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Tailored online cognitive behavioural therapy with or without therapist support calls to target psychological distress in adults receiving haemodialysis: a feasibility randomised controlled trial

Tailored online cognitive behavioural therapy with or without therapist support calls to target psychological distress in adults receiving haemodialysis: a feasibility randomised controlled trial
Tailored online cognitive behavioural therapy with or without therapist support calls to target psychological distress in adults receiving haemodialysis: a feasibility randomised controlled trial
Background:

Psychological distress is prevalent in haemodialysis (HD) patients yet access to psychotherapy remains limited. This study assessed the feasibility and acceptability of online cognitive-behavioural therapy (CBT) tailored for HD patients, with or without therapist support, for managing psychological distress.

Methods:

This feasibility randomised controlled trial recruited patients from a UK HD centre. Following psychological distress screens, patients with mild-moderate psychological distress (Patient Health Questionnaire PHQ-9; score: 5–19 and/or Generalised Anxiety Disorder; GAD-7 score: 5–14) who met remaining inclusion criteria were approached for consent. Consenters were individually randomised (1:1) to online-CBT or online-CBT plus three therapist support calls. Outcomes included recruitment, retention, and adherence rates. Exploratory change analyses were performed for: psychological distress, quality of life (QoL), illness perceptions, and costs. The statistician was blinded to allocation.

Results:

182 (44%) out of 410 patients approached completed psychological distress screens. 26% found screening unacceptable; a further 30% found it unfeasible. Psychological distress was detected in 101 (55%) patients, 60 of these met remaining inclusion criteria. The primary reason for ineligibility was poor computer literacy (N = 17, 53%). Twenty-five patients were randomised to the supported (N = 18) or unsupported arm (N = 7); 92% were retained at follow-up. No differences in psychological distress or cost-effectiveness were observed. No trial adverse events occurred.

Conclusion:

Online CBT appears feasible but only for computer literate patients who identify with the label psychological distress. A definitive trial using the current methods for psychological distress screening and online care delivery is unfeasible.

ClinicalTrials.gov Identifier: NCT02352870
0022-3999
61-70
Hudson, Joanna
383f9969-e883-4765-b1f7-674fca78540f
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Norton, Sam
e6b46b72-037d-4225-a71f-119973d37a23
Picariello, Federica
1035c544-75f7-41e8-97f0-08bedb7d950c
Game, David
d4b16998-4492-4c6a-b4c0-2508003e18b4
Carroll, Amy
5a423f09-b5c9-49e8-8b6f-2c7467d0729c
Spencer, Jonathan
85119fbc-50d9-4569-b5d1-b6f48381be00
McCrone, Paul
ce0c78b3-8fba-43ff-b305-e331c00cb9f9
Hotopf, Matthew
5a23f5d8-579f-4386-ae4b-07bfebe1b5fa
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Chilcot, Joseph
8629be02-350f-4ad4-afaf-11879b2c38a2
Hudson, Joanna
383f9969-e883-4765-b1f7-674fca78540f
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e
Norton, Sam
e6b46b72-037d-4225-a71f-119973d37a23
Picariello, Federica
1035c544-75f7-41e8-97f0-08bedb7d950c
Game, David
d4b16998-4492-4c6a-b4c0-2508003e18b4
Carroll, Amy
5a423f09-b5c9-49e8-8b6f-2c7467d0729c
Spencer, Jonathan
85119fbc-50d9-4569-b5d1-b6f48381be00
McCrone, Paul
ce0c78b3-8fba-43ff-b305-e331c00cb9f9
Hotopf, Matthew
5a23f5d8-579f-4386-ae4b-07bfebe1b5fa
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Chilcot, Joseph
8629be02-350f-4ad4-afaf-11879b2c38a2

Hudson, Joanna, Moss-Morris, Rona, Norton, Sam, Picariello, Federica, Game, David, Carroll, Amy, Spencer, Jonathan, McCrone, Paul, Hotopf, Matthew, Yardley, Lucy and Chilcot, Joseph (2017) Tailored online cognitive behavioural therapy with or without therapist support calls to target psychological distress in adults receiving haemodialysis: a feasibility randomised controlled trial. Journal of Psychosomatic Research, 102, 61-70. (doi:10.1016/j.jpsychores.2017.09.009).

Record type: Article

Abstract

Background:

Psychological distress is prevalent in haemodialysis (HD) patients yet access to psychotherapy remains limited. This study assessed the feasibility and acceptability of online cognitive-behavioural therapy (CBT) tailored for HD patients, with or without therapist support, for managing psychological distress.

Methods:

This feasibility randomised controlled trial recruited patients from a UK HD centre. Following psychological distress screens, patients with mild-moderate psychological distress (Patient Health Questionnaire PHQ-9; score: 5–19 and/or Generalised Anxiety Disorder; GAD-7 score: 5–14) who met remaining inclusion criteria were approached for consent. Consenters were individually randomised (1:1) to online-CBT or online-CBT plus three therapist support calls. Outcomes included recruitment, retention, and adherence rates. Exploratory change analyses were performed for: psychological distress, quality of life (QoL), illness perceptions, and costs. The statistician was blinded to allocation.

Results:

182 (44%) out of 410 patients approached completed psychological distress screens. 26% found screening unacceptable; a further 30% found it unfeasible. Psychological distress was detected in 101 (55%) patients, 60 of these met remaining inclusion criteria. The primary reason for ineligibility was poor computer literacy (N = 17, 53%). Twenty-five patients were randomised to the supported (N = 18) or unsupported arm (N = 7); 92% were retained at follow-up. No differences in psychological distress or cost-effectiveness were observed. No trial adverse events occurred.

Conclusion:

Online CBT appears feasible but only for computer literate patients who identify with the label psychological distress. A definitive trial using the current methods for psychological distress screening and online care delivery is unfeasible.

ClinicalTrials.gov Identifier: NCT02352870

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More information

Accepted/In Press date: 15 September 2017
e-pub ahead of print date: 21 September 2017
Published date: November 2017

Identifiers

Local EPrints ID: 414395
URI: https://eprints.soton.ac.uk/id/eprint/414395
ISSN: 0022-3999
PURE UUID: 9f4c1f25-c844-4d59-a84e-4e00cd1d8614
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 28 Sep 2017 16:31
Last modified: 17 Sep 2019 04:39

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