Telehealth Cognitive Behavioural Therapy in Patients with Diabetes - European Medical Journal

Telehealth Cognitive Behavioural Therapy in Patients with Diabetes

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TELEHEALTH cognitive behavioural therapy (CBT) can improve HbA1c and distress in patients with Type 2 diabetes (T2D), according to new data. Skills practice outside of therapy sessions are an essential component of CBT and can help contradict negative beliefs that stop patients from taking their medications consistently, explained Judith Callan, University of Pittsburgh School of Nursing and VA Pittsburgh Healthcare System, Mental Illness Research Education and Clinical Center, Pennsylvania, USA.  

Completing CBT skills practice outside of sessions allows patients to achieve earlier treatment responses and better clinical outcomes, but barriers such as chaotic lifestyles, excessive responsibilities, feeling overwhelmed, and procrastination are common in patients with T2D. The randomised study included 12 participants with T2D (mean age: 57.17 years) who had an HbA1c 8 and who were prescribed antihyperglycaemic medication. Usual T2D care was compared with 6, 8, and 12-weekly phone-delivered CBT sessions enhanced with a CBT skills practice smartphone app. The CBT aimed to address self-management and distress.  

All participants experienced a decrease in HbA1c and diabetes distress after 16 weeks. The most significant improvement was observed in participants in the 12-week CBT group, where researchers noted a decrease of 36.67 percentage points in diabetes distress levels based on the Diabetes Distress Scale and a mean decrease in HbA1c of 2.33 percentage points. In the usual care group, the team noted a decrease of 21.00 percentage points in diabetes distress levels and 2.15 percentage points in HbA1c. Completion rate for phone CBT sessions was 83% across all groups.  

The researchers stated “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 T2D patients.”

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