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Improving Adherence and Clinical Outcomes in Self-Guided Internet Treatment for Anxiety and Depression: Randomised Controlled Trial

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Listed:
  • Nickolai Titov
  • Blake F Dear
  • Luke Johnston
  • Carolyn Lorian
  • Judy Zou
  • Bethany Wootton
  • Jay Spence
  • Peter M McEvoy
  • Ronald M Rapee

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

Suggested Citation

  • Nickolai Titov & Blake F Dear & Luke Johnston & Carolyn Lorian & Judy Zou & Bethany Wootton & Jay Spence & Peter M McEvoy & Ronald M Rapee, 2013. "Improving Adherence and Clinical Outcomes in Self-Guided Internet Treatment for Anxiety and Depression: Randomised Controlled Trial," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-11, July.
    • Handle: RePEc:plo:pone00:0062873
    DOI: 10.1371/journal.pone.0062873
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    References listed on IDEAS

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    1. Nickolai Titov & Gavin Andrews & Matthew Davies & Karen McIntyre & Emma Robinson & Karen Solley, 2010. "Internet Treatment for Depression: A Randomized Controlled Trial Comparing Clinician vs. Technician Assistance," PLOS ONE, Public Library of Science, vol. 5(6), pages 1-9, June.
    2. Emma Robinson & Nickolai Titov & Gavin Andrews & Karen McIntyre & Genevieve Schwencke & Karen Solley, 2010. "Internet Treatment for Generalized Anxiety Disorder: A Randomized Controlled Trial Comparing Clinician vs. Technician Assistance," PLOS ONE, Public Library of Science, vol. 5(6), pages 1-9, June.
    3. Gavin Andrews & Pim Cuijpers & Michelle G Craske & Peter McEvoy & Nickolai Titov, 2010. "Computer Therapy for the Anxiety and Depressive Disorders Is Effective, Acceptable and Practical Health Care: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 5(10), pages 1-6, October.
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    1. Nickolai Titov & Blake F Dear & Luke Johnston & Peter M McEvoy & Bethany Wootton & Matthew D Terides & Milena Gandy & Vincent Fogliati & Rony Kayrouz & Ronald M Rapee, 2014. "Improving Adherence and Clinical Outcomes in Self-Guided Internet Treatment for Anxiety and Depression: A 12-Month Follow-Up of a Randomised Controlled Trial," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-8, February.

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