Table 2.
Post-intervention and follow-up effects of guided iCBT for rheumatic conditions: two-armed studies with a passive control condition.
| Author, year | Outcome | Outcome measurea | Significance level of between-group effects at post-treatmentb (time x group effects were reported if post-hoc between-group effects were not reported) | Post-treatment between-group effect sizes (95% confidence intervals when reported in article)c | Significance level of between-group effects at follow-upb | Follow-up between-group effect sizes (95% confidence intervals when reported in article)c |
|---|---|---|---|---|---|---|
| Friesen et al., 2017 | General psychological | ITT | Follow-up at 1 month after treatment | |||
| Depression Anxiety Self-efficacy Pain catastrophizing |
PHQ-9 GAD-7 PSEQ PRSS |
p = 0.005 (-) p = 0.124 p = 0.060 (time x group) p = 0.066 (time x group) |
d = 0.72 (0.20 to 1.24) d = 0.40 (-0.11 to 0.91) d = 0.75 (0.23 to 1.27) d = 0.73 (0.21 to 1.25) |
There was only a follow-up for the treatment group, so no between-group effects were reported. | ||
| Physical | ||||||
| Pain Fatigue |
BPI FSI |
p = 0.001 (-) p = 0.365 (time x group) |
d = 0.87 (0.34 to 1.40) d = 0.59 (0.07 to 1.10) |
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|
Impact on daily life Fibromyalgia impact |
FIQ-R p = 0.008 |
d = 0.70 (0.17 to 1.22) |
||||
| Pain impact Quality of life (physical health) Quality of life (mental health) |
BPI-pain interference SF-12 Physical SF-12 Mental |
p < 0.062 (time x group) p = 0.367 p = 0.393 (time x group) |
d = 1.00 (0.46 to 1.54) d = 0.23 (20.27 to 0.74) d = 0.07 (20.44 to 0.57) |
|||
| Ferwerda et al., 2017 | General psychological | ITT | Follow-up at 3, 6, 9 and 12 months after treatment | |||
| Depression Anxiety |
BDI IRGL |
p < 0.001 (-) p < 0.001 (-) |
d = 0.54 d = 0.48 |
For all analyses, time did not have a significant effect on the outcome. As a result, all the presented results represent group differences across all post- and follow-up assessment points. | ||
| Physical | ||||||
| Fatigue Pain |
CIS IRGL |
p = 0.06 p = 0.35 |
d = 0.24 d = 0.11 |
|||
| Impact on daily life | ||||||
| Impact on daily life | Composite score of scales of the IRGL and RAND-36 |
p = 0.09 | d = 0.18 | |||
| Lorig et al., 2008d | General psychological | IT | Follow-up at 12 months after entry to treatment | |||
| Self-efficacy | Arthritis SE scale |
p = 0.018 (+ time x group) | n.r. |
p = 0.018 (+ time x group) |
n.r. | |
| Physical | ||||||
| Pain Fatigue |
VNS VNS |
p < 0.001 (- time x group) p = 0.08 (time x group) |
n.r. n.r. |
p < 0.001 (- time x group) p = 0.08 (time x group) |
n.r. n.r. |
|
| Impact on daily life | ||||||
| n.r. | ||||||
| Shigaki et al., 2013 | General psychological | Non-ITT | Follow-up at 9 months after treatment | |||
| Depression Self-efficacy |
CES-D ASES |
p = 0.14 p < 0.001 (+) |
0.44 0.92 |
p = 0.14 p < 0.001 (+) |
0.49 0.92 |
|
| Physical | ||||||
| Pain today Impact on daily life Quality of life |
RADAR QLS |
p = 0.24 p = 0.003 (+) |
0.37 0.66 |
p = 0.58 p = 0.004 (+) |
0.19 0.71 |
|
| Simister et al., 2018 | General psychological | ITT | Follow-up at 3 months after treatment | |||
| Depression Pain catastrophizing Physical Pain Impact on daily life Fibromyalgia impact |
CES-D PCS SF-MPQ FIQ-R |
p = 0.020 (- time x group) p = 0.051 (time x group) p = 0.010 (- time x group) p < 0.001 (- time x group) |
d = 0.87 (0.34 to 1.39) d = 0.36 (-0.14 to 0.87) d = 0.84 (0.32 to 1.36) d = 1.26 (0.70 to 1.80) |
p = 0.020 (- time x group) p = 0.051 (- time x group) p = 0.010 (- time x group) p < 0.001 (- time x group) |
d = 0.56 (0.04 to 1.07) d = 0.26 (-0.24 to 0.76) d = 0.11 (-0.39 to 0.62) d = 1.59 (1.00 to 2.16) |
|
| Hedman-Lagerlöf et al., 2018 | General psychological | ITT | Follow-up at 6 months and 12 months after treatment | |||
| Depression Anxiety Physical Pain Fatigue Impact on daily life |
PHQ-9 GAD-7 FIQ-pain FSS |
p < 0.001 (- time x group) p < 0.001 (- time x group) p < 0.001 (- time x group) p < 0.001 (- time x group) |
d = 0.66 (0.32 to 1.00) d = 0.67 (0.32 to 1.01) d = 0.86 (0.51 to 1.20) d = 0.88 (0.53 to 1.22) |
No between-group effects were reported at follow-up, since the waitlist condition was crossed over to treatment then. | ||
| Fibromyalgia impact Quality of Life |
FIQ BBQ |
p < 0.001 (- time x group) p < 0.001 (+ time x group) |
d = 0.90 (0.55 to 1.24) d = 0.73 (0.38 to 1.07) |
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ASES = Arthritis Self-Efficacy Scale; BDI = Beck Depression Inventory; BPI = Brief Pain Inventory; BBQ = Brunnsviken Brief Quality of Life Scale; CIS = Checklist Individual Strength; CES-D = Center for Epidemiologic Studies Depression Scale; FIQ-R = Fibromyalgia Impact Questionnaire – Revised; FSI = Fatigue Symptom Inventory; FSS = Fatigue Severity Scale; GAD-7 = Generalized Anxiety Disorder-7; HDS = Health Distress Scale; IRGL = Invloed van Reuma op Gezondheid en Leefwijze (Effect of Rheumatic Disease on Health and Lifestyle); ITT = intent-to-treat analysis; PCS = Pain Castastrophizing Scale; PHQ-9 = Patient Health Questionnaire-9; PSEQ = Pain Self-Efficacy Questionnaire; PRSS = Pain-Related Self-statements Scale; QLS = Quality of Life Scale; RADAR = Rapid Assessment of Disease Activity in Rheumatology; SF-12 = Short Form-12; SF-MPQ = McGill Pain Questionnaire-short form; VNS = Visual Numeric Scale.
(-) = statistically significant effect indicating a reduction in the outcome for the guided iCBT condition when compared to the control condition, (+) = statistically significant effect showing an increase in the outcome for the guided iCBT condition when compared to the control condition.
n.r. = not reported.
Since the study mentioned measurements at 6 months and at 12 months, whereas the intervention duration was 6 weeks, the 6-month measurement has been considered a post-treatment measurement in this review.