Tailored online cognitive behavioural therapy with or without therapist support calls to target psychological distress in adults receiving haemodialysis: A feasibility randomised controlled trial

Joanna L Hudson, Rona Moss-Morris, Sam Norton, Federica Picariello, David Game, Amy Carroll, Jonathan Spencer, Paul McCrone, Matthew Hotopf, Lucy Yardley, Joseph Chilcot

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

BACKGROUND: Psychological distress is prevalent in haemodialysis (HD) patients yet access to psychotherapy remains limited. This study assessed the feasibility and acceptability of online cognitive-behavioural therapy (CBT) tailored for HD patients, with or without therapist support, for managing psychological distress.

METHODS: This feasibility randomised controlled trial recruited patients from a UK HD centre. Following psychological distress screens, patients with mild-moderate psychological distress (Patient Health Questionnaire PHQ-9; score: 5-19 and/or Generalised Anxiety Disorder; GAD-7 score: 5-14) who met remaining inclusion criteria were approached for consent. Consenters were individually randomised (1:1) to online-CBT or online-CBT plus three therapist support calls. Outcomes included recruitment, retention, and adherence rates. Exploratory change analyses were performed for: psychological distress, quality of life (QoL), illness perceptions, and costs. The statistician was blinded to allocation.

RESULTS: 182 (44%) out of 410 patients approached completed psychological distress screens. 26% found screening unacceptable; a further 30% found it unfeasible. Psychological distress was detected in 101 (55%) patients, 60 of these met remaining inclusion criteria. The primary reason for ineligibility was poor computer literacy (N=17, 53%). Twenty-five patients were randomised to the supported (N=18) or unsupported arm (N=7); 92% were retained at follow-up. No differences in psychological distress or cost-effectiveness were observed. No trial adverse events occurred.

CONCLUSION: Online CBT appears feasible but only for computer literate patients who identify with the label psychological distress. A definitive trial using the current methods for psychological distress screening and online care delivery is unfeasible. ClinicalTrials.gov Identifier: NCT02352870.

Original languageEnglish
Pages (from-to)61-70
Number of pages10
JournalJournal of Psychosomatic Research
Volume102
DOIs
Publication statusPublished - 1 Nov 2017

Keywords

  • Cognitive Therapy/methods
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life/psychology
  • Renal Dialysis/methods
  • Stress, Psychological/therapy
  • Surveys and Questionnaires

Fingerprint Dive into the research topics of 'Tailored online cognitive behavioural therapy with or without therapist support calls to target psychological distress in adults receiving haemodialysis: A feasibility randomised controlled trial'. Together they form a unique fingerprint.

Cite this