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

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. The aim of this study was to evaluate the effectiveness of an iCBT treatment to reduce self-reported symptoms of depres...

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Bibliographic Details
Published in:Journal of medical Internet research 2018-03, Vol.20 (3), p.e88-e88
Main Authors: Norlund, Fredrika, Wallin, Emma, Olsson, Erik Martin Gustaf, Wallert, John, Burell, Gunilla, von Essen, Louise, Held, Claes
Format: Article
Language:English
Subjects:
Anxiety
Behavior modification
Cardiovascular disease
Clinical trials
Cognitive behavioral therapy
Cognitive-behavioral factors
Communication
Feedback
Heart attacks
Homework
Hospitals
Internet
Medicin och hälsovetenskap
Mental depression
Multimedia
Myocardial infarction
Original Paper
Patient compliance
Patients
Prevention
Problem solving
Psychologists
Quality of life
Rehabilitation
Sleep
Text messaging
Therapists
Therapy
Values
Women
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Summary: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. The aim of this study was to evaluate the effectiveness of an iCBT treatment to reduce self-reported symptoms of depression and anxiety among patients with a recent MI. In total, 3928 patients were screened for eligibility in 25 Swedish hospitals. Of these, 239 patients (33.5%, 80/239 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 (TAU; 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 over the internet. 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. There was a reduction in HADS scores over time in the total study sample (mean delta=-5.1, P
ISSN:1438-8871
1439-4456
1438-8871
DOI:10.2196/jmir.9710