The aim of this study was to investigate the long-term effectiveness (3-4 years later) of an online intervention that was previously found to effectively reduce depressive symptoms in people with... Show moreThe aim of this study was to investigate the long-term effectiveness (3-4 years later) of an online intervention that was previously found to effectively reduce depressive symptoms in people with HIV on the short term. Participants were people with HIV who had participated in the large RCT on the short-term effectiveness of the guided online intervention. The primary outcome measure was depressive symptoms [Patient Health Questionnaire-9 (PHQ-9)] and the secondary outcome measure was anxiety symptoms [Generalized Anxiety Disorder-2 (GAD-2) scale]. Forty-seven participants completed the long-term follow-up. PHQ-9 scores, previously found to have been significantly reduced on the short term, remained low on the long term. GAD-2 scores did not decrease significantly on the short term, however, on the long term, a significant decrease was found. The intervention may not only be effective in lowering depressive symptoms on the short term but also retain the results on the long term. Show less
This dissertation contains the results of an RCT into the effectiveness of an online self-help intervention for people living with HIV (PLWH) and depressive symptoms. Many PLWH suffer from... Show moreThis dissertation contains the results of an RCT into the effectiveness of an online self-help intervention for people living with HIV (PLWH) and depressive symptoms. Many PLWH suffer from depressive symptoms. Online interventions to treat depression may have benefits, such as less perceived stigma, a large reach and high accessibility. The online self-help intervention that we investigated is based on cognitive behavioral therapy and contains 4 components: stimulating activities, relaxation exercises, changing negative thoughts and goal attainment. Two meta-analyses were conducted and the results point to the effectiveness of psychosocial interventions for PLWH to improve depressive symptoms, anxiety symptoms, quality of life, psychological well-being, and medication adherence. The most important result of the RCT was that the intervention together with telephone coaching is effective in reducing depressive symptoms, compared to an attention-only control group. It was also found that the intervention may be effective for all PLWH, regardless of certain baseline characteristics. Furthermore, behavioral activation and goal reengagement were found to be mediators of the intervention effect. Also, the intervention is likely to be cost-effective compared to attention only. As eHealth interventions have benefits compared to face-to-face interventions, they should be more widely implemented in the mental healthcare for PLWH. Show less
Luenen, S. van; Kraaij, V.; Garnefski, N.; Spinhoven, P.; Akker-van Marie, M.E. van den 2019
Objective: The aim of this study was to evaluate the cost-utility of a guided Internet-based intervention for people living with HIV and depressive symptoms, compared to attention only (control... Show moreObjective: The aim of this study was to evaluate the cost-utility of a guided Internet-based intervention for people living with HIV and depressive symptoms, compared to attention only (control condition). It was previously found that the intervention was effective in decreasing depressive symptoms, compared to the control group.Methods: This economic evaluation was conducted alongside a randomized controlled trial. The control group received attention only and was put on a waiting list. Quality adjusted life years were calculated over six months. The study was conducted from a societal perspective and included intervention costs, healthcare costs, and non healthcare costs. Participants completed a pretest, a post-test after two to three months, and a second post-test after six months. Cost-utility acceptability curves were constructed and two sensitivity analyses were conducted.Results: No differences between the intervention and the control group were found in quality adjusted life years and total societal costs. The results indicate that the intervention is likely to be cost-effective, compared to attention only. The findings of the sensitivity analyses point in the same direction.Conclusion: More research with larger samples is necessary to confirm the findings. The outcomes of this study may inform policy makers to decide which interventions will be included in policies. The guided Internet intervention may improve psychological care for people living with HIV and depressive symptoms, against low costs. Show less
Luenen, S. van; Garnefski, N.; Spinhoven, P.; Spaan, P.; Dusseldorp, E.; Kraaij, V. 2018
