Digital therapy reduces distress in long-term conditions

Digital therapy has been found to reduce anxiety and depression in people living with long-term physical health conditions in a new study by King’s College London.

The study recruited 194 patients via long-term condition charities, including Crohn’s & Colitis UK, Kidney Care UK, MS Society, Shift.ms and The Psoriasis Association in the UK. Half of the participants received the therapist-guided digital program called COMPASS and the other half did not. Both groups continued to access their usual charity support.

Those who received the COMPASS program showed a significant reduction in psychological distress (a combined score of anxiety and depression) 12 weeks after starting the study.

Overall, 89% of participants who received COMPASS showed a clinically significant improvement in distress, compared to 45% of those who did not have access to the program.

Alongside improvements in anxiety and depression, the program was also associated with improved ability to undertake daily activities, reduction in illness-specific distress and better quality of life, according to the researchers.

“Currently, the main treatments for anxiety and depression in people with long-term physical health conditions are psychotherapies, such as cognitive behavioural therapy, combined with medication. However, growing evidence shows that NHS (National Health Service) Talking Therapies services are less effective for people with long-term physical health conditions. This may be because the challenges of living with the long-term physical health condition are often not central to the treatment approach,” said Dr Federica Picariello, post-doctoral health psychology research associate at King’s Institute of Psychiatry, Psychology & Neuroscience (IoPPN) and joint first author of the study.

The study shows that COMPASS offers an effective and potentially scalable intervention for people whose long-term physical health condition is, in fact, the key driver for their anxiety and/or depression, Picariello said.

Developed with the support of the Mind and Body Programme at King’s Health Partners, COMPASS adapted standard cognitive behavioural therapy (CBT) protocols to integrate mental and physical health needs and specifically address the challenges of living with a long-term health condition.

Using interactive pathways tailored to the individual’s needs, the program helps people manage their symptoms of anxiety and depression alongside building strategies to manage stressors associated with living with a long-term condition, such as relapses or unpleasant treatments.

Senior author Professor Rona Moss-Morris, Digital Therapies theme lead at NIHR Maudsley BRC and Professor Psychology as Applied to Medicine at King’s College London, said, “Accessing psychological therapies which are tailored to the needs of people with long-term conditions is challenging for both the patient (due to time, travel and/or mobility) and healthcare providers (due to treatment costs and availability of adequately trained therapists). As a CE-marked digital therapy with minimal therapist input, COMPASS offers a potential solution to overcome some of these challenges, whilst being an effective intervention to reduce psychological distress.”

The research, published in Psychological Medicine, was part-funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre.

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