Examining internet-delivered cognitive behaviour therapy for patients with chronic kidney disease on haemodialysis: A feasibility open trial

Ramony Chan; Blake F Dear; Nick Titov; Josephine Chow; Michael Suranyi

doi:10.1016/j.jpsychores.2016.08.012

Examining internet-delivered cognitive behaviour therapy for patients with chronic kidney disease on haemodialysis: A feasibility open trial

J Psychosom Res. 2016 Oct:89:78-84. doi: 10.1016/j.jpsychores.2016.08.012. Epub 2016 Aug 29.

Authors

Ramony Chan¹, Blake F Dear², Nick Titov², Josephine Chow³, Michael Suranyi⁴

Affiliations

¹ Renal Unit, Liverpool Hospital, Sydney, Australia; Consultation Liaison Psychiatry, Liverpool Hospital, Sydney, Australia; The University of New South Wales, Sydney, Australia. Electronic address: ramony.chan@sswahs.nsw.gov.au.
² eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia.
³ Clinical Innovation & Business Unit, South Western Sydney Local Health District, Sydney, Australia; The University of Sydney, Sydney, Australia; The University of Tasmania, Hobart, Australia.
⁴ Renal Unit, Liverpool Hospital, Sydney, Australia; The University of New South Wales, Sydney, Australia; Western Sydney University, Sydney, Australia.

PMID: 27663114
DOI: 10.1016/j.jpsychores.2016.08.012

Abstract

Objective: Treating depression among patients with chronic kidney disease (CKD) is imperative because of its high prevalence and health-related costs. However, many patients with CKD experience significant barriers to effective face-to-face psychological treatments. Internet-delivered cognitive behaviour therapy (iCBT) may help overcome the treatment barriers. The aim of the present study was to explore the acceptability and preliminary efficacy of iCBT for depression and anxiety among patients with CKD on haemodialysis.

Methods: A single-group open trial design involving 22 patients on dialysis and an established iCBT treatment for anxiety and depression was employed. The primary outcomes were symptoms of depression, anxiety and general psychological distress. The secondary and tertiary outcomes were disability, quality of life, kidney disease-related loss and kidney disease burden. A generalised estimation equation modelling technique was employed.

Results: Clinically significant improvements (avg. % of improvement) were observed in the primary outcomes of depression (34%), anxiety (31%) and general distress (26%), which were maintained or further improved to 3-month follow-up. Improvements were also observed for quality of life (12%) and kidney disease-related loss (30%). However, no improvements in disability and kidney disease burden were found. High levels of acceptability were reported and relatively little clinician time (99.45min; SD=14.61) was needed to provide the treatment.

Conclusion: The present results provide encouraging support for the potential of iCBT as an innovative way of increasing access to effective psychological treatment for CKD patients. These results provide much needed support for further research in this area.

Trial registration: Australian and New Zealand Clinical Trials Registry: ACTRN12613000103763.

Keywords: Anxiety; Chronic; Clinical trial; Cognitive behaviour therapy; Depression; Internet based intervention; Kidney disease related loss; Kidney failure; Mental health; Psychological adaptation; Renal dialysis.

MeSH terms

Adult
Aged
Anxiety / epidemiology
Anxiety / psychology
Anxiety / therapy
Australia
Cognitive Behavioral Therapy / methods*
Cognitive Behavioral Therapy / trends
Depression / epidemiology
Depression / psychology
Depression / therapy
Feasibility Studies
Female
Follow-Up Studies
Humans
Internet* / trends
Male
Middle Aged
Quality of Life / psychology
Renal Dialysis / psychology*
Renal Dialysis / trends
Renal Insufficiency, Chronic / epidemiology
Renal Insufficiency, Chronic / psychology*
Renal Insufficiency, Chronic / therapy*
Therapy, Computer-Assisted / methods
Therapy, Computer-Assisted / trends
Treatment Outcome

Associated data

ANZCTR/ACTRN12613000103763