Telemedicine Cognitive Behavioral Therapy for Anxiety After Stroke: Proof-of-Concept Randomized Controlled Trial

Ho-Yan Yvonne Chun; Alan J Carson; Athanasios Tsanas; Martin S Dennis; Gillian E Mead; Clementina Calabria; William N Whiteley

doi:10.1161/STROKEAHA.120.029042

Telemedicine Cognitive Behavioral Therapy for Anxiety After Stroke: Proof-of-Concept Randomized Controlled Trial

Ho-Yan Yvonne Chun, Alan J Carson, Athanasios Tsanas, Martin S Dennis, Gillian E Mead, Clementina Calabria, William N Whiteley

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND AND PURPOSE: Disabling anxiety affects a quarter of stroke survivors but access to treatment is poor. We developed a telemedicine model for delivering guided self-help cognitive behavioral therapy (CBT) for anxiety after stroke (TASK-CBT). We aimed to evaluate the feasibility of TASK-CBT in a randomized controlled trial workflow that enabled all trial procedures to be carried out remotely. In addition, we explored the feasibility of wrist-worn actigraphy sensor as a way of measuring objective outcomes in this clinical trial.

METHODS: We recruited adult community-based stroke patients (n=27) and randomly allocated them to TASK-CBT (n=14) or relaxation therapy (TASK-Relax), an active comparator (n=13).

RESULTS: In our sample (mean age 65 [±10]; 56% men; 63% stroke, 37% transient ischemic attacks), remote self-enrolment, electronic signature, intervention delivery, and automated follow-up were feasible. All participants completed all TASK-CBT sessions (14/14). Lower levels of anxiety were observed in TASK-CBT when compared with TASK-Relax at both weeks 6 and 20. Mean actigraphy sensor wearing-time was 33 days (±15).

CONCLUSIONS: Our preliminary feasibility data from the current study support a larger definitive clinical trial and the use of wrist-worn actigraphy sensor in anxious stroke survivors.

REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03439813.

Original language	English
Pages (from-to)	STROKEAHA120029042
Journal	Stroke
DOIs	https://doi.org/10.1161/STROKEAHA.120.029042
Publication status	Published - 24 Jun 2020

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10.1161/STROKEAHA.120.029042

STROKEAHA.120.029042Final published version, 798 KBLicence: Creative Commons: Attribution (CC-BY)

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@article{ed9e7175a59d48acaea9e126f3a2bad8,

title = "Telemedicine Cognitive Behavioral Therapy for Anxiety After Stroke: Proof-of-Concept Randomized Controlled Trial",

abstract = "BACKGROUND AND PURPOSE: Disabling anxiety affects a quarter of stroke survivors but access to treatment is poor. We developed a telemedicine model for delivering guided self-help cognitive behavioral therapy (CBT) for anxiety after stroke (TASK-CBT). We aimed to evaluate the feasibility of TASK-CBT in a randomized controlled trial workflow that enabled all trial procedures to be carried out remotely. In addition, we explored the feasibility of wrist-worn actigraphy sensor as a way of measuring objective outcomes in this clinical trial.METHODS: We recruited adult community-based stroke patients (n=27) and randomly allocated them to TASK-CBT (n=14) or relaxation therapy (TASK-Relax), an active comparator (n=13).RESULTS: In our sample (mean age 65 [±10]; 56% men; 63% stroke, 37% transient ischemic attacks), remote self-enrolment, electronic signature, intervention delivery, and automated follow-up were feasible. All participants completed all TASK-CBT sessions (14/14). Lower levels of anxiety were observed in TASK-CBT when compared with TASK-Relax at both weeks 6 and 20. Mean actigraphy sensor wearing-time was 33 days (±15).CONCLUSIONS: Our preliminary feasibility data from the current study support a larger definitive clinical trial and the use of wrist-worn actigraphy sensor in anxious stroke survivors.REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03439813.",

author = "Chun, {Ho-Yan Yvonne} and Carson, {Alan J} and Athanasios Tsanas and Dennis, {Martin S} and Mead, {Gillian E} and Clementina Calabria and Whiteley, {William N}",

year = "2020",

month = jun,

day = "24",

doi = "10.1161/STROKEAHA.120.029042",

language = "English",

pages = "STROKEAHA120029042",

journal = "Stroke",

issn = "0039-2499",

publisher = "Lippincott Williams & Wilkins",

}

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T1 - Telemedicine Cognitive Behavioral Therapy for Anxiety After Stroke

