Do sociodemographic variables moderate effects of an internet intervention for mild to moderate depressive symptoms? An exploratory analysis of a randomised controlled trial (EVIDENT) including 1013 participants

TY - JOUR

T1 - Do sociodemographic variables moderate effects of an internet intervention for mild to moderate depressive symptoms? An exploratory analysis of a randomised controlled trial (EVIDENT) including 1013 participants

AU - Nolte, Sandra

AU - Busija, Ljoudmila

AU - Berger, Thomas

AU - Meyer, Björn

AU - Moritz, Steffen

AU - Rose, Matthias

AU - Schröder, Johanna

AU - Späth-Nellissen, Christina

AU - Klein, Jan Philipp

N1 - © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2021/1/26

Y1 - 2021/1/26

N2 - OBJECTIVE: To explore the moderating effects of sociodemographic variables on treatment benefits received from participating in an internet intervention for depression.DESIGN: Randomised, assessor-blind, controlled trial.SETTING: Online intervention, with participant recruitment using multiple settings, including inpatient and outpatient medical and psychological clinics, depression online forums, health insurance companies and the media (eg, newspaper, radio).PARTICIPANTS: The EVIDENT trial included 1013 participants with mild to moderate depressive symptoms.INTERVENTIONS: The intervention group subjects (n=509) received an online intervention (Deprexis) in addition to care as usual (CAU), while 504 participants received CAU alone.METHODS: To explore subgroup differences, moderating effects were investigated using linear regression models based on intention-to-treat analyses. Moderating effects included sex, age, educational attainment, employment status, relationship status and lifetime frequency of episodes.PRIMARY AND SECONDARY OUTCOME MEASURES: The primary endpoint was change in self-rated depression severity measured by the Patient Health Questionnaire-9 (PHQ-9), comparing baseline versus 12-week post-test assessment. Secondary outcome measures were the Hamilton Rating Scale for Depression and the Quick Inventory of Depressive Symptoms each at 12 weeks and at 6 and 12 months, and PHQ-9 at 6 and 12 months, respectively. In this article, we focus on the primary outcome measure only.RESULTS: Between-group differences were observed in post-test scores, indicating the effectiveness of Deprexis. While the effects of the intervention could be demonstrated across all subgroups, some showed larger between-group differences than others. However, after exploring the moderating effects based on linear regression models, none of the selected variables was found to be moderating treatment outcomes.CONCLUSIONS: Our findings suggest that Deprexis is equally beneficial to a wide range of people; that is, participant characteristics were not associated with treatment benefits. Therefore, participant recruitment into web-based psychotherapeutic interventions should be broad, while special attention may be paid to those currently under-represented in these interventions.TRIAL REGISTRATION NUMBER: NCT01636752.

AB - OBJECTIVE: To explore the moderating effects of sociodemographic variables on treatment benefits received from participating in an internet intervention for depression.DESIGN: Randomised, assessor-blind, controlled trial.SETTING: Online intervention, with participant recruitment using multiple settings, including inpatient and outpatient medical and psychological clinics, depression online forums, health insurance companies and the media (eg, newspaper, radio).PARTICIPANTS: The EVIDENT trial included 1013 participants with mild to moderate depressive symptoms.INTERVENTIONS: The intervention group subjects (n=509) received an online intervention (Deprexis) in addition to care as usual (CAU), while 504 participants received CAU alone.METHODS: To explore subgroup differences, moderating effects were investigated using linear regression models based on intention-to-treat analyses. Moderating effects included sex, age, educational attainment, employment status, relationship status and lifetime frequency of episodes.PRIMARY AND SECONDARY OUTCOME MEASURES: The primary endpoint was change in self-rated depression severity measured by the Patient Health Questionnaire-9 (PHQ-9), comparing baseline versus 12-week post-test assessment. Secondary outcome measures were the Hamilton Rating Scale for Depression and the Quick Inventory of Depressive Symptoms each at 12 weeks and at 6 and 12 months, and PHQ-9 at 6 and 12 months, respectively. In this article, we focus on the primary outcome measure only.RESULTS: Between-group differences were observed in post-test scores, indicating the effectiveness of Deprexis. While the effects of the intervention could be demonstrated across all subgroups, some showed larger between-group differences than others. However, after exploring the moderating effects based on linear regression models, none of the selected variables was found to be moderating treatment outcomes.CONCLUSIONS: Our findings suggest that Deprexis is equally beneficial to a wide range of people; that is, participant characteristics were not associated with treatment benefits. Therefore, participant recruitment into web-based psychotherapeutic interventions should be broad, while special attention may be paid to those currently under-represented in these interventions.TRIAL REGISTRATION NUMBER: NCT01636752.

U2 - 10.1136/bmjopen-2020-041389

DO - 10.1136/bmjopen-2020-041389

M3 - SCORING: Journal article

C2 - 33500282

VL - 11

SP - e041389

JO - BMJ OPEN

JF - BMJ OPEN

SN - 2044-6055

IS - 1

ER -