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Adherence in internet interventions for anxiety and depression
Helen Christensen1, Kathleen M Griffiths, Louise Farrer
1Centre for Mental Health Research, Australian National University, Canberra ACT 0200, Australia. Helen.Christensen@anu.edu.au
Journal of Medical Internet Research
|May 1, 2009
Summary
Internet interventions for anxiety and depression show lower dropout rates in trials compared to open access sites. Understanding adherence predictors is key to improving mental health treatment impact.
Area of Science:
- Digital Health
- Mental Health Interventions
- Behavioral Science
Background:
- Open access websites for anxiety and depression interventions suffer from poor patient adherence.
- Understanding adherence is crucial for maximizing the effectiveness of Internet-based mental health treatments.
Purpose of the Study:
- To review adherence literature for Internet interventions.
- To investigate dropout and compliance rates in randomized controlled trials (RCTs) of Web-based anxiety and depression studies.
Main Methods:
- Systematic review of RCTs for Internet interventions targeting anxiety and depression.
- Data collection on dropout, adherence, adherence predictors, and reasons for dropout.
Main Results:
- Attrition rates in RCTs (1-50%) were lower than those reported for open access sites.
- Disease severity, treatment duration, and chronicity were identified as adherence predictors.
- Few studies formally analyzed reasons for dropout or used appropriate statistical methods for missing data.
Conclusions:
- Dropout rates in RCTs of Web interventions are lower compared to open access websites.
- Developing theoretical models for adherence is vital for Internet intervention research.
- Further investigation into disease-specific factors influencing adherence in anxiety and depression is needed.
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