Web-Based Distress Management Program for Implantable Cardioverter Defibrillator Patients (Webcare): Long-Term Follow-up of a Randomized Controlled Trial

Background: Sudden cardiac arrest is one of the leading causes of death worldwide, costing more than 7 million lives each year. To prevent sudden cardiac arrest, implantable cardioverter defibrillators (ICDs) are considered as standard care. ICD treatment is generally well accepted by the majority of patients, however, a subgroup (1 in 4) experiences psychological distress post implantation. Psychological distress within the ICD population has shown to be associated with adverse health outcomes and mortality. Objective: The WEB-based distress management program for ICD patients (WEBCARE) was developed to mitigate distress (e.g. anxiety and depression) and enhance health-related quality of life in ICD patients. This study investigates the treatment effectiveness at 6- and 12-months follow-up for generic and disease specific outcome measures. Methods: Consecutive patients implanted with first-time ICD from six referral hospitals (N=289) in The Netherlands were randomized to either the ‘WEBCARE’ (N=146) or ‘Usual Care’ (N=143) group. Patients in the WEBCARE group received an online, 12-weeks fixed, 6 lesson behavioral treatment based on the problem solving principles of cognitive behavioral therapy. Five of the 6 lessons were accompanied by homework assignments which were, after submission, provided with personalized therapist feedback. In addition, the WEBCARE group was provided with relaxation training exercises on CD which they were encouraged to use. Results: Results of the primary outcomes at 6- and 12-months follow up will be presented at the meeting. By that time, we expect to have complete data for 289 patients on anxiety, depression, and health-related quality of life. Conclusions: This is the first randomized trial to examine the (long-term) effectiveness of a web-based behavioural intervention for ICD patients. Current findings will inform the clinical practice on the use of web-based behavioural treatments as additional care post ICD implant. Trial registration: http://www.ClinicalTrials.gov. Identifier: NCT00895700 []