Adherence to self-care interventions for depression or anxiety: A systematic review

Abstract

Objective:

The objective of this study was to synthesise and describe adherence to intervention in published studies of supported self-care for depression or anxiety, and to identify participant characteristics associated with higher adherence.

Methods:

We searched the databases EMBASE, MEDLINE, CINAHL, and PSYCINFO for the period from January 1986 until September 2010. Eligible studies reporting on adherence to supported self-care interventions for depression or anxiety symptoms were identified.

Results:

We identified 40 studies of supported self-care interventions for depression and anxiety, of which 22 (55%) reported any measure of adherence to the intervention. Among these 22 studies, 18 (82%) reported the percentage of participants completing the entire self-care tool (20%–93%; Mean = 66%, SD 17), 13 studies reported the amount of self-care tools completed by the average participant (50.6%–96.4%; Mean = 80%, SD 11.6). Four studies (18%) reported the frequency of contacts with the self-care guide. Three (14%) studies reported participant characteristics associated with adherence.

Conclusion:

Overall, reported adherence levels to supported self-care interventions for depression and anxiety indicate a significant amount of patient involvement in these interventions. Routine reporting of adherence will improve our understanding of adherence to supported self-care interventions, and will allow researchers to link adherence with intervention outcome.

Keywords

Self-care anxiety depression adherence systematic review

Get full access to this article

View all access options for this article.

References

Anderson

Lewis

Araya

Elgie

Harrison

Proudfoot

Schmidt

Sharp

Weightman

Williams

(2005) Self-help books for depression: How can practitioners and patients make the right choice? The British Journal of General Practice 55(514): 387–92.

Andersson

Bergström

Holländare

Carlbring

Kalso

Ekselius

(2005) Internet-based self-help for depression: Randomised controlled trial. The British Journal of Psychiatry 187(5): 456–61.

Andersson

Carlbring

Holmström

Sparthan

Furmark

Nilsson-Ihrfelt

Buhrman

Ekselius

(2006) Internet-based self-help with therapist feedback and in vivo group exposure for social phobia: A randomized controlled trial. Journal of Consulting and Clinical Psychology 74(4): 677–86.

Berman

Iris

Bode

Drengenberg

(2009) The effectiveness of an online mind-body intervention for older adults with chronic pain. Journal of Pain 10(1): 68–79.

Bilich

Deane

Phipps

Barisic

Gould

(2008) Effectiveness of bibliotherapy self-help for depression with varying levels of telephone helpline support. Clinical Psychology & Psychotherapy 15(2): 61–74.

Bower

Richards

Lovell

(2001) The clinical and cost-effectiveness of self-help treatments for anxiety and depressive disorders in primary care: A systematic review. The British Journal of General Practice 51(471): 838–45.

Carlbring

Bohman

Brunt

Buhrman

Westling

Ekselius

Andersson

(2006) Remote treatment of panic disorder: A randomized trial of internet-based cognitive behavior therapy supplemented with telephone calls. The American Journal of Psychiatry 163(12): 2119–25.

Carlbring

Gunnarsdottir

Hedensjo

Andersson

Ekselius

Furmark

(2007) Treatment of social phobia: Randomised trial of internet-delivered cognitive-behavioural therapy with telephone support. The British Journal of Psychiatry 190: 123–8.

Christensen

(2009) Adherence in internet interventions for anxiety and depression: Systematic review. Journal of Medical Internet Research 11(2): e13.

10.

Den Boer

Wiersma

Van den Bosch

(2004) Why is self-help neglected in the treatment of emotional disorders? A meta-analysis. Psychological Medicine 34(6): 959–71.

11.

DiMatteo

Giordani

Lepper

Croghan

(2002) Patient adherence and medical treatment outcomes: A meta-analysis. Medical Care 40(9): 794–811.

12.

DiMatteo

Haskard

Williams

(2007) Health beliefs, disease severity, and patient adherence: A meta-analysis. Medical Care 45(6): 521–8.

13.

DiMatteo

(2004) Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology 23(2): 207–18.

14.

Donkin

(2011) A systematic review of the impact of adherence on the effectiveness of e-therapies. Journal of Medical Internet Research 13(3): e52.

15.

Floyd

Scogin

McKendree-Smith

Floyd

Rokke

(2004) Cognitive therapy for depression. Behavior Modification 28(2): 297–318.

16.

Foster

Taylor

Eldridge

Ramsay

Griffiths

(2007) Self-management education programmes by lay leaders for people with chronic conditions. Cochrane Database of Systematic Reviews (4). Available at: http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD005108/frame.html (accessed 1 October 2013).

17.

Furmark

Carlbring

Hedman

Sonnenstein

Clevberger

Bohman

Eriksson

Hållén

Frykman

Holmström

Sparthan

Tillfors

Ihrfelt

Spak

Ekselius

Andersson

(2009) Guided and unguided self-help for social anxiety disorder: Randomised controlled trial. The British Journal of Psychiatry 5: 440–7.

18.

Gellatly

Bower

Hennessy

Richards

Gilbody

Lovell

(2007) What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychological Medicine 37(9): 1217–28.

19.

Gould

Clum

(1993) A meta-analysis of self-help treatment approaches. Clinical Psychology Review 13(2): 169–86.

