Adherence to the iFightDepression® online self-help tool for depression - A pilot study

Ideggyogy Sz. 2023 Jul 30;76(7-8):221-229. doi: 10.18071/isz.76.0221.

Abstract

Background and purpose: <p>The aim of the current observational study was to examine the level of adherence of Hungarian patients suffering from depression, using iFightDep&shy;ression (iFD) guided online self-help tool with and without an extra weekly phone call support as well as identifying the predictors of adherence. Our hypotheses were: the additional weekly phone-calls would increase the adherence with the online self-help tool; furthermore, symptoms of depression will significantly decrease in the weekly phone support group.</p>.

Methods: <p>During the 6 weeks of iFD&reg; intervention, patients were divided into two groups: the first, alongside of the treatment as usual (TAU) and iFD&reg;, received a 20-minu&shy;tes weekly phone call support while the other group partook in only the TAU+iFD&reg; intervention. Measures: number of completed modules and Patient Health Questionnaire-9. The study included 102 participants with diagnosis of depression (70% female, mean age: 36.9 [SD = 11.40] ys).&nbsp;</p>.

Results: <p>Participants completed on average 4.8 (SD = 1.73) out of 6 modules. The intervention group with additional phone support completed more modules than the group of no additional phone calls (Z = &ndash;5.416, p &lt; 0.001, rank Cohen&rsquo;s d = &ndash;1.267). Participants with higher level of education completed more modules than those with lower level of education (Z = &ndash;2.198, p = 0.028, rank Cohen&rsquo;s d = &ndash;0.444). Baseline depressive symptoms correlated negatively with the number of completed modules (rS = &ndash;0.22, p = 0.028). Depressive symptoms were significantly reduced between the two measurement points (main effect of time: (F(1) = 179.173,&nbsp;p &lt; 0.001, partial &eta;2 = 0.642), the improvement was significantly larger in the iFD&reg; + phone support group (time &times; group interaction: F(1) = 6.492, p = 0.012, partial &eta;2 = 0.061).</p>.

Conclusion: <p>Weekly phone support increased treatment adherence. Negative correlation of symptom severity with adherence suggests that iFD can be effective in mild or moderate forms of depression. With regards to sociodemographic variables, only the level of education showed significant correlation with adherence. Our results support applicability of the iFD intervention in various kinds of sociodemographic groups.</p>.

Background and purpose: <p>Tanulmányunk célja&nbsp;az iFightDepression&reg; (iFD&reg;) online önsegítő programban az adherencia mértékének vizsgálata heti kiegészítő telefonos segítséggel és a nélkül, valamint az adherencia prediktorainak beazonosítása. Hipotéziseink: a kiegészítő heti telefonos segítség növeli az online önsegítő beavatkozással való adherenciát, valamint a heti telefont&aacute;mogat&aacute;sban r&eacute;szes&uuml;lő csoport depresszi&oacute;s t&uuml;netei az intervenci&oacute; hat&aacute;s&aacute;ra szignifik&aacute;nsan cs&ouml;kkennek.&nbsp;</p>.

Methods: <p>A hat h&eacute;tig tart&oacute; iFight&shy;Dep&shy;ression&reg; intervenció előtt a pácienseket két csoportra osztottuk: az egyik a hagyom&aacute;nyos (TAU) kezel&eacute;s &eacute;s az iFD&reg; mellett heti 20 per&shy;&shy;ces kiegészítő telefonos támogatásban részesült, a másik csak TAU &eacute;s iFD&reg; beavat&shy;koz&aacute;st kapott. Mérőeszközök: az el&shy;vég&shy;zett modulok száma &eacute;s Patient Health Ques&shy;tionnaire-9. A mintát 102 páciens alkotta (70% nő, átlagéletkor: 36,9 [SD = 11,40] év).</p>.

Results: <p>A r&eacute;sztvevők a program 6 mo&shy;&shy;dulj&aacute;b&oacute;l &aacute;tlagosan 4,8 (SD = 1,73) modult v&eacute;geztek el. A kieg&eacute;szítő telefonos segíts&eacute;gben r&eacute;szes&uuml;lő csoport szignifik&aacute;nsan t&ouml;bb modult teljesített (Z = 5,416, p &lt;0,001, rang Cohen-d = &ndash;1.267). A magasabb iskolai v&eacute;gzetts&eacute;ggel rendelkezők szignifik&aacute;nsan t&ouml;bb modult v&eacute;geztek el, mint az alacsonyabb is&shy;kolai v&eacute;gzetts&eacute;gűek (Z = &ndash;2,198, p = 0,028, rang Cohen-d = &ndash;0.444). A kiindul&aacute;skor m&eacute;rt depresszi&oacute;s t&uuml;netek s&uacute;lyoss&aacute;ga negatívan korrel&aacute;lt az elv&eacute;gzett modulok sz&aacute;m&aacute;val (Spear&shy;man rho = &ndash;0,22, p = 0,028). A k&eacute;t m&eacute;&shy;r&eacute;si pont k&ouml;z&ouml;tt a depresszív t&uuml;netek szignifik&aacute;nsan cs&ouml;kkentek (az ism&eacute;tl&eacute;s főhat&aacute;sa: F(1) = 179,173, p &lt;0,001, parci&aacute;lis &eta;2 = 0,642), a t&uuml;netek javul&aacute;sa szignifik&aacute;nsan nagyobb m&eacute;rt&eacute;kű volt az iFD&reg; + telefonos cso&shy;portban, (ism&eacute;tl&eacute;s &times; csoport interakci&oacute;ja: F(1) = 6,492, p = 0,012, parci&aacute;lis &eta;2 = 0,061).</p>.

Conclusion: <p>A heti kieg&eacute;szítő telefo&shy;nos segíts&eacute;g n&ouml;velte a beavatkoz&aacute;shoz kap&shy;cso-&shy;l&oacute;&shy;d&oacute; adherenci&aacute;t. A depresszi&oacute;s t&uuml;&shy;&shy;ne&shy;tek s&uacute;lyoss&aacute;ga &eacute;s az adherencia k&ouml;&shy;z&ouml;t&shy;ti ne&shy;ga&shy;tív korrel&aacute;ci&oacute; azt sugallja, hogy az iFight&shy;Depression enyhe vagy k&ouml;zepesen s&uacute;lyos depresszi&oacute; eset&eacute;n hat&eacute;kony. A szo&shy;&shy;cio&shy;&shy;demogr&aacute;fiai v&aacute;ltoz&oacute;k k&ouml;z&uuml;l egyedül az iskolai végzettség mutatott szignifikáns össze&shy;függést az elvégzett modulok számával.&nbsp;Eredményeink alátámasztják az iFD&reg; inter&shy;&shy;venció változatos szociodemogr&aacute;fiai&nbsp;csoportokban történő alkalmazhatóságát.</p>.

Keywords: adherence; cognitive behavioral therapy; depression; iFightDepression; internet-based intervention.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Depression* / therapy
  • Female
  • Health Behavior*
  • Humans
  • Internet
  • Male
  • Pilot Projects
  • Surveys and Questionnaires