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Completed

NCT Number: NCT05128981

Internet-delivered Cognitive Behavioral Therapy Following Myocardial Infarction

Myocardial infarction (MI) is one of the leading cause s of health loss globally, representing a large proportion of general disability. Anxiety and depression occur in 20-30 percent of patients following MI and have been identified as risk factors for recurrent adverse cardiac event. The purpose of our this study is to develop and evaluate a disease specific cognitive behavioral therapy (C BT) protocol to reduce cardia anxiety, depression, increase physical inactivity and quality of life (Q oL) in patients following MI

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Key information

Age range

18 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Karolinska Institutet

Stockholm, Sweden

About this study

The study will include 30 patients. The MI-specific CBT lasts for 8 weeks and is therapist guided and delivered via internet via a secure digital platform by licensed psychologists expertise in CBT for cardiac disease or final year psychologist under supervision. During treatment, the psychologists will have direct access to a cardiologist assigned to the project and treatments are conducted in close interdisciplinary collaboration to ensure patient safety

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

( - )MI ≥ 6 months before assessment ( - )Age 18-75 years endorsed cardiac anxiety that leads to significant distress or interferes with daily life (Cardiac Anxiety Questionnaire (CAQ); score ≥20) ( - ) On optimal medical treatment ( - )Able to read and write in Swedish.

Exclusion criteria

( - ) heart failure with severe systolic dysfunction (ejection fraction ≤ 35%) ( - ) significant valvular disease ( - ) planned coronary artery bypass surgery or other invasive therapy ( - ) other severe medical illness ( - )any medical restriction to physical exercise ( - )severe psychiatric disorder, severe depression, or risk of suicide ( - )alcohol dependency

Treatment and study plan

MI-CBT

Behavioral

Education of MI and common reactions, Interoceptive exposure, Exposure in-vivo, Behavioral activation, Relapse prevention

Primary outcomes

  1. 12-Item Short-Form Health Survey (SF-12)

    Time frame: Baseline

    General quality of life, with a score ranging from 0 to 100. A higher score indicating a better quality of life.

    General quality of life, with a score ranging from 0 to 100. A higher score indicating a better quality of life.

    General quality of life, with a score ranging from 0 to 100. A higher score indicating a better quality of life.

  2. 12-Item Short-Form Health Survey (SF-12)

    Time frame: 2 months from baseline

    General quality of life, with a score ranging from 0 to 100. A higher score indicating a better quality of life.

    General quality of life, with a score ranging from 0 to 100. A higher score indicating a better quality of life.

    General quality of life, with a score ranging from 0 to 100. A higher score indicating a better quality of life.

  3. 12-Item Short-Form Health Survey (SF-12)

    Time frame: 8 months from baseline

    General quality of life, with a score ranging from 0 to 100. A higher score indicating a better quality of life.

    General quality of life, with a score ranging from 0 to 100. A higher score indicating a better quality of life.

    General quality of life, with a score ranging from 0 to 100. A higher score indicating a better quality of life.

Secondary outcomes

  1. Cardiac anxiety questionnaire

    Time frame: Baseline

    Measure of cardiac anxiety, fear, avoidance and attention. The score ranges between 0 and 72, with a greater score indicating elevated cardiac anxiety.

  2. Cardiac anxiety questionnaire

    Time frame: 2 months from baseline

    Measure of cardiac anxiety, fear, avoidance and attention. The score ranges between 0 and 72, with a greater score indicating elevated cardiac anxiety.

  3. Cardiac anxiety questionnaire

    Time frame: 8 months from baseline

    Measure of cardiac anxiety, fear, avoidance and attention. The score ranges between 0 and 72, with a greater score indicating elevated cardiac anxiety.

  4. Body Sensation Questionnaire

    Time frame: Baseline

    Fear of bodily symptoms, score ranging from 0 to 72 . Higher scores indicate more fear of body sensations.

    Fear of bodily symptoms, score ranging from 0 to 72 . Higher scores indicate more fear of body sensations.

    Fear of bodily symptoms, score ranging from 0 to 72 . Higher scores indicate more fear of body sensations.

  5. Body Sensation Questionnaire

    Time frame: 2 months from baseline

    Fear of bodily symptoms, score ranging from 0 to 72 . Higher scores indicate more fear of body sensations.

    Fear of bodily symptoms, score ranging from 0 to 72 . Higher scores indicate more fear of body sensations.

    Fear of bodily symptoms, score ranging from 0 to 72 . Higher scores indicate more fear of body sensations.

  6. Body Sensation Questionnaire

    Time frame: 8 months from baseline

    Fear of bodily symptoms, score ranging from 0 to 72 . Higher scores indicate more fear of body sensations.

    Fear of bodily symptoms, score ranging from 0 to 72 . Higher scores indicate more fear of body sensations.

    Fear of bodily symptoms, score ranging from 0 to 72 . Higher scores indicate more fear of body sensations.

  7. Patient Health Questionnaire-9

    Time frame: Baseline

    Measure of depression, score ranging 0 to 27 with a higher score indicating higher level of depression

  8. Patient Health Questionnaire-9

    Time frame: 2 months from baseline

    Measure of depression, score ranging 0 to 27 with a higher score indicating higher level of depression

  9. Patient Health Questionnaire-9

    Time frame: 8 months from baseline

    Measure of depression, score ranging 0 to 27 with a higher score indicating higher level of depression

  10. Generalized Anxiety Disorder 7-item

    Time frame: Baseline

    General anxiety, score ranging from 0-21, with a higher score indicating more anxiety and worry.

