Efficacy of a Blended Low Intensity Internet-delivered Psychological Program in Patients With Multimorbidity in Primary Care.

NCT ID: NCT03426709

Last Updated: 2023-02-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

196 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-26

Study Completion Date

2020-12-21

Brief Summary

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The aim of this study is to assess the efficacy in Primary Care (PC) of a low intensity psychological intervention applied using Information and communication technologies (ICTs) for the treatment of multimorbidity in PC (depression and diabetes/low back pain) by a randomized controlled trial (RCT). A protocol will be design that combines face to face intervention with a supporting online program that will be tried in a RCT conducted in 3 different regions (Andalucía, Aragón, y Baleares). Our main hypothesis is that improved usual care combined with psychological therapy applied by ICTs, will be more efficacious to improve the symptomatology of multimorbidity, compared to a group with only improved treatment as usual three months after the end of treatment.

Detailed Description

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Although multimorbidity is highly prevalent, health care systems are designed for the management individual diseases. New strategies are needed to help general practitioners to provide appropriate personalized care to patients. The World Health Organization (WHO) has included comorbidity between depression and a chronic disease as one of the 10 main priorities in global public health. Studies in meta-analysis confirm that the 2 main interventions of first choice for depression are pharmacotherapy and/or psychotherapy, with similar results in the short term but superior in the long term for psychological treatments. Given the difficulty of delivering face to face psychological treatments (high costs) alternative models of delivering treatments have been proposed, emphasizing the role of technologies like Internet. The aim of this study is to assess the efficacy in Primary Care (PC) of a low intensity psychological intervention (8 weeks) applied using Information and communication technologies (ICTs) for the treatment of multimorbidity in PC (depression and diabetes/low back pain) by a randomized controlled trial (RCT). Our main hypothesis is that improved usual care combined with psychological therapy applied by ICTs, will be more efficacious to improve the symptomatology of multimorbidity, compared to a group with only improved treatment as usual three months after the end of treatment. A protocol will be design that combines face to face intervention with a supporting online program that will be tried in a RCT conducted in 3 different regions (Andalucía, Aragón, y Baleares). 180 participants diagnosed with depression and diabetes/low back pain will participate in the RCT. It´s proposed a coordinated study by 4 highly experienced groups with great possibilities of translation and transference to usual clinical practice.

Conditions

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Depression Chronic Disease (Diabetes/Low Back Pain)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Low intensity Internet-delivered psychotherapy

improved Treatment-as-usual (TAU) + face to face (2 sessions of 90 minutes/session) + low intensity psychological intervention (6 sessions of 60 minutes/session) applied by ICTs (Information and communication technologies).

Group Type EXPERIMENTAL

Low intensity Internet-delivered psychotherapy

Intervention Type BEHAVIORAL

The online intervention will be individual and interactive, which will be supported by multimedia material (videos, sound recordings, etc.) and will have internet support. The estimated duration of the program is 8 weeks. Low Intensity Internet-delivered psychotherapy: Psychoeducation, Healthy living habits, Behavioral activation, Positive Psychology, Mindfulness and Compassion

Improved Treatment-as-usual (TAU)

In this group, the general practitioner (GP) will apply the usual but improved treatment. The GP will have a training meeting and will be provided with the recommendations of one of the Guidelines for the Treatment of Adult Depression in AP most used in our country.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Low intensity Internet-delivered psychotherapy

The online intervention will be individual and interactive, which will be supported by multimedia material (videos, sound recordings, etc.) and will have internet support. The estimated duration of the program is 8 weeks. Low Intensity Internet-delivered psychotherapy: Psychoeducation, Healthy living habits, Behavioral activation, Positive Psychology, Mindfulness and Compassion

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Be adult
* Willingness to participate in the study and signing informed consent
* Ability to understand oral and written Spanish.
* DSM-5 diagnose of Major Depression or Dysthymia, mild or moderate depression expressed as score lower than 19 in the Patient Health Questionnaire (PHQ-9)
* Duration of depressive symptoms 2 months or more
* Diagnosis of one of the following two conditions: Diabetes (Diagnosis according to criteria of the American Diabetes Association (ADA)) or low back pain (Diagnosis of non-specific chronic low back pain according to the definition established by the Clinical Practice Guide of the European Program COST B-13 (CPG COST B-13) with a duration of at least 6 months)
* To have and to handle the computer, internet and mobile phone

Exclusion Criteria

* Any diagnose of disease that may affect central nervous system (brain pathology, traumatic brain injury, dementia, etc.),
* Other psychiatric diagnoses or acute psychiatric illness (substance dependence or abuse, history of schizophrenia or other psychotic disorders, eating disorders, etc.), except for anxious pathology or personality disorders
* Any medical, infectious or degenerative disease that may affect mood
* Presence of delusional ideas or hallucinations consistent or not with mood
* Suicide risk
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Carlos III Health Institute

OTHER_GOV

Sponsor Role collaborator

Javier Garcia Campayo

OTHER

Sponsor Role lead

Responsible Party

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Javier Garcia Campayo

Principal investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Javier García-Campayo

Role: PRINCIPAL_INVESTIGATOR

Miguel Servet Hospital and University os Zaragoza, Spain

Locations

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Health Science Research Institute, University Balearic Islands

Palma de Mallorca, Mallorca, Spain

Site Status

Psychiatric Service. University Hospital Carlos Haya

Málaga, , Spain

Site Status

Valencia University and CIBER Physiopathology of Obesity and Nutrition. Carlos III Health Institute

Valencia, , Spain

Site Status

Department of Psychiatry. Miguel Servet University Hospital

Zaragoza, , Spain

Site Status

Countries

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Spain

References

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Reference Type BACKGROUND
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Andersson G, Cuijpers P. Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cogn Behav Ther. 2009;38(4):196-205. doi: 10.1080/16506070903318960.

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Monreal-Bartolome A, Castro A, Perez-Ara MA, Gili M, Mayoral F, Hurtado MM, Varela Moreno E, Botella C, Garcia-Palacios A, Banos RM, Lopez-Del-Hoyo Y, Garcia-Campayo J, Montero-Marin J. Efficacy of a Blended Low-Intensity Internet-Delivered Psychological Program in Patients With Multimorbidity in Primary Care: Randomized Controlled Trial. J Med Internet Res. 2025 Feb 10;27:e56203. doi: 10.2196/56203.

Reference Type DERIVED
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Varela-Moreno E, Anarte-Ortiz MT, Jodar-Sanchez F, Garcia-Palacios A, Monreal-Bartolome A, Gili M, Garcia-Campayo J, Mayoral-Cleries F. Economic Evaluation of a Web Application Implemented in Primary Care for the Treatment of Depression in Patients With Type 2 Diabetes Mellitus: Multicenter Randomized Controlled Trial. JMIR Mhealth Uhealth. 2024 May 16;12:e55483. doi: 10.2196/55483.

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Monreal-Bartolome A, Barcelo-Soler A, Castro A, Perez-Ara MA, Gili M, Mayoral F, Hurtado MM, Moreno EV, Botella C, Garcia-Palacios A, Banos RM, Lopez-Del-Hoyo Y, Garcia-Campayo J. Efficacy of a blended low-intensity internet-delivered psychological programme in patients with multimorbidity in primary care: study protocol for a randomized controlled trial. BMC Psychiatry. 2019 Feb 11;19(1):66. doi: 10.1186/s12888-019-2037-3.

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Related Links

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http://www.rediapp.org/

Official website of the Spanish Research Network in Primary Care (Rediapp)

Other Identifiers

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PI16/00962

Identifier Type: -

Identifier Source: org_study_id

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