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Anastasiadou D, Folkvord F, Brugnera A, Cañas Vinader L, SerranoTroncoso E, Carretero Jardí C, Linares Bertolin R, Muñoz Rodríguez R, Martínez Nuñez B, Graell Berna M, Torralbas-Ortega J, Torrent-Solà L, Puntí-Vidal J, Carrera Ferrer M, Muñoz Domenjó A, Diaz Marsa M, Gunnard K, Cusido J, Arcal Cunillera J, Lupiañez-Villanueva F. An mHealth intervention for the treatment of patients with an eating disorder: A multicenter randomized controlled trial. Int J Eat Disord 2020; 53:1120-1131. [PMID: 32383503 DOI: 10.1002/eat.23286] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/21/2020] [Accepted: 04/21/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The current multicentre randomized controlled trial assessed the clinical efficacy of a combined mHealth intervention for eating disorders (EDs) based on cognitive behavioral therapy (CBT). METHOD A total of 106 ED patients from eight different public and private mental health services in Spain were randomly assigned to two parallel groups. Patients of the experimental group (N = 53) received standard face-to-face CBT plus a mobile intervention through an application called "TCApp," which provides self-monitoring and an online chat with the therapist. The control group (N = 53) received standard face-to-face CBT only. Patients completed self-report questionnaires on ED symptomatology, anxiety, depression, and quality of life, before and after treatment. RESULTS Significant reductions in primary and secondary outcomes were observed for participants of both groups, with no differences between groups. Results also suggested that the frequency with which patients attended their referral mental health institution after the intervention was lower for patients in the experimental group than for those in the control group. DISCUSSION The current study showed that CBT can help to reduce symptoms relating to ED, regardless of whether its delivery includes online components in addition to traditional face-to-face treatment. Besides, the additional component offered by the TCApp does not appear to be promising from a purely therapeutic perspective but perhaps as a cost-effective tool, reducing thus the costs and time burden associated with weekly visits to health professionals.
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Affiliation(s)
- Dimitra Anastasiadou
- Department of Information and Communication Sciences, Universitat Oberta de Catalunya, Barcelona, Spain.,Open Evidence Research Group, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Frans Folkvord
- Open Evidence Research Group, Universitat Oberta de Catalunya, Barcelona, Spain.,Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, The Netherlands
| | - Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Laura Cañas Vinader
- Child and Adolescent Psychiatry and Psychology Department, Sant Joan de Déu Hospital of Barcelona, Esplugues de Llobregat, Spain.,Children and Adolescent Mental Health Research Group, Sant Joan de Déu Research Institut, Esplugues de Llobregat, Spain
| | - Eduardo SerranoTroncoso
- Child and Adolescent Psychiatry and Psychology Department, Sant Joan de Déu Hospital of Barcelona, Esplugues de Llobregat, Spain.,Children and Adolescent Mental Health Research Group, Sant Joan de Déu Research Institut, Esplugues de Llobregat, Spain
| | | | | | - Rudiger Muñoz Rodríguez
- Child and Adolescent Psychiatry and Psychology Service, Niño Jesús University Children's Hospital, Madrid, Spain
| | - Beatriz Martínez Nuñez
- Child and Adolescent Psychiatry and Psychology Service, Niño Jesús University Children's Hospital, Madrid, Spain
| | - Montserrat Graell Berna
- Child and Adolescent Psychiatry and Psychology Service, Niño Jesús University Children's Hospital, Madrid, Spain
| | - Jordi Torralbas-Ortega
- Child and Adolescent Mental Health Service, Parc Taulí Foundation, Research and Innovation Institute Parc Taulí (I3PT) - Autonomous University of Barcelona, Sabadell, Spain
| | - Lidia Torrent-Solà
- Child and Adolescent Mental Health Service, Parc Taulí Foundation, Research and Innovation Institute Parc Taulí (I3PT) - Autonomous University of Barcelona, Sabadell, Spain
| | - Joaquim Puntí-Vidal
- Child and Adolescent Mental Health Service, Parc Taulí Foundation, Research and Innovation Institute Parc Taulí (I3PT) - Autonomous University of Barcelona, Sabadell, Spain.,Department of Clinical and Health Psychology, Autonomous University of Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Maria Carrera Ferrer
- Eating Disorders Programme IBSMIA, University Hospital Son Espases, Palma de Mallorca, Spain
| | | | - Marina Diaz Marsa
- Eating Disorders Unit, San Carlos University Hospital, Madrid, Spain
| | - Katarina Gunnard
- Eating Disorders Unit, Quirón Dexeus University Hospital, Barcelona, Spain
| | - Jordi Cusido
- Board Member, HealthApp SL, Sabadell, Spain.,Department of Engineering Projects, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Jordina Arcal Cunillera
- Board Member, HealthApp SL, Sabadell, Spain.,Department of Engineering Projects, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Francisco Lupiañez-Villanueva
- Department of Information and Communication Sciences, Universitat Oberta de Catalunya, Barcelona, Spain.,Open Evidence Research Group, Universitat Oberta de Catalunya, Barcelona, Spain
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Ruiz-Rodríguez P, Cano-Vindel A, Muñoz-Navarro R, Wood CM, Medrano LA, Moretti LS. Cost-Effectiveness and Cost-Utility Analysis of the Treatment of Emotional Disorders in Primary Care: PsicAP Clinical Trial. Description of the Sub-study Design. Front Psychol 2018; 9:281. [PMID: 29559944 PMCID: PMC5845711 DOI: 10.3389/fpsyg.2018.00281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 02/19/2018] [Indexed: 01/06/2023] Open
Abstract
Introduction: In the primary care (PC) setting in Spain, the prevalence of emotional disorders (EDs) such as anxiety, depression and somatoform disorder is high. In PC patients, these disorders are not always managed in accordance with the recommendations provided by clinical practice guidelines, resulting in major direct and indirect economic costs and suboptimal treatment outcomes. The aim is to analyze and compare the cost-effectiveness and cost-utility of group-based psychological therapy versus treatment as usual (TAU). Methods: Multicenter, randomized controlled trial involving 300 patients recruited from PC centers in Madrid, Spain, with symptoms or possible diagnosis of anxiety, mood (mild or moderate), or somatoform disorders. Patients will be randomized to one of two groups: an experimental group, which will receive group-based transdiagnostic cognitive-behavioral therapy (TD-CBT); and a control group, which will receive TAU (mainly pharmacological interventions) prescribed by their general practitioner (GP). Clinical assessment will be performed with the Patient Health Questionnaire (PHQ). Direct and indirect costs will be calculated and relevant socio-demographic variables will be registered. The Spanish version of the EuroQol 5D-5L will be administered. Patients will be assessed at baseline, immediately after treatment finalization, and at 6 and 12 months post-treatment. Discussion: To our knowledge, this is the first study to compare TD-CBT to TAU in the PC setting in Spain. This is the first comparative economic evaluation of these two treatment approaches in PC. The strength of the study is that it is a multicenter, randomized, controlled trial of psychotherapy and TAU for EDs in PC. Trial registration: Protocol code: ISCRCTN58437086; 20/05/2013. EUDRACT: 2013-001955-11. Protocol Version: 6, 11/01/2014.
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Affiliation(s)
| | - Antonio Cano-Vindel
- Department of Basic Psychology II (Cognitive Processes), Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Roger Muñoz-Navarro
- Department of Basic Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Cristina M Wood
- Department of Basic Psychology II (Cognitive Processes), Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Leonardo A Medrano
- Department of Psychological Assessment, Universidad Siglo 21, Córdoba, Argentina
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