Efficacy of Internet-Delivered Cognitive Behavioural Therapy Following An Acute Coronary Event: A Randomized Controlled Trial

Abstract

Depression and anxiety are common among people who have experienced an acute coronary event (e.g., heart attack). Multidisciplinary cardiac rehabilitation programs often focus on reducing risk factors associated with future cardiac events (e.g., smoking, lipid management), however, mental health interventions are not routinely available following significant coronary events. The present study sought to explore the efficacy and acceptability of an Internet-delivered cognitive behavioural therapy program (Cardiac Wellbeing Course) for managing depression and anxiety symptoms among participants who experienced an acute coronary event. Participants were randomized to an intervention (n = 25) or waiting-list control group (n = 28). Symptoms were assessed at pre-treatment, post-treatment, and four-week follow-up, with only 12% of participants not providing follow-up data. Statistically significant within-group improvements were observed for the treatment group on primary measures of depression (d = 1.97; 61% reduction) and anxiety (d = 1.75; 67% reduction). Statistically significant improvements were also observed on secondary measures of distress (d = 1.70; 51% reduction), heartfocused anxiety (d = 1.24; 34% reduction), activity levels (d = 0.73; 70% reduction), and mental-health quality of life (d = 1.27; 24% improvement). Improvements in physical health quality of life were not statistically different between groups. The changes observed were maintained at 4-week follow-up and satisfaction rates were high among intervention participants (95%). The current findings add to the existing literature and highlight the specific potential of Internet-delivered cognitive behavioural therapy programs among participants who have experienced an acute coronary event.