Telehealth cognitive behavioral therapy improves HbA1c, type 2 diabetes distress
Click Here to Manage Email Alerts
Cognitive behavioral therapy delivered by telehealth and enhanced with a smartphone app helped adults with type 2 diabetes improve their HbA1c and diabetes distress, according to data from a pilot study.
“An essential component of cognitive behavioral therapy is skills practice (homework) outside the therapy sessions. Skills practice functions as a critical data-gathering method to disconfirm negative beliefs and/or distortions that potentially lead to problems with taking medications consistently,” Judith A. Callan, PhD, RN, a psychiatric nurse at the University of Pittsburgh School of Nursing and the VA Pittsburgh Healthcare System, Mental Illness Research Education and Clinical Center, and colleagues wrote. “Patients who complete the cognitive behavioral therapy skills practice outside the session achieve earlier treatment response and better clinical outcomes. However, patients report many barriers to skills practice, such as chaotic lifestyles, feeling overwhelmed, excessive responsibilities and procrastination, all of which may be especially relevant to individuals with type 2 diabetes.”
This randomized pilot study included 12 adults with type 2 diabetes (mean age, 57.17 years; 75% women; 50% white) who were prescribed antihyperglycemic medication and had an HbA1c of 8% or greater. Researchers assessed treatment with usual type 2 diabetes care (n = 3) compared with phone-delivered cognitive behavioral therapy (CBT) during 6 (n = 3), 8 (n = 3) or 12 (n = 3) weekly sessions that were enhanced with a CBT skills practice smartphone app. The CBT intervention addressed self-management and distress in type 2 diabetes.
After 16 weeks, all participants experienced a decrease in HbA1c and diabetes distress. Researchers observed the most improvement among participants in the 12-week CBT group, with a mean decrease in HbA1c of 2.33 percentage points and a mean decrease of 31.67 percentage points in diabetes distress levels based on the Diabetes Distress Scale. The usual care group experienced a mean decrease of 2.15 percentage points in HbA1c and a mean decrease of 21 percentage points in diabetes distress.
Overall, there was a completion rate of 83% for phone CBT sessions across all three CBT groups.
“These findings suggest that the use of CBT phone sessions augmented with a CBT smartphone application has the potential to improve physical and mental health outcomes, increase diabetes self-management and reduce diabetes distress among type 2 diabetes patients,” the researchers wrote.
Collapse
Click Here to Manage Email Alerts