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Published on: November 29, 2024
Implementing internet-delivered cognitive behavioural therapy for patients with cardiovascular disease and
Margit Neher1, Annette Nygårdh2, Per Nilsen1
11 Department of Medical and Health Sciences, Linköping University, Sweden.
Insights
Internet-based cognitive behavioral therapy can help cardiovascular disease patients with depression. More research is needed on its effectiveness and implementation for both depression and insomnia in this population.
Area of Science:
- Cardiology
- Psychiatry
- Digital Health
Background:
- 20-40% of cardiovascular disease patients experience psychological distress, including insomnia and depression.
- This distress negatively impacts patient health, quality of life, and increases healthcare costs.
- Internet-based cognitive behavioral therapy (iCBT) offers potential for treating psychological distress in cardiovascular disease patients.
Purpose of the Study:
- To conduct a scoping review of literature on internet-based cognitive behavioral therapy (iCBT) for cardiovascular disease (CVD).
- To identify strategies for implementing iCBT in clinical practice for CVD patients.
- To explore the effectiveness and implementation of iCBT in managing psychological distress in CVD.
Main Methods:
- A comprehensive search of electronic databases, journals, and internet sources was performed.
- Scoping review methodology was followed, screening 267 titles and 11 full-text articles.
- Qualitative content analysis using an implementation framework was applied to four selected articles.
Main Results:
- Three of four included articles focused on iCBT for mild to moderate depressive symptoms in CVD patients; none addressed insomnia.
- Evidence suggests iCBT is effective for depression in CVD, with patient factors influencing outcomes.
- Significant gaps exist in understanding iCBT implementation aspects and stakeholder perspectives.
Conclusions:
- iCBT shows promise for reducing psychological distress in cardiovascular disease patients.
- Further research is necessary to fully understand the effectiveness and implementation of iCBT for both depression and insomnia in CVD.
- Bridging the research gap is crucial for successful clinical integration of iCBT.
Background:
Comorbid psychological distress (i.e. insomnia and depression) is experienced by 20-40% of patients with cardiovascular disease. This has a considerable impact on their health and quality of life, leading to frequent re-hospitalisations, higher healthcare costs and a shorter life expectancy. Internet-based cognitive behavioural therapy shows great potential for treating psychological distress in cardiovascular disease. Effective and feasible treatments can, however, only benefit patients if they are fully implemented in clinical care.
Aim:
This scoping review aimed to explore the literature for internet-based cognitive behavioural therapy in cardiovascular disease and for strategies to implement the intervention.
Methods:
We searched electronic databases, journals and internet sources to find original studies about internet-based cognitive behavioural therapy in cardiovascular disease, adhering to scoping methodology guidelines. After identifying 267 titles, we screened 40 abstracts and chose 11 full-text articles for full-text screening. The results sections in four articles were searched for outcomes that related to the effectiveness and implementation of internet-based cognitive behavioural therapy by directed qualitative content analysis using an implementation framework.
Results:
Three of the four articles fulfilling the inclusion criteria concerned internet-based cognitive behavioural therapy for treating mild to moderate depressive symptoms in cardiovascular disease, and none focused on insomnia. The studies showed evidence for the effectiveness of internet-based cognitive behavioural therapy, and/or described patient factors influencing clinical effectiveness. Our qualitative content analysis showed that many implementation aspects and stakeholder perspectives remain unexplored.
Conclusions:
Internet-based cognitive behavioural therapy promises to alleviate patient suffering in cardiovascular disease. There is, however, little research about internet-based cognitive behavioural therapy for cardiovascular disease, and about how this evidence-based intervention is implemented.
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