Web-based distress management for implantable cardioverter defibrillator patients: a randomized controlled trial
Open accessAbstract
OBJECTIVE: Sudden cardiac arrest caused by cardiac arrhythmias is 1 of the leading causes of death worldwide. Implantable cardioverter defibrillators (ICDs) are considered as standard care for patients with increased risk of arrhythmias. However, 1 in 4 ICD patients experiences psychological distress post-ICD implantation. The WEB-based distress management program for ICD patients (WEBCARE) was developed to mitigate anxiety and depression and enhance health-related quality of life in ICD patients. This study investigates the 6- and 12-months outcomes. METHOD: A total of 289 consecutive ICD patients from 6 referral hospitals in the Netherlands were randomized to either the WEBCARE (n = 146) or usual care (n = 143) group. Patients in the WEBCARE group received an online, 12-weeks fixed, 6 lesson behavioral treatment based on problem solving therapy. Patients in the usual care group receive care as usual. RESULTS: Current findings show no significant difference on anxiety, depression or quality of life between the WEBCARE and Usual Care group at 6- and 12-months postimplantation. CONCLUSIONS: In this clinical trial of a Web-based behavioral intervention for ICD patients, the Web-based treatment was not superior to usual care on the long-term regarding patient reported outcomes. Future studies are warranted to examine the applicability of blended-care models and focus on further personalizing the program in order to increase adherence and improve outcomes. (PsycINFO Database Record
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The ICD-FORUM trial included only patients with distress, whereas ACQUIRE-ICD and WEBCARE targeted a broad scope of ICD patients, regardless of pre-intervention distress.
“Whereas the ICD-FORUM trial included only patients with distress, ACQUIRE-ICD and WEBCARE targeted a broad scope of ICD patients, regardless of pre-intervention distress.”
The absence of intervention effects on anxiety and depression mimics the results from the WEBCARE trial, but not from the ICD-FORUM trial, which found that a web-based intervention reduced anxiety and depression symptoms at 1 year follow-up compared with usual care.
“The absence of intervention effects on anxiety and depression levels mimics the results from the WEBCARE trial,26 but not from the ICD-FORUM trial,25 which found that a web-based intervention reduced anxiety and depression symptoms at 1 year follow-up compared with usual care.”
The null finding for the primary endpoint is in line with results from other RCTs of web-based interventions in ICD patients that also found neutral primary endpoints.
“this finding is in line with the results from other RCTs of web-based interventions in ICD patients that also found neutral primary endpoints albeit on anxiety and a composite outcome of psychosocial well-being, respectively.25,26”
Intervention trials targeting symptoms of depression and anxiety in the ICD population have largely used cognitive behavioral therapy, relaxation and mindfulness techniques, supplemented with telephone support, education and exercise, and online therapies, as single, one-time interventions.
“Intervention trials targeting symptoms of depression and anxiety in the ICD population have largely used cognitive behavioral therapy, relaxation and mindfulness techniques, supplemented with telephone support, education and exercise, and online therapies, as single, one-time interventions [25, 26].”
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“The absence of intervention effects on anxiety and depression levels mimics the results from the WEBCARE trial, 26 but not from the ICD-FORUM trial, 25 which found that a web-based intervention reduced anxiety and depression symptoms at 1 year follow-up compared with usual care.”
ResultSelf-citation
- Authors
- Habibović, M., Denollet, J., Cuijpers, P., van der Voort, P. H., Herrman, J.-P., Bouwels, L., Valk, S. D. A., Alings, M., Theuns, D. A. M. J., & Pedersen, S. S.
- Affiliations
- Vrije Universiteit Amsterdam (NL)
- OLVG (NL)
- Canisius-Wilhelmina Ziekenhuis (NL)
- Franciscus Vlietland (NL)
- Amphia Ziekenhuis (NL)
- Erasmus MC (NL)
- University of Southern Denmark (DK)
- ORCID
- Venue
- Health Psychology
- Published
- 2017-04
- Volume
- 36
- Issue
- 4
- Pages
- 392-401
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- OpenAlex
- W2579337029
- Cited by
- 26
- References
- 45
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 6 · 2018: 2 · 2017: 3
- FWCI
- 4.06
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- Health Psychology (publishedVersion)
- Research portal (Tilburg University) (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- VU Research Portal (submittedVersion, other-oa)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- Netherlands Organization for Health Research and Development (300020002; 91710393)
- Dutch Heart Foundation
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- implantable cardioverter-defibrillator, psychological distress, online intervention, problem-solving therapy, anxiety, depression, health-related quality of life, sudden cardiac arrest, behavior therapy, long-term outcomes, blended care
- MeSH terms
- Aged, Anxiety, Arrhythmias, Cardiac, Behavior Therapy, Depression, Female, Humans, Male, Middle Aged, Netherlands, Patient Education as Topic, Quality of Life, Defibrillators, Implantable, Internet
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