Researchers from the Department of Preventive Medicine at Northwestern University in Chicago, IL mounted a single arm feasibility trial to examine whether an internet-based, 7-week intervention for depression (including phone support) could increase adherence rates and improvement in depression outcomes.
The intervention required frequent brief log-ins for self-monitoring and feedback as well as email and brief telephone support, guided by a theory-driven manualized protocol.
Of the 21 patients enrolled, 2 (9.5%) dropped out of treatment. Patients logged in 23.2 ± 12.2 times over the 7 weeks. Significant reductions in depression were found on all measures, including the Patient Health Questionnaire depression scale (PHQ-8) (Cohen's d = 1.96, P < .001), the Hamilton Rating Scale for Depression (d = 1.34, P < .001), and diagnosis of major depressive episode (P < .001).
In this small study, the attrition rate was far lower than seen either in Internet studies or trials of face-to-face interventions, and depression outcomes were substantial. Therefore, these findings support the feasibility of providing a multimodal e-mental health treatment to patients with depression.
Although it is premature to make any firm conclusions based on these data, they do support taking this to the next step with a randomized controlled trial examining the independent and joint effects of Internet and telephone administered treatments for depression.