20.

Grime

(2004) Computerized cognitive behavioural therapy at work: A randomized controlled trial in employees with recent stress-related absenteeism. Occupational Medicine 54(5): 353–9.

21.

Jamison

Scogin

(1995) The outcome of cognitive bibliotherapy with depressed adults. Journal of Consulting and Clinical Psychology 63(4): 644–50.

22.

Johnston

Foster

Shennan

Starkey

Johnson

(2010) The effectiveness of an acceptance and commitment therapy self-help intervention for chronic pain. The Clinical Journal of Pain 26(5): 393–402.

23.

Kaldo

Levin

Widarsson

Buhrman

Larsen

Andersson

(2008) Internet versus group cognitive-behavioral treatment of distress associated with tinnitus: A randomized controlled trial. Behavior Therapy 39(4): 348–59.

24.

Kazantzis

Deane

Ronan

(2004) Assessing compliance with homework assignments: Review and recommendations for clinical practice. Journal of Clinical Psychology 60(6): 627–41.

25.

Kazantzis

Deane

Ronan

(2000) Homework assignments in cognitive and behavioral therapy: A meta-analysis. Clinical Psychology: Science and Practice 7(2): 189–202.

26.

Learmonth

Trosh

Rai

Sewell

(2008) Cavanagh K. The role of computer-aided psychotherapy within an nhs cbt specialist service. Counselling and Psychotherapy Research 8(2): 117–23.

27.

Lorig

Ritter

Dost

Plant

Laurent

McNeil

(2008) The expert patients programme online, a 1-year study of an internet-based self-management programme for people with long-term conditions. Chronic Illness 4(4): 247–56.

28.

Mead

MacDonald

Bower

Lovell

Richards

Roberts

Bucknall

(2005) The clinical effectiveness of guided self-help versus waiting-list control in the management of anxiety and depression: A randomized controlled trial. Psychological Medicine 35(11): 1633–43.

29.

Montgomery

Kunik

Wilson

Stanley

Weiss

(2010) Can paraprofessionals deliver cognitive-behavioral therapy to treat anxiety and depressive symptoms? Bulletin of the Menninger Clinic 74(1): 45–62.

30.

National Collaborating Centre for Mental Health (2009) Depression: The treatment and management of depression in adults. London, UK: NHS,NICE Clinical guideline 90. Available at: http://guidance.nice.org.uk/CG90 (accessed 17 October 2013).

31.

National Collaborating Centre for Mental Health (2011) Generalised anxiety disorder and panic disorder (with or without agoraphobia) in adults. London: NHS, NICE Clinical guideline 113. Available at: http://publications.nice.org.uk/generalised-anxiety-disorder-and-panic-disorder-with-or-without-agoraphobia-in-adults-cg113/guidance (accessed 17 October 2013).

32.

Newman

Erickson

Przeworski

Dzus

(2003) Self-help and minimal-contact therapies for anxiety disorders: Is human contact necessary for therapeutic efficacy? Journal of Clinical Psychology 59(3): 251–74.

33.

Osgood-Hynes

Greist

Marks

Baer

Heneman

Wenzel

Manzo

Parkin

Spierings

Dottl

Vitse

(1998) Self-administered psychotherapy for depression using a telephone-accessed computer system plus booklets: An open U.S.-U.K. Study. The Journal of Clinical Psychiatry 59(7): 358–65.

34.

Perini

Titov

Andrews

(2009) Clinician-assisted internet-based treatment is effective for depression: Randomized controlled trial. Australian and New Zealand Journal of Psychiatry 43(6): 571–8.

35.

Robinson

Katon

Von Korff

Bush

Simon

Lin

Walker

(1997) The education of depressed primary care patients: What do patients think of interactive booklets and a video? Journal of Family Practice 44(6): 562–71.

36.

Sabate

(2003) Adherence to long-term therapies: Evidence for action. Geneva: WHO.

37.

Shapiro

Bickerstaffe

Cavanagh

(2004) Computerized cognitive-behaviour therapy for anxiety and depression: A practical solution to the shortage of trained therapists. Journal of Psychiatric and Mental Health Nursing 11(5): 508–13.

38.

Tate

Zabinski

(2004)Computer and internet applications for psychological treatment: Update for clinicians. Journal of Clinical Psychology 60(2): 209–20.

39.

Titov

Andrews

Davies

McIntyre

Robinson

Solley

(2010) Internet treatment for depression: A randomized controlled trial comparing clinician vs. Technician assistance. Public Library of Science One 5(6): e10939.

40.

van Straten

Cuijpers

Smits

(2008) Effectiveness of a web-based self-help intervention for symptoms of depression, anxiety, and stress: Randomized controlled trial. Journal of Medical Internet Research 10(1): e7.

41.

Waller

Gilbody

(2009) Barriers to the uptake of computerized cognitive behavioural therapy: A systematic review of the quantitative and qualitative evidence. Psychological Medicine 39(5): 705–12.

42.

Whitfield

Hinshelwood

Pashely

Campsie

Williams

(2006) The impact of a novel computerized cbt cd rom (overcoming depression) offered to patients referred to clinical psychology. Behavioural and Cognitive Psychotherapy 34(1): 1–11.