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Internet-based Cognitive Behavior Therapy After Myocardial Infarction (U-CARE: Heart)

27. oktober 2020 opdateret af: Louise-von Essen, Uppsala University

A Randomized Controlled Study of the Effects of Internet-based Cognitive Behavior Therapy on Depression and Anxiety in Patients With a Previous Myocardial Infarction

The overall aim and primary objective is to evaluate the effects on level of depression and anxiety of an Internet-based CBT-program in depressed and/or anxious patients after a myocardial infarction (MI).

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Major or minor depressive disorders and anxiety disorders are present in many patients with cardiovascular disease (CVD) and are associated with adverse cardiovascular outcomes, even after controlling for other risk factors. 500 patients with symptoms of anxiety and/or depression after MI will be randomized either to a 14 week Internet-based CBT-program or to treatment as usual (TAU) which is the control condition. A reference group of 250 participants without depressive or anxiety symptoms will also be studied during TAU. Data will be collected before, after and 7 months after treatment. Anxiety and depression according to ratings on the Hospital Anxiety and Depression Scale (HADS) are the primary outcome measures.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

239

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Sverige
      • Enköping, Sverige
        • Enköpings lassarett
      • Falun, Sverige, 79129
        • Falu Lasarett
      • Gävle, Sverige, 80187
        • Gavle Sjukhus
      • Göteborg, Sverige
        • Sahlgrenska sjukhuset
      • Hässleholm, Sverige
        • Hässleholms Sjukhus
      • Karlskrona, Sverige
        • Blekinge sjukhus
      • Karlstad, Sverige
        • Karlstad sjukhus
      • Kungälv, Sverige
        • Kungälvs sjukhus
      • Lidköping, Sverige
        • Skaraborgs sjukhus
      • Ljungby, Sverige
        • Ljungby lasarett
      • Malmö, Sverige
        • Skånes universitetssjukhus
      • Mora, Sverige
        • Mora lassarett
      • Nyköping, Sverige
        • Nyköpings sjukhus
      • Oskarshamn, Sverige
        • Oskarshamns sjukhus
      • Piteå, Sverige
        • Piteå älvdals sjukhus
      • Stockholm, Sverige
        • Danderyds sjukhus
      • Stockholm, Sverige
        • Karolinska sjukhuset i Huddinge
      • Stockholm, Sverige
        • Karolinska sjukhuset i Solna
      • Stockholm, Sverige
        • Södersjukhuset
      • Sundsvall, Sverige
        • Länssjukhuset Sundsvall-Härnösand
      • Uppsala, Sverige, 75185
        • Uppsala Akademiska Sjukhus
      • Varberg, Sverige
        • Varberg sjukhus
      • Växjö, Sverige
        • Växjö centrallasarett
      • Ängelholm, Sverige
        • Ängelholms sjukhus
      • Örebro, Sverige, 70185
        • Universitetssjukhuset Örebro

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

Ikke ældre end 75 år (Barn, Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Patients younger than 75 years with a recent acute MI (< 3 months)
  • Depression and/or anxiety score of > 7 on one or both of the HADS subscales (concerns only the intervention, not the reference group)

Exclusion Criteria:

  • Patients that are scheduled for a coronary artery bypass surgery (CABG)
  • Unable or unwilling to use computer or Internet
  • Difficulties in reading or understanding Swedish
  • A life expectancy of less than a year
  • Anticipated poor compliance (multi-disease, substance abuse etc.)
  • Highly depressed or suicidal (MADRS-score > 29 or MADRS item 9 > 3)

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Internet-based CBT
Randomized patients with symptoms of anxiety and/or depression after MI will participate in an Internet-based CBT-program.
Adfærdsmæssigt: Internet-based CBT

The participants read texts and do weekly homework assignments instructed from an Internet page. Additional resources like discussion forum, pictures, animations, videos and sounds will be a part of the treatment program.

A psychologist will communicate with the participants through internal text-messages. The therapist will devote about 10 minutes to each participant each week via the Internet. The content of the intervention will be standard components from CBT, for example relaxation training, behavioral activation, exposure for fear related stimuli, cognitive restructuring, behavioral sleep treatment etc.
Ingen indgriben: Treatment as usual (TAU)

Control: After randomization patients with symptoms of anxiety and/or depression after MI will participate in the treatment as usual (TAU).

