Improving Adherence and Clinical Outcomes in Self-Guided Internet Treatment for Anxiety and Depression

Randomised Controlled Trial

Nickolai Titov*, Blake F. Dear, Luke Johnston, Carolyn Lorian, Judy Zou, Bethany Wootton, Jay Spence, Peter M. McEvoy, Ronald M. Rapee

*Corresponding author for this work

Research output: Contribution to journalArticle

131 Citations (Scopus)
6 Downloads (Pure)

Abstract

Background:Depression 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.Aims:To 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.Method:A 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).Results:Participants 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.Conclusions:The 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 Registration: Australian and New Zealand Clinical Trials Registry ACTRN12610001058066.

Original languageEnglish
Article numbere62873
Pages (from-to)1-11
Number of pages11
JournalPLoS ONE
Volume8
Issue number7
DOIs
Publication statusPublished - 3 Jul 2013

Bibliographical note

Copyright the Author(s) 2013. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

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