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eHealth cognitieve gedragstherapie voor patiënten met chronische somatische aandoeningen

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Tijdschrift voor gezondheidswetenschappen Aims and scope

Samenvatting

Veel patiënten met chronische somatische aandoeningen ervaren op zowel lichamelijk als psychologisch gebied beperkingen in het dagelijks leven. Een manier om patiënten hierbij te ondersteunen is het aanbieden van online zorgprogramma’s op basis van cognitieve gedragstherapie (eHealth cognitieve gedragstherapie; eCGt). Hoewel uit eerder onderzoek al is gebleken dat eCGt effectief kan zijn bij het verminderen van bijvoorbeeld depressieve klachten in het algemeen, loopt het onderzoek bij patiënten met chronische somatische aandoeningen daarbij nog wat achter. In de laatste jaren is er echter een toenemend aantal studies verschenen die de effectiviteit van eCGt bij diverse chronische somatische aandoeningen hebben onderzocht. Om de overkoepelende resultaten van deze studies te kunnen evalueren is er een meta-analyse uitgevoerd, waarvan de resultaten in dit artikel worden besproken. Hieruit blijkt dat eCGt ook bij chronische somatische aandoeningen effectief is, met kleine tot middelgrote effecten. Grote effecten werden soms gevonden bij ziektespecifieke klachten zoals symptomen van de aandoening en ziektespecifieke kwaliteit van leven. Ook werd gevonden dat een langere behandelduur enigszins samenhing met een grotere afname van depressieve klachten. In aanvulling op de resultaten van de meta-analyse wordt in dit artikel een overzicht gegeven van de recente literatuur over enkele klinisch relevante eCGt onderwerpen: kosteneffectiviteit, begeleiding versus zelfhulp, de rol van behandelduur, en optimaal ontwerp en implementatie van interventies.

Abstract

Internet-based cognitive behavioral therapy for patients with chronic somatic conditions

Many patients with chronic somatic conditions regularly experience impairments in physical and psychological functioning in their daily life. A way to support these patients is to offer online programs based on cognitive behavioral therapy (Internet-based cognitive behavioral therapy; ICBT). Although a substantial evidence base already exists regarding the effectiveness of ICBT in treating, for example, depressive symptoms, research on ICBT for chronic somatic conditions is still upcoming. In recent years, a growing number of randomized controlled trials were published that examined the effectiveness of ICBT in various chronic somatic conditions. To systematically and quantitatively evaluate the results of these studies, a metaanalysis was conducted, the results of which are discussed in this article. Results indicated that ICBT is also overall effective for chronic somatic conditions, with small to moderate effect sizes. Larger effects were occasionally found for disease-specific outcomes such as disease symptoms and disease-specific quality of life. A longer treatment duration was found to be marginally related to a larger decrease in depressive symptoms. In addition to the results of the meta-analysis, this article provides an overview of the recent literature regarding several clinically relevant ICBT topics: cost-effectiveness, guided ICBT interventions versus self-help, the role of treatment duration, and optimal design and implementation of eHealth interventions.

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Notes

  1. De gerapporteerde resultaten in dit artikel zijn in sterke mate gebaseerd op een eerder verschenen publicatie van deze onderzoeksgroep.28

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Authors and Affiliations

  1. Instituut Psychologie, Sectie Gezondheids-, Medische en Neuropsychologie, Faculteit der Sociale Wetenschappen, Universiteit Leiden, 9555, 2300, Leiden, RB, The Netherlands

    S. van Beugen, H. van Middendorp, R. van der Vaart, M. Ferwerda & A.W.M. Evers

  2. afdeling Medische Psychologie, Radboud universitair medisch centrum, Nijmegen, The Netherlands

    S. van Beugen, H. van Middendorp, M. Ferwerda & A.W.M. Evers

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  1. S. van Beugen
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  2. H. van Middendorp
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Mw. drs. S. van Beugen, Sectie Gezondheids-, Medische en Neuropsychologie, Instituut Psychologie, Faculteit der Sociale Wetenschappen, Universiteit Leiden, Postbus 9555, 2300 RB Leiden, tel. 071-5274047, e-mail: s.van.beugen@fsw.leidenuniv.nl

b Deze studie is mede gesubsidieerd door een research grant (WS682746) van Pfizer Inc.

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van Beugen, S., van Middendorp, H., van der Vaart, R. et al. eHealth cognitieve gedragstherapie voor patiënten met chronische somatische aandoeningen. Tijds. gezondheids.wetenschappen 93, 68–76 (2015). https://doi.org/10.1007/s12508-015-0030-x

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