees who have had frequent SA in a prior year also have frequent SA in subsequent years: 39% in the first follow-up year and 61% within 4 years. Also, 19% have long-term SA in the first followup year and 50% within 4 years. We developed an e-health intervention, consisting of fully-automated feedback and advice, to use either as a stand-alone tool (EHI-only) or combined with consultation with an occupational physician (EHI-OP).Objective: To evaluate the effect of an e-health intervention, with or without additional OP consultation, to reduce SA frequency for employees with frequent SA, versus care as usual (CAU). Method:This study was a three-armed randomized controlled trial. Employees with frequent SA received invitational letters, which were distributed by their employers. The follow-up period was 12 months. The primary outcome measure was register-based SA 1 frequency. Secondary outcome measures were register-based total SA days and selfassessed burn out, engagement and work ability. In a process evaluation 3 months after baseline, we examined adherence to the intervention and additional actions such as GP and OP visit, communication with the manager, and lifestyle change.Results: A total of 79 participants were included in the analyses, 20 in the EHI-only group, 30 in the EHI-OP group and 29 in the care as usual group (CAU). We found no significant difference in SA frequency between the groups at 1-year follow-up. SA frequency decreased in the EHI-only group from 3 (IQR 3-4) to 1 episode (IQR 0.3-2.8), in the EHI-OP group from 4 episodes ( IQR 3-5) to 3 episodes (IQR 1-4) and in the CAU group from 3 episodes (IQR 3-4) to 2 episodes (IQR 1-3). For secondary outcomes we found no significant differences between the intervention groups and the control group.The process evaluation showed that only 3 participants from the EHI-OP group visited the OP upon invitation. Conclusion:Among employees with frequent SA we found the e-health intervention as a stand-alone tool to have no effect in reducing SA frequency. We also found no effect on the secondary outcome measures (total SA days, burn out, engagement and work ability).This may be due to low adherence to the intervention because of insufficient urgency to act. We cannot draw any conclusion on the effect of blended care (EHI-OP), i.e. the EHItool combined with an OP consultation, due to very low adherence to the OP consultation. An OP consultation could increase a sense of urgency and lead to more focus and appropriate support. Recent meta-analyses showed that blended care is often more effective than stand-alone e...

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Section: Introductionmentioning

confidence: 99%

Effect of an eHealth Intervention to Reduce Sickness Absence Frequency Among Employees With Frequent Sickness Absence: Randomized Controlled Trial (Preprint)

Notenbomer¹,

Roelen²,

Groothoff³

et al. 2018

Preprint

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“…Previous findings suggest iCBT as an effective treatment for comorbid symptoms of depression and anxiety in patients with somatic conditions [13] and effective psychological interventions for emotional distress related to coronary heart disease are characterized by CBT techniques [9]. Given this, the lack of effect of the iCBT intervention found in the present study may have several explanations.…”

Section: Discussionmentioning

confidence: 55%

“…To improve access to effective support, increased engagement in e-health solutions within the cardiac community has been called upon [10], with internet-based CBT (iCBT) representing an e-health solution that may improve access to acceptable, effective and cost-effective psychological treatment [11] iCBT has been found to reduce symptoms of depression and anxiety among adults with common mental health difficulties [12]. In addition, evidence suggests guided iCBT may improve disease-related functioning and reduce psychological distress in patients with chronic somatic conditions [13]. Furthermore, preliminary evidence suggests iCBT may reduce symptoms of depression and anxiety for adults with high cardiovascular risk [14].…”

Section: Introduction Backgroundmentioning

confidence: 99%

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 (Preprint)

Norlund¹,

Wallin²,

Olsson³

et al. 2017

Preprint

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Background: Symptoms of depression and anxiety are common after a myocardial infarction (MI). Internet-based cognitive behavioral therapy (iCBT) has shown good results in other patient groups. Objective: The aim was to evaluate the effectiveness of an iCBT treatment to reduce selfreported symptoms of depression and anxiety among patients with a recent MI. Methods: In total, 3928 patients were screened for eligibility in 25 Swedish hospitals. Of these, 239 patients (33% women, mean age 60 years) with a recent MI and symptoms of depression or anxiety were randomly allocated to a therapist-guided, 14 week iCBT treatment (n=117), or treatment as usual (n=122). The iCBT treatment was designed for post MI patients. The primary outcome was the total score of the Hospital Anxiety and Depression Scale (HADS) 14 weeks post baseline, assessed online. Treatment effect was evaluated according to the intention-to-treat principle, with multiple imputations. For the main analysis, a pooled treatment effect was estimated, controlling for age, sex, and baseline HADS. Results: There was a reduction in HADS scores over time in the total study sample (mean = -5.1, Δ P < .001) but no difference between the study groups at follow-up ( β = -0.47 [95% confidence interval, -1.95 to 1.00], P = .53). Treatment adherence was low. 46% of the iCBT group did not complete the introductory module. Conclusions: iCBT treatment for an MI population did not result in lower levels of symptoms of depression or anxiety compared to treatment as usual. Low treatment adherence might have influenced the result.

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“…eHealth has several important advantages, such as a greater reach of care and better access to care, less time consumption and travel costs for the patient and a great flexibility for therapist and patient. There are indications that eHealth interventions can be as effective as face to face treatments for various physical ailments [56]. Additionally, psychological interventions focused on mindfulness and acceptance, which are increasingly used in treating chronic conditions, offer promising possibilities for the psychological treatment of skin conditions [52].…”

Section: A U T H O R ' S C O P Y N O T F O R S a L E O R D I S T R I mentioning

confidence: 99%

Psychological Treatments for Dermatological Conditions

2016

Skin and Psyche

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Abstract:The impact of dermatological conditions on a patient's life is frequently underestimated. Patients with skin conditions experience several physical complaints, including itch, pain and fatigue. Furthermore, in comparison to the general population, patients report a decreased psychological well-being, lowered quality of life and feelings of stigmatization and shame. Psychological treatments are widely used in addition to regular dermatological treatments to improve physical and psychological functioning of patients with chronic skin conditions. These treatments are usually aimed at changing the psychosocial factors that can influence the onset and/or course of skin conditions, such as dysfunctional coping behaviors, itch-scratching problems and stress. There are unimodal interventions in which single treatments are used, for example psychoeducation or relaxation exercises, and multimodal treatments in which a variety of different interventions are applied based on cognitive-behavioral therapy and self-management principles. Furthermore, a distinction can be made between interventions that focus primarily on skin-related psychosocial problems, interventions that focus on itch-scratching problems, and interventions that are focused on psychiatric problems in the dermatological practice. This chapter gives an overview on the psychosocial factors relevant for dermatological conditions, relevant diagnostic methods and the content and scientific evidence of specific psychological treatments in these different categories.

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Internet-Based Cognitive Behavioral Therapy for Patients With Chronic Somatic Conditions: A Meta-Analytic Review

Cited by 167 publications

References 72 publications

Effect of an eHealth Intervention to Reduce Sickness Absence Frequency Among Employees With Frequent Sickness Absence: Randomized Controlled Trial (Preprint)

Effect of an eHealth Intervention to Reduce Sickness Absence Frequency Among Employees With Frequent Sickness Absence: Randomized Controlled Trial (Preprint)

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 (Preprint)

Psychological Treatments for Dermatological Conditions

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