Improving Adherence and Clinical Outcomes in Self-Guided Internet Treatment for Anxiety and Depression: Randomised Controlled Trial |
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| Authors: | Nickolai Titov Blake F. Dear Luke Johnston Carolyn Lorian Judy Zou Bethany Wootton Jay Spence Peter M. McEvoy Ronald M. Rapee |
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| Affiliation: | 1. Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.; 2. Specialist Clinical Psychologist, Centre for Clinical Interventions and School of Psychology, University of Western Australia, Perth, Australia.; Linkoping University, Sweden, |
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| Abstract: | BackgroundDepression and anxiety are common, disabling and chronic. Self-guided internet-delivered treatments are popular, but few people complete them. New strategies are required to realise their potential.AimsTo evaluate the effect of automated emails on the effectiveness, safety, and acceptability of a new automated transdiagnostic self-guided internet-delivered treatment, the Wellbeing Course, for people with depression and anxiety.MethodA randomised controlled trial was conducted through the website: www.ecentreclinic.org. Two hundred and fifty seven people with elevated symptoms were randomly allocated to the 8 week course either with or without automated emails, or to a waitlist control group. Primary outcome measures were the Patient Health Questionnaire 9-Item (PHQ-9) and the Generalized Anxiety Disorder 7-Item (GAD-7).ResultsParticipants in the treatment groups had lower PHQ-9 and GAD-7 scores at post-treatment than controls. Automated emails increased rates of course completion (58% vs. 35%), and improved outcomes in a subsample with elevated symptoms.ConclusionsThe new self-guided course was beneficial, and automated emails facilitated outcomes. Further attention to strategies that facilitate adherence, learning, and safety will help realise the potential of self-guided interventions.Trial RegistrationAustralian and New Zealand Clinical Trials Registry ACTRN12610001058066 |
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