Period: 2006-2010
Funding: Dutch Diabetes research Foundation
Contact person: K. van Bastelaar
Trial registration: Current Controlled Trials ISRCTN24874457
Publications: www.ncbi.nlm.nih.gov/pubmed/
Depression is common among people with diabetes, negatively affecting quality of life, treatment adherence and diabetes outcomes. In routine clinical care, diabetes patients are not offered specialized mental health services. Depression therefore often remains untreated. Web-based therapy could potentially be an effective way to improve the reach of psychological care for diabetes patients, at relatively low costs. This study seeks to test the effectiveness of a web-based self-help depression program for people with diabetes and co-morbid depression.
The effectiveness of a moderated web-based 8-week self-help course for adults with diabetes with co-morbid depression is tested in a randomised trial, using a wait-list controlled design. The intervention is a self-help course tailored to the needs of persons living with diabetes and is offered on an individual basis, with homework assignments and a moderated forum. We aim to include 286 patients (143/143), as power analyses showed that this number is needed to detect an effect size of 0.35, with measurements at baseline, directly after completing the web-based intervention and at 1, 3, 4 and 6 months follow-up. Patients in the control condition are placed on a waiting list, and follow the course 12 weeks after the experimental group.
Primary outcomes are depressive symptoms and diabetes-specific emotional distress. Secondary outcomes are satisfaction with the course, perceived health status, self-care behaviours, glycaemic control, and days in bed/absence from work. Questionnaires are administered via the Internet.
The intervention is expected to help improve mood and reduce diabetes-specific emotional distress in diabetes patients with depression, with subsequent beneficial effects on diabetes self-care and glycaemic outcomes. When proven efficacious, the intervention could be disseminated to reach large groups of patients with diabetes and concurrent depressive symptoms.