  11. Generalized Anxiety Disorder 7-item

    Time frame: 2 months from baseline

    General anxiety, score ranging from 0-21, with a higher score indicating more anxiety and worry.

  12. Generalized Anxiety Disorder 7-item

    Time frame: 8 months from baseline

    General anxiety, score ranging from 0-21, with a higher score indicating more anxiety and worry.

  13. The Godin Leisure-time Exercise

    Time frame: Baseline

    Level of physical activity. The participant rate numbers of time per week that they engage in physical activity. The numb ers are the categorized in to low, moderate, and high levels of physical activity.

  14. The Godin Leisure-time Exercise

    Time frame: 2 months from baseline

    Level of physical activity. The participant rate numbers of time per week that they engage in physical activity. The numb ers are the categorized in to low, moderate, and high levels of physical activity.

  15. The Godin Leisure-time Exercise

    Time frame: 8 months from baseline

    Level of physical activity. The participant rate numbers of time per week that they engage in physical activity. The numb ers are the categorized in to low, moderate, and high levels of physical activity.

  16. Tampas Scale for Kinesophobia-Heart version

    Time frame: Baseline

    Fear of physical activity. The total score varies between 17 and 68, with higher values indicating more severe kinesiophobia.

  17. Tampas Scale for Kinesophobia-Heart version

    Time frame: 2 months from baseline

    Fear of physical activity. The total score varies between 17 and 68, with higher values indicating more severe kinesiophobia.

  18. Tampas Scale for Kinesophobia-Heart version

    Time frame: 8 months from baseline

    Fear of physical activity. The total score varies between 17 and 68, with higher values indicating more severe kinesiophobia.

  19. Client satisfaction Questionnaire

    Time frame: Baseline

    Treatment satisfaction, score ranging from 0 to 32, with a higher score indication more satisfaction with the treatment.

  20. Client satisfaction Questionnaire

    Time frame: 2 months from baseline

    Treatment satisfaction, score ranging from 0 to 32, with a higher score indication more satisfaction with the treatment.

  21. Adverse events

    Time frame: 2 months from treatment

    Potential adverse reactions to the treatment. Participants will be asked to report and rate the short- and long term discomfort of the adverse event on a scale from 0 ('did not affect me at all') and 3 ('affected me very negatively').

  22. Adverse events

    Time frame: 8 months from treatment

    Potential adverse reactions to the treatment. Participants will be asked to report and rate the short- and long term discomfort of the adverse event on a scale from 0 ('did not affect me at all') and 3 ('affected me very negatively').

  23. Symptom Checklist (SCL)

    Time frame: Baseline

    Measures frequency and severity of 16 cardiac-related symptoms. Scoring range from 0 to 64 for frequency with a greater score indicating more frequent symptoms, and from range from 0 to 48 for severity, with a greater score indicating more severe symptoms

  24. Symptom Checklist (SCL)

    Time frame: 2 months from baseline

    Measures frequency and severity of 16 cardiac-related symptoms. Scoring range from 0 to 64 for frequency with a greater score indicating more frequent symptoms, and from range from 0 to 48 for severity, with a greater score indicating more severe symptoms

  25. Symptom Checklist (SCL)

    Time frame: 8 months from baseline

    Measures frequency and severity of 16 cardiac-related symptoms. Scoring range from 0 to 64 for frequency with a greater score indicating more frequent symptoms, and from range from 0 to 48 for severity, with a greater score indicating more severe symptoms

  26. Perceived stress scale (4-item version)

    Time frame: Baseline

    Stress reactivity. A greater score indicate more perceived stress.

  27. Perceived stress scale (4-item version)

    Time frame: 2 months from Baseline

    Stress reactivity. A greater score indicate more perceived stress.

  28. Perceived stress scale (4-item version)

    Time frame: 8 months from Baseline

    Stress reactivity. A greater score indicate more perceived stress.

  29. Insomnia Severity Index

    Time frame: Baseline

    Measurement of sleep

  30. Insomnia Severity Index

    Time frame: 2 months from Baseline

    Measure of insomnia, score ranging from 0-20, with a higher score indicating more severe insomnia

  31. Insomnia Severity Index

    Time frame: 8 months from Baseline

    Measure of insomnia, score ranging from 0-20, with a higher score indicating more severe insomnia

  32. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)

    Time frame: Baseline

    Measure of post traumatic stress, score ranging from 0-80, with a higher score indicating more post traumatic stress.

  33. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)

    Time frame: 2 months from Baseline

    Measure of post traumatic stress, score ranging from 0-80, with a higher score indicating more post traumatic stress.

  34. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)

    Time frame: 8 months from Baseline

    Measure of post traumatic stress, score ranging from 0-80, with a higher score indicating more post traumatic stress.

Sponsors and collaborators

Lead sponsor

Karolinska Institutet

Other

Registry information

Acronym: MI-CBT

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
Nov 22, 2021
Registry last updated
Jan 10, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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