Accepted for/Published in: JMIR Mental Health
Date Submitted: Nov 7, 2018
Date Accepted: Jun 10, 2019
Unravelling the black box: exploring usage patterns of a blended treatment for depression in a multicentre study
ABSTRACT
Background:
Blended treatments, combining digital components with face-to-face therapy, are starting to find their way in 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 get a full picture of what actually happens during treatments when applied in routine mental healthcare.
Objective:
To gain insight into the usage of the different components of a blended Cognitive Behavioural Therapy (bCBT) for depression, to reflect on actual engagement as compared to intended application and to explore different patterns of engagement.
Methods:
Data used were collected from participants of the E-COMPARED project; a European multisite randomised controlled trial comparing bCBT with regular care for depression. Patients were recruited in routine mental healthcare settings, between February 2015 and January 2018. 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 was available (n=200).
Results:
Overall, there was a large variability in the usage of the blended treatment. A clear distinction between care setting was observed, with longer treatment duration and more FTF sessions in specialized care and a more active and intensive usage of the online part by patients in primary care. 89.5% of patients who started the bCBT, also continued with this treatment format. Treatment preference, educational level and 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 healthcare. Rather than striving for one ‘optimal’ blend, a more personalized blended care approach seems to be most suitable. The next step is to get more insight into the clinical- and cost-effectiveness of blended treatments and to further facilitate uptake in routine mental healthcare.
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