Reference: A reference group without depressive or anxiety symptoms will participate in the treatment as usual (TAU).

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Depression (difference between the intervention and the control group)
Tidsramme: At baseline and 3 months later (after intervention)

Hospital Anxiety and Depression Scale (HADS) - depression ratings;

Montgomery Åsberg Depression Rating Scale (MADRS)
At baseline and 3 months later (after intervention)
Change in Anxiety (difference between the intervention and the control group)
Tidsramme: At baseline and 3 months later (after intervention)
Hospital Anxiety and Depression Scale (HADS) - anxiety ratings
At baseline and 3 months later (after intervention)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Quality of Life (difference between the intervention and the control group)
Tidsramme: At baseline, during, after (3 months after baseline) and 7 months after treatment
Ratings on EQ5d and Ladder of Life (LL)
At baseline, during, after (3 months after baseline) and 7 months after treatment
Change in Perceived Social Support (difference between the intervention and the control group)
Tidsramme: At baseline, after (3 months after baseline) and 7 months after treatment
ENRICHED Social Support Inventory (ESSI)-ratings
At baseline, after (3 months after baseline) and 7 months after treatment
Change in Stress behaviors (difference between the intervention and the control group)
Tidsramme: At baseline, after (3 months after baseline) and 7 months after treatment
Everyday Life Stress Scale (ELSS)-ratings
At baseline, after (3 months after baseline) and 7 months after treatment
Change in Fatigue (difference between the intervention and the control group)
Tidsramme: At baseline, after (3 months after baseline) and 7 months after treatment
Maastricht Questionnaire (MQ)-ratings
At baseline, after (3 months after baseline) and 7 months after treatment
Change in Cardiac Anxiety (difference between the intervention and the control group)
Tidsramme: At baseline, after (3 months after baseline) and 7 months after treatment
Cardiac Anxiety Questionnaire (CAQ)-ratings
At baseline, after (3 months after baseline) and 7 months after treatment
Change in Sleeping Problems (difference between the intervention and the control group)
Tidsramme: At baseline, after (3 months after baseline) and 7 months after treatment
Insomnia Severity Index (ISI)-ratings
At baseline, after (3 months after baseline) and 7 months after treatment
Change in Posttraumatic Stress (difference between the intervention and the control group)
Tidsramme: At baseline, after (3 months after baseline) and 7 months after treatment
Posttraumatic Stress Disorder Checklist- Civilian Version (PCL-C)-ratings
At baseline, after (3 months after baseline) and 7 months after treatment
Change in Posttraumatic Growth (difference between the intervention and the control group)
Tidsramme: At baseline, after (3 months after baseline) and 7 months after treatment
The Posttraumatic Growth Inventory - Short Form (PTGI-SF)-ratings
At baseline, after (3 months after baseline) and 7 months after treatment
Quality of the Intervention
Tidsramme: At baseline, after (3 months after baseline) and 7 months after treatment
Behavioral Activation for Depression Scale (BADS)-ratings
At baseline, after (3 months after baseline) and 7 months after treatment
Change to Follow-up in Anxiety (difference between the intervention and the control group)
Tidsramme: At baseline, after (3 months after baseline) and 7 months after treatment
Hospital Anxiety and Depression Scale (HADS) - anxiety ratings
At baseline, after (3 months after baseline) and 7 months after treatment
Change to Follow-up in Depression (difference between the intervention and the control group)
Tidsramme: At baseline, after (3 months after baseline) and 7 months after treatment

Hospital Anxiety and Depression Scale (HADS) - depression ratings;

Montgomery Åsberg Depression Rating Scale (MADRS)
At baseline, after (3 months after baseline) and 7 months after treatment

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Uppsala University

Efterforskere

  • Ledende efterforsker: Louise von Essen, PhD, Uppsala University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Hjælpsomme links

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. september 2013

Primær færdiggørelse (Faktiske)

1. december 2017

Studieafslutning (Faktiske)

1. december 2017

Datoer for studieregistrering

Først indsendt

19. december 2011

Først indsendt, der opfyldte QC-kriterier

4. januar 2012

Først opslået (Skøn)

5. januar 2012

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

29. oktober 2020

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

27. oktober 2020

Sidst verificeret

1. oktober 2020

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • U-CARE: Heart

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Kliniske forsøg med Depression

Kliniske forsøg med Internet-based CBT

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Betingelser

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