TY - JOUR
KW - Cognitive Therapy
KW - Communication
KW - Data Collection
KW - Depression/therapy
KW - Depressive Disorder/therapy
KW - Humans
KW - Internet
KW - Middle Aged
KW - Patient Acceptance of Health Care
KW - Pilot Projects
KW - Primary Health Care
KW - Program Evaluation
KW - Suicidal Ideation
KW - Treatment Outcome
AU - U. Whiteside
AU - J. Richards
AU - B. Steinfeld
AU - G. Simon
AU - S. Caka
AU - C. Tachibana
AU - S. Stuckey
AU - E. Ludman
A1 - 
AB - CONTEXT: Cognitive behavioral therapy (CBT) is a goal-oriented treatment that guides patients to healthy thoughts and behaviors. Internet-delivered CBT with supportive coaching can be as effective as in-person psychotherapy treatment of depression. OBJECTIVE: To test the feasibility of engaging depressed primary care patients not currently receiving psychotherapy and to measure the outcomes of Internet-delivered CBT with supportive coaching. DESIGN: Pilot feasibility project. MAIN OUTCOME MEASURES: 1) Uptake rate. 2) Reduction in depressive symptoms (average score on 20-item Hopkins Symptom Checklist) from baseline to 4-month follow-up. METHODS: Medical records data were queried to identify patients experiencing a new episode of depression. Eligible patients were invited via secure messaging (patient and clinician communication using a secure Web site linked to the medical record) to participate in the Internet-delivered CBT program (also known as Thrive), which was algorithm-driven and delivered through didactic segments, interactive tools, and assessments. Patients completed a self-administered online follow-up survey four months after enrollment. RESULTS: Of 196 eligible patients who were sent an invitation, 39 (20%) enrolled in the Internet-delivered CBT program. At follow-up, enrolled patients experienced a clinically significant decrease (average = 46%) in depressive symptoms. Suicidal thoughts also decreased both overall and by severity. CONCLUSIONS: Seamless, scalable integration of Internet-delivered CBT into health care systems is feasible. The 20% uptake rate suggests that future work should focus on strategies to increase the initial response rate. One promising direction is the addition of "human touch" to the secure message invitation. Depression outcomes suggest promise for systemwide implementation of Internet-delivered CBT programs.
BT - The Permanente journal
C5 - HIT & Telehealth
CP - 2
CY - United States
DO - 10.7812/TPP/13-155
IS - 2
JF - The Permanente journal
N2 - CONTEXT: Cognitive behavioral therapy (CBT) is a goal-oriented treatment that guides patients to healthy thoughts and behaviors. Internet-delivered CBT with supportive coaching can be as effective as in-person psychotherapy treatment of depression. OBJECTIVE: To test the feasibility of engaging depressed primary care patients not currently receiving psychotherapy and to measure the outcomes of Internet-delivered CBT with supportive coaching. DESIGN: Pilot feasibility project. MAIN OUTCOME MEASURES: 1) Uptake rate. 2) Reduction in depressive symptoms (average score on 20-item Hopkins Symptom Checklist) from baseline to 4-month follow-up. METHODS: Medical records data were queried to identify patients experiencing a new episode of depression. Eligible patients were invited via secure messaging (patient and clinician communication using a secure Web site linked to the medical record) to participate in the Internet-delivered CBT program (also known as Thrive), which was algorithm-driven and delivered through didactic segments, interactive tools, and assessments. Patients completed a self-administered online follow-up survey four months after enrollment. RESULTS: Of 196 eligible patients who were sent an invitation, 39 (20%) enrolled in the Internet-delivered CBT program. At follow-up, enrolled patients experienced a clinically significant decrease (average = 46%) in depressive symptoms. Suicidal thoughts also decreased both overall and by severity. CONCLUSIONS: Seamless, scalable integration of Internet-delivered CBT into health care systems is feasible. The 20% uptake rate suggests that future work should focus on strategies to increase the initial response rate. One promising direction is the addition of "human touch" to the secure message invitation. Depression outcomes suggest promise for systemwide implementation of Internet-delivered CBT programs.
PP - United States
PY - 2014
SN - 1552-5775; 1552-5767
SP - 21
EP - 27
EP - 
T1 - Online cognitive behavioral therapy for depressed primary care patients: a pilot feasibility project
T2 - The Permanente journal
TI - Online cognitive behavioral therapy for depressed primary care patients: a pilot feasibility project
U1 - HIT & Telehealth
U2 - 24867546
U3 - 10.7812/TPP/13-155
VL - 18
VO - 1552-5775; 1552-5767
Y1 - 2014
ER -