Background: Depressive symptoms in patients with cardiovascular disease (CVD) seem to induce higher healthcare use and thereby causing a burden on society. Thus, interventions aiming to decrease depressive symptoms in these patients could decrease the use of healthcare resources. In a previous study we have shown that a 9-week internet-delivered cognitive behavioural therapy (iCBT) program (n=72) compared to an online discussion forum (ODF) (n=72) had moderate to large effect on depressive symptoms in CVD outpatients. However, the effect on healthcare use was not evaluated in that study.

Objectives: To describe and compare the iCBT and ODF groups with regard to healthcare use. 

Methods: Data on healthcare use was retrieved from a population-based diagnose-related administrative database. Patients were predominantly males with a mean age of 61±13 and 64±12 years in the iCBT and ODF respectively. The groups did not differ significantly. Collected data was divided into outpatient clinic and/or primary care contacts, and hospital admissions.

Results: The year before the intervention, the iCBT group had a mean of 31±31 contacts per patient compared with 21±25 the year after the intervention. The corresponding number of contacts for the ODF group were 37±31 and 25±23. No between group differences were found, but in both groups, there were a statistically significant decrease (p<0.01) after the intervention. In both groups, most contacts were to physicians and nurses, but also rehabilitation staff.

The iCBT group had 0.8±1.5 admissions per patient the year before and 0.6±1.6 the year after the intervention, and the ODF group had 1.1±1.6 admissions the year before and 0.6±2.2 the year after the intervention. There were no significant differences between the groups regarding number of admissions. Only the ODF group showed a significant decrease in number of admissions the year after compared to the year before the intervention. 

Improvement in depressive symptoms was not associated with decreased healthcare use.

Conclusion: Despite decreased depressive symptoms by iCBT, the program was not superior compared to ODF in decreasing healthcare use.