In England, approximately 15.4 million people live with at least one long-term medical condition (LTCs), of which nearly a third also experience mental health issues such as anxiety and depression, exacerbating their health outcomes and elevating mortality risks. These comorbidities not only impact personal health but also result in higher healthcare and societal costs due to increased medical expenses and decreased productivity. Traditional mental health interventions, including psychotherapy and pharmacotherapy, alongside addressing the LTC itself, often face barriers such as cost, availability, contraindications, and logistical challenges. Furthermore, individuals with LTCs tend to experience poorer therapy outcomes for anxiety and depression compared to those without LTCs, indicating the need for more tailored interventions.
COMPASS, a digital therapy developed at King’s College London, offers a transdiagnostic approach to addressing both mental and physical aspects of LTCs, providing a new strategy for enhancing patient care and optimizing resource utilization. This study aimed to evaluate the effectiveness of COMPASS compared to a control group in a population experiencing distress related to an LTC. The study enrolled 195 adults with elevated scores on depression or anxiety measures and assessed them over 12 weeks, with participants randomized to either the COMPASS treatment group or a treatment as usual group. Various assessments were conducted, with the primary outcome measure being the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS).
Results showed significant benefits for participants in the COMPASS group, with lower distress levels at 12 weeks compared to the control group. Additionally, the COMPASS group reported a clinically meaningful improvement in comparison to the control group. Secondary outcomes also demonstrated the positive impact of COMPASS on depression, anxiety, and illness-related distress, with modest improvements in daily functioning and quality of life favoring the COMPASS group.
Despite challenges such as attrition rates and potential biases, the study highlights the scalability and efficacy of COMPASS for individuals with moderate to severe symptoms, showing promise for easing the burden on healthcare services by offering an effective digital treatment option for psychological distress associated with LTCs. The study design adhered to CONSORT guidelines, ensuring transparency and reliability in reporting, though limitations such as self-reported measures and lack of diversity in the sample were noted.
The transdiagnostic approach of COMPASS offers a more inclusive and potentially more efficient treatment solution compared to disease-specific interventions, aligning with the interconnected nature of mental health symptoms. Its online delivery format and therapist support through minimal sessions enhance accessibility, particularly for patients facing barriers to traditional therapy. This study serves as a model for centralized delivery pathways for psychological treatments, advocating for expanded access to similar therapies in the future to meet the increasing demand for mental health services.
