Just returned from a fantastic Rural Clinical School conference in Busselton over the weekend.
Great to see so many people passionate about the potential for #FOAM in the rural and remote setting. I really believe the online space will provide great educational opportunities for everybody to share and learn form a cross section of healthcare professionals and their work on the global stage.
Unfortunately we were not able to see Prof Gavin Andrews in person at the conference – but through the power of technology had the opportunity to review his excellent work on iCBT (internet cognitive behaviour therapy) for depression. His talk is well worth watching!
Patients were prescribed an iCBT program by primary care clinicians showed that suicidal ideation dropped from 54% to 30% after the six-lesson online course, regardless of sex and age.
BMJ Open 2012 [Full Text]
Objectives To examine reductions in suicidal ideation among a sample of patients who were prescribed an internet cognitive behavior therapy (iCBT) course for depression.
Design Effectiveness study within a quality assurance framework.
Setting Primary care.
Participants 299 patients who were prescribed an iCBT course for depression by primary care clinicians.
Intervention Six lesson, fully automated cognitive behaviour therapy course delivered over the internet. Primary outcome: suicidal ideation as measured by question 9 on the Patient Health Questionnaire (PHQ-9).
Results Suicidal ideation was common (54%) among primary care patients prescribed iCBT treatment for depression but dropped to 30% post-treatment despite minimal clinician contact and the absence of an intervention focused on suicidal ideation. This reduction in suicidal ideation was evident regardless of sex and age.
Conclusions The findings do not support the exclusion of patients with significant suicidal ideation.
About Mike Cadogan
That’s awesome outcome measures for such a simple intervention. Of course, the issue remains access to CBT which is why web-based services can be so darn good in rural areas
Thanks Mike for your generous comments. I was really sorry not to be in Busselton but I woke at 2am that morning with the front end of the flu -febrile etc -- and thought it wise to say in sydney in bed. Isn’t it amazing that we could find the video and that the conference could use it.
Rural and remote docs are twice as likely to be registered to prescribe thiswayp courses as city docs. Great!