Online therapy platform found to boost mental health of patients

COMPASS uses cognitive behavioral therapy to help those with chronic diseases

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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COMPASS, a digital tool that provides support for managing the daily challenges of living with a long-term health condition such as multiple sclerosis (MS), significantly reduces psychological distress and improves mental health in these patients, data from a randomized clinical trial show.

The intervention consists of multiple online modules that help patients better navigate their symptoms and create strategies to deal with their emotions and improve life quality. It has received the CE mark, a designation given in Europe to therapies that meet safety standards.

“I highly recommend to those in the MS community as a best practice,” Simon Brodie, an MS patient who participated in the study, said in a press release.

The study, “A randomized controlled trial of a digital cognitive-behavioral therapy program (COMPASS) for managing depression and anxiety related to living with a long-term physical health condition,” was published in Psychological Medicine.

Living with a lifelong disease such as MS can take a toll on a person’s mental health. Patients need to navigate not only the acute manifestations of the disease itself, but also the stresses of navigating healthcare and treatment.

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I’m struggling with mental health as MS causes major life changes

COMPASS online program created by scientists at King’s College London

“COMPASS: Navigating your long-term condition” is an online program created by scientists at King’s College London (KCL) to provide support to people dealing with many different types of long-term health problems.

“COMPASS directs you to areas of your life you’d like to improve and explore by enabling skills, providing supported tools to guide you with along your journey,” Brodie said.

The tool includes 11 modules that address issues such as managing the uncertainty of a long-term condition, creating a routine, accepting and expressing emotions, creating a healthy lifestyle, and building self-compassion and self-efficacy. The process is supported by therapists, and is based on concepts from cognitive behavioral therapy to help patients build resilience and coping strategies.

“Accessing psychological therapies which are tailored to the needs of people with long-term conditions is challenging for both the patient (due to time, travel, and/or mobility) and healthcare providers (due to treatment costs and availability of adequately trained therapists),” said Rona Moss-Morris, PhD, co-author of the study at KCL.

“As a CE-marked digital therapy with minimal therapist input, COMPASS offers a potential solution to overcome some of these challenges, whilst being an effective intervention to reduce psychological distress,” Moss-Morris said.

Due to thankfully being part of the COMPASS trial, I feel empowered and confident to deal with changes and emotions that life throws at you as a person with a long-term condition.

Trial tested efficacy of COMPASS to help patients with chronic conditions

After developing the tool, scientists conducted a clinical trial (NCT04535778) to test its efficacy in helping patients with chronic conditions.

“This trial is the culmination of several years of work, starting in 2018; throughout the project, we developed the COMPASS programme and training for therapists, conducted user testing, got regulatory approval, launched in healthcare clinics and conducted this trial,” said Katrin Hulme, PhD, co-first author of the study.

Working with disease-specific charities, the study enrolled nearly 200 people with chronic health conditions, including 34 people diagnosed with MS, all of whom reported clinically significant anxiety and/or depression related to their condition.

During the 12-week study, half of the participants engaged in the COMPASS platform, with a median of more than two hours cumulatively spent on the platform. These participants also had access to up to five short check-ins with a therapist. The other half of participants, acting as the control group, had no specific support other than resources from charities which were available to all patients.

The study’s main goal was to assess changes in patients’ psychological distress, as measured with a questionnaire called the Patient Health Questionnaire Anxiety and Depression Scale. Results showed patients who had access to the COMPASS platform reported a significant reduction in distress, by nearly seven points on average compared with the control group.

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88.7% of patients who used COMPASS report significant improvements

In total, 88.7% of patients who used the COMPASS platform reported clinically significant improvements after 12 weeks, whereas less than half (45.1%) of control patients reported improvements.

Other measurements of psychological stress generally indicated more benefits for patients who used the COMPASS platform.

“COMPASS appears an effective treatment for psychological distress related to living with [long-term health conditions] with significant moderate effects on both depression and anxiety,” the researchers concluded.

Statistical analyses also indicated patients in the control arm were more likely to report worsening of stress over the course of the study. No safety issues related to the digital tool were noted during the study.

“As a person with Multiple Sclerosis, my life had changed significantly as a direct result of my diagnosis. Due to thankfully being part of the COMPASS trial, I feel empowered and confident to deal with changes and emotions that life throws at you as a person with a long-term condition,” Brodie said.