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

N. Titov, B.F. Dear, L. Johnston, C. Lorian, J. Zou, B. Wootton, J. Spence, Peter Mcevoy, R.M. Rapee

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123 Citations (Scopus)

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. © 2013 Titov et al.
Original languageEnglish
Pages (from-to)11pp
JournalPLoS One
Volume8
Issue number7
DOIs
Publication statusPublished - 2013

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    Titov, N., Dear, B. F., Johnston, L., Lorian, C., Zou, J., Wootton, B., Spence, J., Mcevoy, P., & Rapee, R. M. (2013). Improving Adherence and Clinical Outcomes in Self-Guided Internet Treatment for Anxiety and Depression: Randomised Controlled Trial. PLoS One, 8(7), 11pp. https://doi.org/10.1371/journal.pone.0062873