Instant Message-delivered Brief Internet-based Cognitive Behavioural Therapy (iCBT) for Post-stroke Depression: a Mixed Method Study

Status: Recruiting
Location: See all (7) locations...
Intervention Type: Other
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Around one third of stroke survivors develop depression at any point of time following the stroke event. Post-stroke depression (PSD) is associated with negative care outcomes including poorer function, longer hospital stays, increased outpatient and inpatient clinic use, and higher mortality rate. In Hong Kong (HK), the prevalence of PSD within the hospital setting was 36%, and up to 68% in the community setting. However, PSD is seldom addressed in either settings in HK and elsewhere. Meta-analyses reported the effectiveness of Internet-based cognitive behavioural therapy (iCBT), particularly when guided by therapists (d = 0.63). Personalised and synchronous instant message-based intervention guided by therapists is an emerging form of psychological intervention. While such intervention showed medium to large effect (Hedges' g = 0.73) on negative psychological distress episodes including depression, no study has investigated its effect on PSD. The proposed study aims to 1) investigate the effect of therapist-guided brief iCBT delivery through instant messaging applications (e.g. WhatsApp and WeChat) to provide personalised and synchronous PSD support and 2) understand the experience of and compliance with the intervention. 160 community-dwelling stroke survivors with Patient Health Questionnaire-9 (PHQ-9) scores ranging from 5 to 19 indicating mild to moderate depressive symptoms will be recruited and then individually randomised into the Intervention group (n=80) or Control group (n=80). Intervention group will receive 1) instant message-delivered brief iCBT for 3 months at participants' chosen times and frequencies, and 2) therapist-led text or voice message-based PSD support to enhance the effects of iCBT through real-time counselling and practical advice. Control group will only receive messages on general mental health information and reminders to participate in follow-up surveys. The primary outcome is PHQ-9 score at 6 months. Secondary outcomes will include anxiety (GAD-7), perceived stress (PSS-4), loneliness (ULS-8), and quality of life (EQ-5D-5L) at 6 months. The study will strictly follow the CONSORT-EHEALTH checklist. Post-trial qualitative study will be conducted to understand the participants' experience of and compliance with the intervention (n≈20) respectively. This study will provide the first and practical evidence on the effectiveness of instant message-delivered brief iCBT intervention in addressing PSD in HK and beyond.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Diagnosis of stroke (ICD-10 codes: I60-I69);

• Aged ≥18;

• Able to read and communicate in Chinese (Cantonese or Putonghua);

• Able to use the text or voice messaging function on smartphone;

• MoCA 5-minute Protocol (cognitive screen) ≥14;

• Community-dwelling

• Less than 1 year after stroke event;

• PHQ-9 (depressive symptom) score ranging from 5 to 19 (note. mild: 5-9, moderate: 10-14, moderately severe: 15-19 and severe: 20-27)

Locations
Other Locations
Hong Kong Special Administrative Region
Hong Kong PHAB Association
RECRUITING
Hong Kong
Hong Kong Stroke Association
RECRUITING
Hong Kong
NT West Community Rehabilitation Day Centre
NOT_YET_RECRUITING
Hong Kong
Queen Mary Hospital
RECRUITING
Hong Kong
The Hong Kong Society for Rehabilitation
RECRUITING
Hong Kong
Tung Wah Hospital
RECRUITING
Hong Kong
United Christian Hospital
RECRUITING
Hong Kong
Contact Information
Primary
Jung Jae LEE
leejay@hku.hk
+85239176971
Time Frame
Start Date: 2023-05-01
Estimated Completion Date: 2025-06
Participants
Target number of participants: 160
Treatments
Experimental: Intervention group
Receive iCBT based EMI with message content, delivery frequency and timing personalised to participants' preferences.
No_intervention: Control group
Receive general mental health information through instant message.
Related Therapeutic Areas
Sponsors
Leads: The University of Hong Kong

This content was sourced from clinicaltrials.gov