Adherence to the iFightDepression® online self-help tool for depression - A pilot study

Background and purpose - The aim of the current observational study was to examine the level of adherence of Hungarian patients suffering from depression, using iFightDepression (R) (iFD (R)) guided online self-help tool with and without an extra weekly phone call support as well as identifying the predictors of adherence. Our hypotheses were: the additional weekly phone-calls would increase the adherence with the online self-help tool; furthermore, symptoms of depression will significantly decrease in the weekly phone support group. Methods - During the 6 weeks of iFD (R) intervention, patients were divided into two groups: the first, alongside of the treatment as usual (TAU) and iFD (R), received a 20-minutes weekly phone call support while the other group partook in only the TAU+iFD (R) intervention. Measures: number of completed modules and Patient Health Questionnaire-9. The study included 102 participants with diagnosis of depression (70% female, mean age: 36.9 [SD = 11.40] ys). Results - Participants completed on average 4.8 (SD = 1.73) out of 6 modules. The intervention group with additional phone support completed more modules than the group of no additional phone calls (Z = -5.416, p < 0.001, rank Cohen's d = -1.267). Participants with higher level of education completed more modules than those with lower level of education (Z = -2.198, p = 0.028, rank Cohen's d = -0.444). Baseline depressive symptoms correlated negatively with the number of completed modules (rS = -0.22, p = 0.028). Depressive symptoms were significantly reduced between the two measurement points (main effect of time: (F(1) = 179.173, p < 0.001, partial.2 = 0.642), the improvement was significantly larger in the iFD (R) + phone support group (time x group interaction: F(1) = 6.492, p = 0.012, partial.2 = 0.061). Conclusion - Weekly phone support increased treatment adherence. Negative correlation of symptom severity with adherence suggests that iFD. can be more effective in mild or moderate forms of depression. With regards to sociodemographic variables, only the level of education showed significant correlation with adherence. Our results support applicability of the iFD. intervention in various kinds of sociodemographic groups.