Telephone-supported computerised cognitive-behavioural therapy: REEACT-2 large-scale pragmatic randomised controlled trial

TY - JOUR

T1 - Telephone-supported computerised cognitive-behavioural therapy

T2 - REEACT-2 large-scale pragmatic randomised controlled trial

AU - Gilbody, Simon

AU - Brabyn, Sally

AU - Lovell, Karina

AU - Kessler, David

AU - Devlin, Thomas

AU - Smith, Lucy

AU - Araya, Ricardo

AU - Barkham, Michael

AU - Bower, Peter

AU - Cooper, Cindy

AU - Knowles, Sarah

AU - Littlewood, Elizabeth

AU - Richards, David A

AU - Tallon, Debbie

AU - White, David

AU - Worthy, Gillian

AU - REEACT collaborative

N1 - © The Royal College of Psychiatrists 2017. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details

PY - 2017/3/2

Y1 - 2017/3/2

N2 - BackgroundComputerised cognitive-behavioural therapy (cCBT) for depression has the potential to be efficient therapy but engagement is poor in primary care trials.AimsWe tested the benefits of adding telephone support to cCBT.MethodWe compared telephone-facilitated cCBT (MoodGYM) (n = 187) to minimally supported cCBT (MoodGYM) (n = 182) in a pragmatic randomised trial (trial registration: ISRCTN55310481). Outcomes were depression severity (Patient Health Questionnaire (PHQ)-9), anxiety (Generalized Anxiety Disorder Questionnaire (GAD)-7) and somatoform complaints (PHQ-15) at 4 and 12 months.ResultsUse of cCBT increased by a factor of between 1.5 and 2 with telephone facilitation. At 4 months PHQ-9 scores were 1.9 points lower (95% CI 0.5-3.3) for telephone-supported cCBT. At 12 months, the results were no longer statistically significant (0.9 PHQ-9 points, 95% CI -0.5 to 2.3). There was improvement in anxiety scores and for somatic complaints.ConclusionsTelephone facilitation of cCBT improves engagement and expedites depression improvement. The effect was small to moderate and comparable with other low-intensity psychological interventions.

AB - BackgroundComputerised cognitive-behavioural therapy (cCBT) for depression has the potential to be efficient therapy but engagement is poor in primary care trials.AimsWe tested the benefits of adding telephone support to cCBT.MethodWe compared telephone-facilitated cCBT (MoodGYM) (n = 187) to minimally supported cCBT (MoodGYM) (n = 182) in a pragmatic randomised trial (trial registration: ISRCTN55310481). Outcomes were depression severity (Patient Health Questionnaire (PHQ)-9), anxiety (Generalized Anxiety Disorder Questionnaire (GAD)-7) and somatoform complaints (PHQ-15) at 4 and 12 months.ResultsUse of cCBT increased by a factor of between 1.5 and 2 with telephone facilitation. At 4 months PHQ-9 scores were 1.9 points lower (95% CI 0.5-3.3) for telephone-supported cCBT. At 12 months, the results were no longer statistically significant (0.9 PHQ-9 points, 95% CI -0.5 to 2.3). There was improvement in anxiety scores and for somatic complaints.ConclusionsTelephone facilitation of cCBT improves engagement and expedites depression improvement. The effect was small to moderate and comparable with other low-intensity psychological interventions.

KW - Journal Article

KW - Anxiety Disorders/therapy

KW - Telephone

KW - Depressive Disorder/therapy

KW - Humans

KW - Male

KW - Treatment Outcome

KW - Therapy, Computer-Assisted/methods

KW - Medication Adherence

KW - Remote Consultation/methods

KW - Adult

KW - Female

KW - Cognitive Behavioral Therapy/methods

UR - http://www.scopus.com/inward/record.url?scp=85019937039&partnerID=8YFLogxK

U2 - 10.1192/bjp.bp.116.192435

DO - 10.1192/bjp.bp.116.192435

M3 - Article

C2 - 28254959

SN - 0007-1250

VL - 210

SP - 362

EP - 367

JO - The British journal of psychiatry : the journal of mental science

JF - The British journal of psychiatry : the journal of mental science

IS - 5

ER -