Internet-based treatment of depression and anxiety in patients with ischemic heart disease (eMindYourHeart)
The eMindYourHeart will develop and examine the efficacy of a therapy-assisted internet-based intervention targeting depression and anxiety. The intervention will be integrated with current and standard cardiac rehabilitation (CR) for patients with ischemic heart disease (IHD) with co-morbid depression and anxiety. Currently, the CR rehabilitation setting has nothing to offer to patients who screen positive for depression and anxiety. Given that the number of patients with IHD has increased exponentially, and both IHD and depression will be among the top contributors to the disease-burden worldwide in 2020, it is essential to bridge this gap and treat heart and mind together.
The national clinical guideline for cardiac rehabilitation from the National Board of Health recommends that patients with ischemic heart disease are screened for depression and anxiety and offered treatment if the screening is positive. As the rehabilitation setting cannot offer treatment for depression and anxiety, patients are referred to their general practitioner. We do not know what happens to patients after referral and if patients receive appropriate treatment for their symptoms. Hence, it seems timely to investigate what happens to patients after referral and to evaluate the effect of an integrated treatment program for depression and anxiety as part of standard cardiac rehabilitation.
Use of internet-based treatment for patients with depression and anxiety has a large potential. There is evidence that internet-based treatment is as effective as face-to-face-treatment. Internet-based treatment is often offered as a structured online program that is supported by a therapist. The advantage of this approach is that patients can engage in treatment from home and at a time that suit them.
Purpose of the study
The project will use a mixed-methods design and will:
(1) Investigate via a register-based study, what happens to patients with ischemic heart disease who screen positive for depression and/or anxiety in the cardiac rehabilitation setting and are referred to their general practitioner;
(2) Develop a therapist-assisted online treatment program for patients referred for cardiac rehabilitation with ischemic heart disease and comorbid depression and/or anxiety by means of a participatory design and the involvement of patients;
(3) In a feasibility study, examine whether patients are satisfied with the online psychological treatment program, whether they complete the program, and if procedures with respect to recruitment and the intervention are appropriate with respect to later implementation;
(4) In a randomized controlled trial, evaluate if the online psychological treatment program integrated with standard cardiac rehabilitation is more effective than standard rehabilitation alone with respect to reducing symptoms of depression and anxiety.
Description of the cohort
Patients with ischemic heart disease referred for cardiac rehabilitation and screening positive for depression, anxiety or both.
Data and biological material
Questionnaire data (e.g. depression, anxiety, illness perceptions, quality of life etc.) and clinical data and outcomes.
Collaborating researchers and departments
Department of Psychology, University of Sounthern Denmark
- Professor Susanne S. Pedersen, PhD, Cand.Psych.
- Dr. Christina Maar Andersen, PhD, Cand.Psych.
- Dr. Robin Kok, PhD
Danish Knowledge Center for Rehabilitation and Palliative Care (REHPA), SDU and OUH:
- Professor Ann-Dorthe Zwisler, MD, PhD
Maersk Mc-Kinney Moller Institute, SDU:
- Professor Uffe Kock Wiil, PhD
- Dr. Thomas Schmidt, PhD
DaCHE - Danish Centre for Health Economics, Department of Public Health, SDU:
Department of Clinical Medicine, Aarhus University Hospital:
- Dr. Lisbeth Frostholm, PhD, Cand.Psych.