The association between adherence and outcome in an Internet intervention for depression
Kristina Fuhr1, Johanna Schröder2, Thomas Berger3
1Department of Psychology, Clinical Psychology and Psychotherapy, Eberhard Karls University Tübingen, Tübingen, Germany.
Journal of Affective Disorders
|January 15, 2018
Summary
Older age and higher depressive symptoms were linked to better adherence in an internet depression intervention. Higher adherence correlated with improved outcomes, though guidance played a significant role.
Area of Science:
- Digital health interventions
- Psychiatry
- Clinical psychology
Background:
- Low adherence to internet interventions can reduce effectiveness.
- The EVIDENT trial investigated patient characteristics and adherence in an online depression intervention.
Purpose of the Study:
- To examine patient characteristics associated with adherence to an internet intervention for depression.
- To determine if adherence to the intervention predicts treatment outcomes.
Main Methods:
- 509 participants with mild-to-moderate depression were randomized to care as usual or care as usual plus the Deprexis internet intervention.
- Adherence was measured by usage time and number of sessions.
- Depression symptoms were assessed pre- and post-intervention (12 weeks).
Main Results:
- Adherence was good, with an average of 7 hours usage and 8 sessions.
- Older age, higher depressive symptoms, and confidence predicted more sessions.
- Higher adherence (sessions and duration) was associated with greater symptom reduction, largely explained by guidance received.
Conclusions:
- Older age was associated with better adherence to the internet intervention.
- Adherence positively correlated with improved depression outcomes.
- The observed effects were small, suggesting other factors influence adherence.
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