Telephone-supported computerised cognitive-behavioural therapy: REEACT-2 large-scale pragmatic randomised controlled trial
British Journal of Psychiatry
Royal College of Psychiatrists
Reason for embargo
Background Computerised cognitive–behavioural therapy (cCBT) for depression has the potential to be efficient therapy but engagement is poor in primary care trials. Aims We tested the benefits of adding telephone support to cCBT. Method We compared telephone-facilitated cCBT (MoodGYM) (n = 187) to minimally supported cCBT (MoodGYM) (n = 182) in a pragmatic randomised trial (trial registration: ISRCTN55310481). Outcomes were depression severity (Patient Health Questionnaire (PHQ)-9), anxiety (Generalized Anxiety Disorder Questionnaire (GAD)-7) and somatoform complaints (PHQ-15) at 4 and 12 months. Results Use of cCBT increased by a factor of between 1.5 and 2 with telephone facilitation. At 4 months PHQ-9 scores were 1.9 points lower (95% CI 0.5–3.3) for telephone-supported cCBT. At 12 months, the results were no longer statistically significant (0.9 PHQ-9 points, 95% CI −0.5 to 2.3). There was improvement in anxiety scores and for somatic complaints. Conclusions Telephone facilitation of cCBT improves engagement and expedites depression improvement. The effect was small to moderate and comparable with other low-intensity psychological interventions.
This project was funded by the UK NIHR Health Technology Assessment programme (project number HTA 06/43/504). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health. The funder played no role in the study design, in the collection, analysis or interpretation of the data, in the writing of the paper or in the decision to submit the article for publication. All authors were independent from the funders. Data sharing: reasonable requests for patient level data should be made to the corresponding author and will be considered by the REEACT publications management group. Consent for data sharing was not obtained but the presented data are anonymised and risk of identification is low.
This is the author accepted manuscript. The final version is available from the Royal College of Psychiatrists via the DOI in this record.
Published online 2 March 2017
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