Feasibility of implementing mobile technology-delivered mental health treatment in routine adult sickle cell disease care

• Main Authors: De Castro, L. (Author), Jonassaint, C.R (Author), Kang, C. (Author), Prussien, K.V (Author), Sanger, M.S (Author), Sarkar, U. (Author), Shah, N. (Author), Wilson, J.D (Author), Yarboi, J. (Author)
• Format: Article
• Language: English
• Published: Oxford University Press 2018
• Subjects: adult; Adult; aged; Anemia, Sickle Cell; anxiety assessment; anxiety disorder; Anxiety Disorders; Article; behavior change; Cognitive behavioral therapy; complication; depression; Depression; ecological momentary assessment; Feasibility Studies; feasibility study; female; generalized anxiety disorder scale; health care utilization; Health information technology; human; Humans; life expectancy; major clinical study; male; mental health; Mental health; Mental Health; mental health care; mood disorder; pain assessment; pain intensity; Patient Health Questionnaire 9; patient-reported outcome; priority journal; sickle cell anemia; Sickle cell disease; technology; Technology
• Online Access: View Fulltext in Publisher

 Sickle cell disease (SCD) is a severe hemoglobinopathy characterized by acute and chronic pain. Sufferers of the disease, most of whom are underrepresented minorities, are at increased risk for mental health disorders. The purpose of this study is to test the acceptability and implementation of a computerized cognitive behavioral therapy (cCBT) intervention, Beating the Blues, to improve depression, anxiety, and pain in patients with SCD. Adults with SCD and significant symptoms of depression (Patient Health Questionnaire [PHQ-9] score ≥ 10) or anxiety (Generalized Anxiety Disorder Scale [GAD-7] score ≥ 10) were eligible to participate and be randomized to either receive eight sessions of cCBT with care coach support or treatment as usual. Participants reported daily pain and mood symptoms using a mobile diary app. Depression, anxiety, and pain symptoms were assessed at 1, 3, and 6 months. Thirty patients were enrolled: 18 to cCBT, and 12 to control. The cCBT intervention was feasible to implement in clinical settings and acceptable to participants. Patients in the cCBT arm reported a marginally greater decrease in depression at 6 months (-3.82, SE = 1.30) than those in the control group (-0.50, SE = 1.60; p =. 06). There were no significant effects of treatment on anxiety; however, cCBT was associated with improved daily pain reported via a mobile diary app (p =. 014). cCBT, delivered via mobile device, is a feasible strategy to provide mental health care to adults living with SCD. cCBT was acceptable to the target population; was able to be implemented in real-world, nonideal conditions; and has the potential to improve patient-reported outcomes. © 2018 Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: [e-mail].