Development and reach of a web-based cognitive behavioural therapy programme to reduce symptoms of depression and diabetes-specific distress

There is an urgent need for more effective and efficient depression treatments in diabetes. We developed a diabetes-specific version of the Dutch web-based 'Coping with Depression' (CWD) course. Here, we report on the development, reach, patients' reasons for choosing our intervention and their characteristics. The CWD programme was amended for use in diabetes patients with co-morbid depression. Data were collected using a telephone interview, self-report questionnaires, and medical records. Adding diabetes-specific topics to an effective web-based depression programme resulted in an 8-lesson intervention ("www.diabetergestemd.nl"), with minimal guidance by coaches. In the framework of a randomised trial, the intervention attracted serious interest of 540 patients. After screening, 255 depressed diabetes patients were enrolled. Less than half had a history of depression treatment; 80% reported the diabetes-specific approach to be an important reason for signing up. We successfully developed a diabetes-specific version of the web-based CWD course, which attracted a large group of patients. Our results affirm the importance of addressing diabetes-specific issues in the context of depression treatment. Our intervention could be implemented on a large scale at low costs, and may serve as a model on how to develop other illness-specific online self-help interventions