Adherence as a determinant of effectiveness of internet cognitive behavioural therapy for anxiety and depressive disorders
Adherence as a determinant of effectiveness of internet cognitive behavioural therapy for anxiety and depressive disorders
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DOI：
10.1016/j.brat.2012.04.001
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发表时间：
2012-08-01
影响因子：
4.1
通讯作者：
Andrews, Gavin
中科院分区：
文献类型：
--
作者：
Hilvert-Bruce, Zita;Rossouw, Pieter J.;Andrews, Gavin
自2009年以来，焦虑和抑郁临床研究单位(CRUfAD)一直为初级保健临床医生提供互联网认知行为治疗(ICBT)课程，供患者开出处方。尽管这些课程在研究试验中证明了有效性，但初级保健的依从性还不到研究试验的一半。目前的研究提出了三个问题：第一，课程非完成者是否因为缺乏有效性而退学？第二，交付方面的变化(例如增加选择、提醒和财务成本)能否提高遵从性？最后，临床医生接触是否提高了依从性？结果表明，未完成治疗的患者在退出之前会受益；增加提醒、选择课程和时机以及财务成本可以显著提高依从性；在疗程期间与临床医生接触与增加依从性相关。结论是，提高依从性是有效性的一个重要决定因素。(C)2012爱思唯尔有限公司。保留所有权利。
Since 2009, the Clinical Research Unit for Anxiety and Depression (CRUfAD) has been providing primary care clinicians with internet cognitive behaviour therapy (iCBT) courses to prescribe to patients. Although these courses have demonstrated efficacy in research trials, adherence in primary care is less than half that of the research trials. The present studies pose three questions: first, do course non-completers drop out because of lack of efficacy? Second, can changes in delivery (e.g. adding choice, reminders and financial cost) improve adherence? Last, does clinician contact improve adherence? The results showed that non-completers derive benefit before dropping out; that adding reminders, choice of course and timing, and financial cost can significantly improve adherence; and that clinician contact during the course is associated with increased adherence. It is concluded that improved adherence is an important determinant of effectiveness. (C) 2012 Elsevier Ltd. All rights reserved.