Elison Sarah, Ward Jonathan, Williams Chris, Espie Colin, Davies Glyn, Dugdale Stephanie, Ragan Kathryn, Chisnall Leanne, Lidbetter Nicky, Smith Keith
Breaking Free Group, Manchester, UK.
Institute of Health and Wellbeing, University of Glasgow, UK.
BMJ Open. 2017 Jul 20;7(7):e016392. doi: 10.1136/bmjopen-2017-016392.
There is increasing evidence to support the effectiveness of eTherapies for mental health, although limited data have been reported from community-based services. Therefore, this service evaluation reports on feasibility and outcomes from an eTherapy mental health service.
'Self Help Services', an Increasing Access to Psychological Therapies (IAPT) eTherapy service in Greater Manchester.
1068 service users referred to the service for secondary care for their mental health difficulties.
Participants were triaged into one of three eTherapy programmes: 'Living Life to the Full Interactive' for low mood, stress and anxiety; 'Sleepio' for insomnia; and 'Breaking Free Online' for substance misuse, depending on clinical need.
Standardised psychometric assessments of depression, anxiety and social functioning, collected as part of the IAPT Minimum Data Set, were conducted at baseline and post-treatment.
Data indicated baseline differences, with the Breaking Free Online group having higher scores for depression and anxiety than the Living Life to the Full Interactive (depression CI 1.27 to 3.21, p<0.0001; anxiety CI 077 to 1.72, p<0.0001) and Sleepio (depression CI 1.19 to 4.52, p<0.0001; anxiety CI 2.16 to 5.23, p<0.0001) groups. Promising improvements in mental health scores were found within all three groups (all p<0.0001), as were significant reductions in numbers of service users reaching clinical threshold scores for mental health difficulties (p<0.0001). Number of days of engagement was not related to change from baseline for the Living Life to the Full or Sleepio programmes but was associated with degree of change for Breaking Free Online.
Data presented provide evidence for feasibility of this eTherapy delivery model in supporting service users with a range of mental health difficulties and suggest that eTherapies may be a useful addition to treatment offering in community-based services.
越来越多的证据支持电子疗法对心理健康的有效性，尽管来自社区服务的数据有限。因此，本服务评估报告了一项电子疗法心理健康服务的可行性和结果。
“自助服务”，大曼彻斯特地区一项增加心理治疗可及性（IAPT）的电子疗法服务。
1068名因心理健康问题被转介至该服务接受二级护理的服务使用者。
根据临床需求，参与者被分为三个电子疗法项目之一：针对情绪低落、压力和焦虑的“充分生活互动版”；针对失眠的“睡眠改善计划”；针对药物滥用的“在线摆脱计划”。
作为IAPT最小数据集的一部分，在基线和治疗后进行抑郁、焦虑和社会功能的标准化心理测量评估。
数据显示了基线差异，“在线摆脱计划”组的抑郁和焦虑得分高于“充分生活互动版”组（抑郁：可信区间1.27至3.21，p<0.0001；焦虑：可信区间0.77至1.72，p<0.0001）和“睡眠改善计划”组（抑郁：可信区间1.19至4.52，p<0.0001；焦虑：可信区间2.16至5.23，p<0.0001）。在所有三个组中均发现心理健康得分有显著改善（均p<0.0001），达到心理健康问题临床阈值分数的服务使用者数量也显著减少（p<0.0001）。参与天数与“充分生活计划”或“睡眠改善计划”从基线的变化无关，但与“在线摆脱计划”的变化程度相关。
所呈现的数据为这种电子疗法提供模式在支持有一系列心理健康问题的服务使用者方面的可行性提供了证据，并表明电子疗法可能是社区服务治疗方案中的有益补充。
