Habibović, Mirela3; Denollet, Johan3; Cuijpers, Pim3; Spek, Viola R M3; van den Broek, Krista C3; Warmerdam, Lisanne3; van der Voort, Pepijn H3; Herrman, Jean-Paul3; Bouwels, Leon3; Valk, Suzanne S D3; Alings, Marco3; Theuns, Dominic A M J3; Pedersen, Susanne S4
1 Department of Psychology, Det Sundhedsvidenskabelige Fakultet, SDU2 PSYDOC, Department of Psychology, Det Sundhedsvidenskabelige Fakultet, SDU3 unknown4 Department of Psychology, Det Sundhedsvidenskabelige Fakultet, SDU
Primary Results of the WEBCARE Trial
UNLABELLED: The Web-based distress management program for patients with an implantable cardioverter-defibrillator (ICD; WEBCARE) was developed to mitigate distress and enhance health-related quality of life in ICD patients. This study investigated the treatment effectiveness at 3-month follow-up for generic and disease-specific outcome measures. METHODS: Consecutive patients implanted with a first-time ICD from six hospitals in the Netherlands were randomized to either the "WEBCARE" or the "usual care" group. Patients in the WEBCARE group received a 12-week fixed, six-lesson behavioral treatment based on the problem-solving principles of cognitive behavioral therapy. RESULTS: Two hundred eighty-nine patients (85% response rate) were randomized. The prevalence of anxiety and depression ranged between 11% and 30% and 13% and 21%, respectively. No significant intervention effects were observed for anxiety (β = 0.35; p = .32), depression (β = -0.01; p = .98) or health-related quality of life (Mental Component Scale: β = 0.19; p = .86; Physical Component Scale: β = 0.58; p = .60) at 3 months, with effect sizes (Cohen d) being small (range, 0.06-0.13). There were also no significant group differences as measured with the disease-specific measures device acceptance (β = -0.37; p = .82), shock anxiety (β = 0.21; p = .70), and ICD-related concerns (β = -0.08; p = .90). No differences between treatment completers and noncompleters were observed on any of the measures. CONCLUSIONS: In this Web-based intervention trial, no significant intervention effects on anxiety, depression, health-related quality of life, device acceptance, shock anxiety, or ICD-related concerns were observed. A more patient tailored approach targeting the needs of different subsets of ICD patients may be warranted. TRIAL REGISTRATION: clinicaltrials.gov. Identifier: NCT00895700.
Psychosomatic Medicine, 2014, Vol 76, Issue 8, p. 593-602