Improving mental well-being in psychocardiology-a feasibility trial for a non-blended web application as a brief metacognitive-based intervention in cardiovascular disease patients

Katharina Larionov; Ekaterina Petrova; Nurefsan Demirbuga; Oliver Werth; Michael H Breitner; Philippa Gebhardt; Flora Caldarone; David Duncker; Mechthild Westhoff-Bleck; Anja Sensenhauser; Nadine Maxrath; Michael Marschollek; Kai G Kahl; Ivo Heitland

doi:10.3389/fpsyt.2023.1138475

Improving mental well-being in psychocardiology-a feasibility trial for a non-blended web application as a brief metacognitive-based intervention in cardiovascular disease patients

Front Psychiatry. 2023 Sep 28:14:1138475. doi: 10.3389/fpsyt.2023.1138475. eCollection 2023.

Affiliations

¹ Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
² Information Systems Institute, Leibniz University Hannover, Hannover, Germany.
³ OFFIS - Institute for Information Technology, Oldenburg, Germany.
⁴ Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
⁵ University of Applied Sciences and Arts, Hochschule Hannover, Hannover, Germany.
⁶ TU Braunschweig and Hannover Medical School, Peter L. Reichertz Institute for Medical Informatics, Hannover, Germany.

Abstract

Background: Many patients with cardiovascular disease also show a high comorbidity of mental disorders, especially such as anxiety and depression. This is, in turn, associated with a decrease in the quality of life. Psychocardiological treatment options are currently limited. Hence, there is a need for novel and accessible psychological help. Recently, we demonstrated that a brief face-to-face metacognitive therapy (MCT) based intervention is promising in treating anxiety and depression. Here, we aim to translate the face-to-face approach into digital application and explore the feasibility of this approach.

Methods: We translated a validated brief psychocardiological intervention into a novel non-blended web app. The data of 18 patients suffering from various cardiac conditions but without diagnosed mental illness were analyzed after using the web app over a two-week period in a feasibility trial. The aim was whether a non-blended web app based MCT approach is feasible in the group of cardiovascular patients with cardiovascular disease.

Results: Overall, patients were able to use the web app and rated it as satisfactory and beneficial. In addition, there was first indication that using the app improved the cardiac patients' subjectively perceived health and reduced their anxiety. Therefore, the approach seems feasible for a future randomized controlled trial.

Conclusion: Applying a metacognitive-based brief intervention via a non-blended web app seems to show good acceptance and feasibility in a small target group of patients with CVD. Future studies should further develop, improve and validate digital psychotherapy approaches, especially in patient groups with a lack of access to standard psychotherapeutic care.

Keywords: anxiety; cardiovascular disease; depression; digital intervention; e-health; mental health; metacognitive therapy; psychocardiology.