scholarly journals Internet-based cognitive–behavioural therapy for tinnitus: secondary analysis to examine predictors of outcomes

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049384
Author(s):  
Hansapani Rodrigo ◽  
Eldré W Beukes ◽  
Gerhard Andersson ◽  
Vinaya Manchaiah
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Secondary Analysis ◽  
Behavioural Therapy ◽  
Education Level ◽  
Predictor Variables ◽  
Successful Outcome ◽  
Tinnitus Severity ◽  
Link Type ◽  
Cognitive Behavioural ◽  
Predictors Of Outcomes

ObjectivesThe current study examined predictors of outcomes of internet-based cognitive–behavioural therapy (ICBT) for individuals with tinnitus.DesignSecondary analysis of intervention studies.SettingInternet-based guided tinnitus intervention provided in the UK.Participants228 individuals who underwent ICBT.InterventionsICBT.Primary and secondary outcome measuresThe key predictor variables included demographic, tinnitus, hearing-related and treatment-related variables as well as clinical factors (eg, anxiety, depression, insomnia), which can have an impact on the treatment outcome. A 13-point reduction in Tinnitus Functional Index (TFI) scores has been defined as a successful outcome.ResultsOf the 228 subjects who were included in the study, 65% had a successful ICBT outcome. As per the univariate analysis, participants with a master’s degree or above had the highest odds of having a larger reduction in tinnitus severity (OR 3.47; 95% CI 1.32 to 12.51), compared with the participants who had education only up to high school or less. Additionally, the baseline tinnitus severity was found to be a significant variable (OR 2.65; 95% CI 1.50 to 4.67) contributing to a successful outcome with the intervention. Both linear and logistic regression models have identified education level and baseline tinnitus severity to be significant predictor variables contributing to a reduction in tinnitus severity post-ICBT. As per the linear regression model, participants who had received disability allowance had shown a 25.3-point lower TFI reduction compared with those who did not experience a decrease in their workload due to tinnitus after adjusting for baseline tinnitus severity and their education level.ConclusionsPredictors of intervention outcome can be used as a means of triaging patients to the most suited form of treatment to achieve optimal outcomes and to make healthcare savings. Future studies should consider including a heterogeneous group of participants as well as other predictor variables not included in the current study.ClinicalTrial.gov Registration:NCT02370810 (completed); NCT02665975 (completed)

scholarly journals Healthcare Use in Patients With Cardiovascular Disease and Depressive Symptoms – The Impact of Internet-Delivered Cognitive Behavioural Therapy. A Secondary Analysis of a RCT

2021 ◽  
Author(s):  
Ghassan Mourad ◽  
Johan Lundgren ◽  
Gerhard Andersson ◽  
Mats Westas Klompstra ◽  
Peter Johansson
Keyword(s):  
Cardiovascular Disease ◽  
Depressive Symptoms ◽  
Cognitive Behavioural Therapy ◽  
Hospital Admissions ◽  
Secondary Analysis ◽  
Behavioural Therapy ◽  
Healthcare Use ◽  
Post Intervention ◽  
Cognitive Behavioural ◽  
The Impact

Abstract Background: Depressive symptoms in patients with cardiovascular disease (CVD) can lead to increased healthcare use and cause an economical burden for society. Thus, interventions aiming to decrease depressive symptoms in these patients could reduce the use of healthcare services. In a previous study we reported that a 9-week internet-delivered cognitive behavioural therapy (iCBT) program (n=72) compared to an online discussion forum (ODF) (n=72) had moderate to large effect on depression in CVD outpatients. However, the associations between healthcare use and depressive symptoms were not reported in that study. The aim of this study was to describe and compare the effect of iCBT compared to ODF regarding healthcare use and to identify factors impacting healthcare use in these groups.Methods: Secondary analysis of a RCT. Data on healthcare use (including outpatient clinic/primary care contacts and hospital admissions) were retrieved from care data registries in five hospitals in Southeastern Sweden. Patients were predominantly males in both groups with a mean age of 61±13 and 64±12 years in iCBT and ODF respectively.Results: The year before the intervention, the iCBT group had a mean of 31 outpatient contacts per patient compared with 21 contacts the year after. The corresponding numbers for the ODF group were 37 and 25. The decrease was 32% in both groups and did not differ significantly between the groups.Regarding hospital admissions, the iCBT group had 0.8 admissions per patient the year before and 0.6 the year after the intervention, i.e. a decrease by 25%, whereas the ODF group had 1.1 and 0.6 admissions respectively, i.e. a decrease by 45%. The difference was not significant between the groups.Improvement in depressive symptoms post intervention was significantly associated with a decrease in number of outpatient contacts in the iCBT group. In the ODF group, better mental health-related quality of life post intervention was significantly associated with a decrease in number of hospital admissions.Conclusions: Reduced depressive symptom scores following intervention were associated with lower outpatient service use, but iCBT was not superior compared to ODF in decreasing healthcare use.Trial registration: The study was registered at ClinicalTrials.gov, NCT02778074.

scholarly journals Homework Adherence and Cognitive Behaviour Treatment Outcome for Children and Adolescents with Anxiety Disorders

2015 ◽  
Vol 44 (2) ◽  
pp. 225-235 ◽  
Author(s):  
Kristian Arendt ◽  
Mikael Thastum ◽  
Esben Hougaard
Keyword(s):  
Treatment Outcome ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Cognitive Behavioural Therapy ◽  
Treatment Program ◽  
Behavioural Therapy ◽  
Successful Outcome ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Homework Adherence

Background: Homework assignments are considered an essential component for a successful outcome of cognitive behavioural therapy for youths with anxiety disorders. However, only two studies have examined the association between homework adherence and outcome of cognitive behavioural therapy for youths with anxiety disorders. Aims: The study examined the association between homework adherence and treatment outcome following a generic group cognitive behaviour treatment program (Cool Kids) for anxiety disordered youths and their parents. Method: The treatment program was completed by 98 children and adolescents (ages 7–16). Homework adherence was measured as time spent doing homework assignments between each session, reported by youths as well as parents. Outcome criteria consisted of youth-reported anxiety symptoms and clinician rated severity of primary anxiety diagnosis at posttreatment and 3-month follow-up. Results: Results did not support an association between homework adherence and treatment outcome when controlling for pretreatment severity. Conclusions: The study found no convincing evidence that homework adherence predicted outcome of cognitive behavioural therapy for youths with anxiety disorders. Reasons for divergent findings on homework adherence in cognitive behavioural therapy for youths compared to adults are discussed.

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