T2 - Proof-of-Concept Randomized Controlled Trial

AU - Chun, Ho-Yan Yvonne

AU - Carson, Alan J

AU - Tsanas, Athanasios

AU - Dennis, Martin S

AU - Mead, Gillian E

AU - Calabria, Clementina

AU - Whiteley, William N

PY - 2020/6/24

Y1 - 2020/6/24

N2 - BACKGROUND AND PURPOSE: Disabling anxiety affects a quarter of stroke survivors but access to treatment is poor. We developed a telemedicine model for delivering guided self-help cognitive behavioral therapy (CBT) for anxiety after stroke (TASK-CBT). We aimed to evaluate the feasibility of TASK-CBT in a randomized controlled trial workflow that enabled all trial procedures to be carried out remotely. In addition, we explored the feasibility of wrist-worn actigraphy sensor as a way of measuring objective outcomes in this clinical trial.METHODS: We recruited adult community-based stroke patients (n=27) and randomly allocated them to TASK-CBT (n=14) or relaxation therapy (TASK-Relax), an active comparator (n=13).RESULTS: In our sample (mean age 65 [±10]; 56% men; 63% stroke, 37% transient ischemic attacks), remote self-enrolment, electronic signature, intervention delivery, and automated follow-up were feasible. All participants completed all TASK-CBT sessions (14/14). Lower levels of anxiety were observed in TASK-CBT when compared with TASK-Relax at both weeks 6 and 20. Mean actigraphy sensor wearing-time was 33 days (±15).CONCLUSIONS: Our preliminary feasibility data from the current study support a larger definitive clinical trial and the use of wrist-worn actigraphy sensor in anxious stroke survivors.REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03439813.

AB - BACKGROUND AND PURPOSE: Disabling anxiety affects a quarter of stroke survivors but access to treatment is poor. We developed a telemedicine model for delivering guided self-help cognitive behavioral therapy (CBT) for anxiety after stroke (TASK-CBT). We aimed to evaluate the feasibility of TASK-CBT in a randomized controlled trial workflow that enabled all trial procedures to be carried out remotely. In addition, we explored the feasibility of wrist-worn actigraphy sensor as a way of measuring objective outcomes in this clinical trial.METHODS: We recruited adult community-based stroke patients (n=27) and randomly allocated them to TASK-CBT (n=14) or relaxation therapy (TASK-Relax), an active comparator (n=13).RESULTS: In our sample (mean age 65 [±10]; 56% men; 63% stroke, 37% transient ischemic attacks), remote self-enrolment, electronic signature, intervention delivery, and automated follow-up were feasible. All participants completed all TASK-CBT sessions (14/14). Lower levels of anxiety were observed in TASK-CBT when compared with TASK-Relax at both weeks 6 and 20. Mean actigraphy sensor wearing-time was 33 days (±15).CONCLUSIONS: Our preliminary feasibility data from the current study support a larger definitive clinical trial and the use of wrist-worn actigraphy sensor in anxious stroke survivors.REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03439813.

U2 - 10.1161/STROKEAHA.120.029042

DO - 10.1161/STROKEAHA.120.029042

M3 - Article

C2 - 32576090

SN - 0039-2499

SP - STROKEAHA120029042

JO - Stroke

JF - Stroke

ER -

Telemedicine Cognitive Behavioral Therapy for Anxiety After Stroke: Proof-of-Concept Randomized Controlled Trial

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