scholarly journals Patients’ experiences of a computerised self-help program for treating depression – a qualitative study of Internet mediated cognitive behavioural therapy in primary care

2017 ◽  
Vol 35 (1) ◽  
pp. 46-53 ◽  
Author(s):  
Anna Holst ◽  
Shabnam Nejati ◽  
Cecilia Björkelund ◽  
Maria C. M. Eriksson ◽  
Dominique Hange ◽  
...  
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Self Help ◽  
Cognitive Behavioural

scholarly journals Guided Self-Help Cognitive Behavioural Therapy for Depression in Primary Care: A Randomised Controlled Trial

PLoS ONE ◽  
2013 ◽  
Vol 8 (1) ◽  
pp. e52735 ◽  
Author(s):  
Christopher Williams ◽  
Philip Wilson ◽  
Jill Morrison ◽  
Alex McMahon ◽  
Walker Andrew ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Self Help ◽  
Cognitive Behavioural ◽  
Randomised Controlled

scholarly journals Implementing a hybrid cognitive-behavioural therapy for pain-related insomnia in primary care: lessons learnt from a mixed-methods feasibility study

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034764 ◽  
Author(s):  
Nicole K Y Tang ◽  
Corran Moore ◽  
Helen Parsons ◽  
Harbinder Kaur Sandhu ◽  
Shilpa Patel ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
The Self ◽  
Control Treatment ◽  
Outcomes Measures ◽  
Self Help ◽  
Cognitive Behavioural ◽  
To Receive

ObjectivesTo test the feasibility of implementing a brief but intensive hybrid cognitive behavioural therapy (Hybrid CBT) for pain-related insomnia.DesignMixed-methods, with qualitative process evaluation on a two-arm randomised controlled feasibility trial.SettingPrimary care.ParticipantsTwenty-five adult patients with chronic pain and insomnia.InterventionHybrid CBT or self-help control intervention.Primary and secondary outcome measuresPrimary outcomes measures were the Insomnia Severity Index and interference scale of the Brief Pain Inventory (BPI). Secondary outcomes measures were the present pain intensity rating from the BPI, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale and EQ-5D-5L.ResultsFourteen participants were randomised to receive Hybrid CBT, 11 to receive the self-help control treatment. Of the 14 in the Hybrid CBT group, 9 (64%) completed all four treatment sessions (4 discontinued due to poor health; 1 due to time constraints). Adherence to the self-help control treatment was not monitored. The total number of participants completing the 12-week and 24-week follow-ups were 12 (6 in each group; Hybrid CBT: 43%; self-help: 55%) and 10 (5 in each group; Hybrid CBT: 36%; self-help: 45%). Based on the data available, candidate outcome measures appeared to be sensitive to changes associated with interventions. Thematic analysis of pre-postintervention interview data revealed satisfaction with treatment content among those who completed the Hybrid CBT, whereas those in the self-help control treatment wanted more contact hours and therapist guidance. Other practical suggestions for improvement included shortening the duration of each treatment session, reducing the amount of assessment paperwork, and minimising the burden of sleep and pain monitoring.ConclusionImportant lessons were learnt with regard to the infrastructure required to achieve better patient adherence and retention. Based on the qualitative feedback provided by a subset of treatment completers, future trials should also consider lowering the intensity of treatment and streamlining the data collection procedure.Trial registration numberISRCTN17294365.

Cost-effectiveness of cognitive behavioural therapy, graded exercise and usual care for patients with chronic fatigue in primary care

2004 ◽  
Vol 34 (6) ◽  
pp. 991-999 ◽  
Author(s):  
P. McCRONE ◽  
L. RIDSDALE ◽  
L. DARBISHIRE ◽  
P. SEED
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Usual Care ◽  
Cognitive Behavioural Therapy ◽  
Chronic Fatigue ◽  
Behavioural Therapy ◽  
Self Help ◽  
Cognitive Behavioural ◽  
Graded Exercise ◽  
The Cost

Background. Chronic fatigue is a common condition, frequently presenting in primary care. The aim of this study was to compare the cost-effectiveness of cognitive behavioural therapy (CBT) and graded exercise therapy (GET), and to compare therapy with usual care plus a self-help booklet (BUC).Method. Patients drawn from general practices in South East England were randomized to CBT or GET. The therapy groups were then compared to a group receiving BUC recruited after the randomized phase. The main outcome measure was clinically significant improvements in fatigue. Cost-effectiveness was assessed using the net-benefit approach and cost-effectiveness acceptability curves.Results. Costs were available for 132 patients, and cost-effectiveness results for 130. Costs were dominated by informal care. There were no significant outcome or cost differences between the therapy groups. The combined therapy group had significantly better outcomes than the standard care group, and costs that were on average £149 higher (a non-significant difference). Therapy would have an 81·9% chance of being cost-effective if society were willing to attach a value of around £500 to each four-point improvement in fatigue.Conclusion. The cost-effectiveness of cognitive behavioural therapy and graded exercise were similar unless higher values were placed on outcomes, in which case CBT showed improved cost-effectiveness. The cost of providing therapy is higher than usual GP care plus a self-help booklet, but the outcome is better. The strength of this evidence is limited by the use of a non-randomized comparison. The cost-effectiveness of therapy depends on how much society values reductions in fatigue.

scholarly journals Predictors of outcome in guided self-help cognitive behavioural therapy for common mental disorders in primary care

2019 ◽  
Vol 49 (6) ◽  
pp. 455-474
Author(s):  
Sigrid Salomonsson ◽  
Fredrik Santoft ◽  
Elin Lindsäter ◽  
Kersti Ejeby ◽  
Martin Ingvar ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Cognitive Behavioural Therapy ◽  
Common Mental Disorders ◽  
Behavioural Therapy ◽  
Predictors Of Outcome ◽  
Self Help ◽  
Cognitive Behavioural

scholarly journals Randomised controlled trial of cognitive behavioural therapy in COPD

2018 ◽  
Vol 4 (4) ◽  
pp. 00094-2018 ◽  
Author(s):  
Karen Heslop-Marshall ◽  
Christine Baker ◽  
Debbie Carrick-Sen ◽  
Julia Newton ◽  
Carlos Echevarria ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Self Help ◽  
Cognitive Behavioural ◽  
Life Years ◽  
Cost Effective Treatment ◽  
Anxiety Subscale

Anxiety is an important comorbidity in chronic obstructive pulmonary disease (COPD). We investigated if cognitive behavioural therapy (CBT), delivered by respiratory nurses, reduced symptoms of anxiety and was cost-effective.Patients with COPD and anxiety were randomised to CBT or self-help leaflets. Anxiety, depression and quality of life were measured at baseline, 3, 6 and 12 months. A cost-effectiveness analysis was conducted from a National Health Service hospital perspective and quality-adjusted life-years estimated using the EuroQol-5D questionnaire.In total, 279 patients were recruited. Group mean change from baseline to 3 months in the Hospital Anxiety and Depression Anxiety Subscale was 3.4 (95% CI 2.62–4.17, p<0.001) for the CBT group and 1.88 (95% CI 1.19–2.55, p<0.001) in the leaflet group. The CBT group was superior to leaflets at 3 months (mean difference in the Hospital Anxiety and Depression Anxiety Subscale was 1.52, 95% CI 0.49–2.54, p=0.003). Importantly, the CBT intervention was more cost-effective than leaflets at 12 months, significantly lowering hospital admissions and attendance at emergency departments.CBT delivered by respiratory nurses is a clinically and cost-effective treatment for anxiety in patients with COPD relative to self-help leaflets.

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