TY - JOUR
T1 - Unraveling the Black Box
T2 - Exploring Usage Patterns of a Blended Treatment for Depression in a Multicenter Study
AU - Kemmeren, Lise L
AU - van Schaik, Anneke
AU - Smit, Johannes H
AU - Ruwaard, Jeroen
AU - Rocha, Artur
AU - Henriques, Mário
AU - Ebert, David Daniel
AU - Titzler, Ingrid
AU - Hazo, Jean-Baptiste
AU - Dorsey, Maya
AU - Zukowska, Katarzyna
AU - Riper, Heleen
AU - van Schaik, Digna J. F.
AU - Zukowska, Kasia
N1 - ©Lise L Kemmeren, Anneke van Schaik, Johannes H Smit, Jeroen Ruwaard, Artur Rocha, Mário Henriques, David Daniel Ebert, Ingrid Titzler, Jean-Baptiste Hazo, Maya Dorsey, Katarzyna Zukowska, Heleen Riper. Originally published in JMIR Mental Health (http://mental.jmir.org), 25.07.2019.
PY - 2019/7/25
Y1 - 2019/7/25
N2 - BACKGROUND: Blended treatments, combining digital components with face-to-face (FTF) therapy, are starting to find their way into mental health care. Knowledge on how blended treatments should be set up is, however, still limited. To further explore and optimize blended treatment protocols, it is important to obtain a full picture of what actually happens during treatments when applied in routine mental health care.OBJECTIVE: The aims of this study were to gain insight into the usage of the different components of a blended cognitive behavioral therapy (bCBT) for depression and reflect on actual engagement as compared with intended application, compare bCBT usage between primary and specialized care, and explore different usage patterns.METHODS: Data used were collected from participants of the European Comparative Effectiveness Research on Internet-Based Depression Treatment project, a European multisite randomized controlled trial comparing bCBT with regular care for depression. Patients were recruited in primary and specialized routine mental health care settings between February 2015 and December 2017. Analyses were performed on the group of participants allocated to the bCBT condition who made use of the Moodbuster platform and for whom data from all blended components were available (n=200). Included patients were from Germany, Poland, the Netherlands, and France; 64.5% (129/200) were female and the average age was 42 years (range 18-74 years).RESULTS: Overall, there was a large variability in the usage of the blended treatment. A clear distinction between care settings was observed, with longer treatment duration and more FTF sessions in specialized care and a more active and intensive usage of the Web-based component by the patients in primary care. Of the patients who started the bCBT, 89.5% (179/200) also continued with this treatment format. Treatment preference, educational level, and the number of comorbid disorders were associated with bCBT engagement.CONCLUSIONS: Blended treatments can be applied to a group of patients being treated for depression in routine mental health care. Rather than striving for an optimal blend, a more personalized blended care approach seems to be the most suitable. The next step is to gain more insight into the clinical and cost-effectiveness of blended treatments and to further facilitate uptake in routine mental health care.
AB - BACKGROUND: Blended treatments, combining digital components with face-to-face (FTF) therapy, are starting to find their way into mental health care. Knowledge on how blended treatments should be set up is, however, still limited. To further explore and optimize blended treatment protocols, it is important to obtain a full picture of what actually happens during treatments when applied in routine mental health care.OBJECTIVE: The aims of this study were to gain insight into the usage of the different components of a blended cognitive behavioral therapy (bCBT) for depression and reflect on actual engagement as compared with intended application, compare bCBT usage between primary and specialized care, and explore different usage patterns.METHODS: Data used were collected from participants of the European Comparative Effectiveness Research on Internet-Based Depression Treatment project, a European multisite randomized controlled trial comparing bCBT with regular care for depression. Patients were recruited in primary and specialized routine mental health care settings between February 2015 and December 2017. Analyses were performed on the group of participants allocated to the bCBT condition who made use of the Moodbuster platform and for whom data from all blended components were available (n=200). Included patients were from Germany, Poland, the Netherlands, and France; 64.5% (129/200) were female and the average age was 42 years (range 18-74 years).RESULTS: Overall, there was a large variability in the usage of the blended treatment. A clear distinction between care settings was observed, with longer treatment duration and more FTF sessions in specialized care and a more active and intensive usage of the Web-based component by the patients in primary care. Of the patients who started the bCBT, 89.5% (179/200) also continued with this treatment format. Treatment preference, educational level, and the number of comorbid disorders were associated with bCBT engagement.CONCLUSIONS: Blended treatments can be applied to a group of patients being treated for depression in routine mental health care. Rather than striving for an optimal blend, a more personalized blended care approach seems to be the most suitable. The next step is to gain more insight into the clinical and cost-effectiveness of blended treatments and to further facilitate uptake in routine mental health care.
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UR - https://www.ncbi.nlm.nih.gov/pubmed/31344670
U2 - https://doi.org/10.2196/12707
DO - https://doi.org/10.2196/12707
M3 - Article
C2 - 31344670
SN - 2368-7959
VL - 6
SP - e12707
JO - JMIR Mental Health
JF - JMIR Mental Health
IS - 7
M1 - e12707
ER -