E-health to manage distress in patients with an implantable cardioverter-defibrillator: Primary results of the WEBCARE trial
Habibovic,Mirela Denollet,J. Cuijpers,Pim Spek,Viola R. M. van den Broek,K.C. Warmerdam,Lisanne van der Voort,Pepijn H. Herrman,Jean-Paul Bouwels,Leon Valk,Suzanne S. D.
Habibovic,Mirela
Denollet,J.
Cuijpers,Pim
Spek,Viola R. M.
van den Broek,K.C.
Warmerdam,Lisanne
van der Voort,Pepijn H.
Herrman,Jean-Paul
Bouwels,Leon
Valk,Suzanne S. D.
Abstract
The Web-based distress management program for patients with an implantable cardioverter-defibrillator (ICD; WEBCARE) was developed to mitigate distress and enhance health-related quality of life in ICD patients. This study investigated the treatment effectiveness at 3-month follow-up for generic and disease-specific outcome measures. Methods: Consecutive patients implanted with a first-time ICD from six hospitals in the Netherlands were randomized to either the “WEBCARE” or the “usual care” group. Patients in the WEBCARE group received a 12-week fixed, six-lesson behavioral treatment based on the problem-solving principles of cognitive behavioral therapy. Results: Two hundred eighty-nine patients (85% response rate) were randomized. The prevalence of anxiety and depression ranged between 11% and 30% and 13% and 21%, respectively. No significant intervention effects were observed for anxiety (β = 0.35; p = .32), depression (β = −0.01; p = .98) or health-related quality of life (Mental Component Scale: β = 0.19; p = .86; Physical Component Scale: β = 0.58; p = .60) at 3 months, with effect sizes (Cohen d) being small (range, 0.06-0.13). There were also no significant group differences as measured with the disease-specific measures device acceptance (β = −0.37; p = .82), shock anxiety (β = 0.21; p = .70), and ICD-related concerns (β = −0.08; p = .90). No differences between treatment completers and noncompleters were observed on any of the measures. Conclusions: In this Web-based intervention trial, no significant intervention effects on anxiety, depression, health-related quality of life, device acceptance, shock anxiety, or ICD-related concerns were observed. A more patient tailored approach targeting the needs of different subsets of ICD patients may be warranted.
Description
Date
2014-10
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Volume Title
Publisher
Research Projects
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Keywords
implantable cardioverter-defibrillator, anxiety, depression, quality of life, Web-based behavioral treatment
Citation
Habibovic, M, Denollet, J, Cuijpers, P, Spek, V R M, van den Broek, K C, Warmerdam, L, van der Voort, P H, Herrman, J-P, Bouwels, L, Valk, S S D, Alings, M, Theuns, D A M J & Pedersen, S S 2014, 'E-health to manage distress in patients with an implantable cardioverter-defibrillator : Primary results of the WEBCARE trial', Psychosomatic Medicine, vol. 76, no. 8, pp. 593-602. https://doi.org/10.1097/PSY.0000000000000096