Examining patterns of patient adherence to Cognitive Behavioural Therapy in chronic physical illnesses and comorbid mental health disorders: a scoping review protocol

Almas Khan; Olivia F. O’Leary; Paul Corcoran; Eric Kelleher; Muhammad Fahmi Ismail; Pawel Hursztyn; Ella Arensman

doi:10.12688/hrbopenres.13791.1

Home Browse Examining patterns of patient adherence to Cognitive Behavioural Therapy...

ALL Metrics

-

Views

31

Downloads

Get PDF

Get XML

Export

▬

✚

Study Protocol

Examining patterns of patient adherence to Cognitive Behavioural Therapy in chronic physical illnesses and comorbid mental health disorders: a scoping review protocol

[version 1; peer review: 1 approved]

Almas Khan ^1,2, Olivia F. O’Leary³, Paul Corcoran^1,2, [...] Eric Kelleher^4,5, Muhammad Fahmi Ismail⁵, Pawel Hursztyn^1,2, Ella Arensman^1,2

Almas Khan ^1,2, Olivia F. O’Leary³, [...] Paul Corcoran^1,2, Eric Kelleher^4,5, Muhammad Fahmi Ismail⁵, Pawel Hursztyn^1,2, Ella Arensman^1,2

PUBLISHED 19 Feb 2024

Author details Author details

¹ School of Public Health, University College Cork, Cork, County Cork, Ireland
² National Suicide Research Foundation, Cork, County Cork, Ireland
³ Department of Anatomy and Neuroscience, University College Cork, Cork, County Cork, Ireland
⁴ Department of Liaison Psychiatry, Mercy University Hospital, Cork, CO, Ireland
⁵ Department of Liaison Psychiatry, Cork University Hospital, Cork, CO, Ireland

Almas Khan
Roles: Conceptualization, Methodology, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing

Olivia F. O’Leary
Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Writing – Review & Editing

Paul Corcoran
Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Writing – Review & Editing

Eric Kelleher
Roles: Conceptualization, Supervision, Validation, Writing – Review & Editing

Muhammad Fahmi Ismail
Roles: Conceptualization, Funding Acquisition, Supervision, Writing – Review & Editing

Pawel Hursztyn
Roles: Validation, Writing – Review & Editing

Ella Arensman
Roles: Conceptualization, Funding Acquisition, Methodology, Supervision, Validation, Writing – Original Draft Preparation

OPEN PEER REVIEW

REVIEWER STATUS

Abstract

Objective

To examine the patient adherence patterns to Cognitive Behaviour Therapy (CBT) intervention in persons living with long term physical illness and co-occurring mental health conditions.

Introduction

Current literature on patient treatment adherence is mostly focused on the medical/pharmacological treatment or is disorder/ therapy specific and does not address co-occurring or comorbid mental health disorders with physical health disorders in general. The objective of this scoping review is to provide insights into adherence behaviours and patterns outside of pharmacological intervention focusing on psychotherapeutic intervention specifically Cognitive Behaviour Therapy (CBT) in persons living with long-term medical conditions with co-existing mental health disorders/ conditions. The results of the review will highlight different aspects of adherence to CBT including facilitating and impeding factors influencing adherence, and variations across comorbid mental and physical health conditions. These results will aid in developing targeted CBT interventions and strategies to improve adherence rates. Furthermore, identifying gaps in the existing literature will guide future research to optimise health outcomes in this population.

Inclusion Criteria

Using the Population, Concept, and Context (PCC) criteria, studies will be included if they reported on patient adherence patterns of CBT in persons living with chronic medical conditions and co-occurring mental health conditions.

Methods

The scoping review will follow the Joanna Briggs Institute (JBI) guidelines for scoping review and reported according to the PRISMA-ScR checklist. A systematic search of PubMed, CINAHL Plus (including full academic search, APA PsychInfo, and Medline), Scopus, Cochrane library, EMBASE, Google Scholar, and University College Cork (UCC) library’s one search platform will be conducted. The JBI standard data extraction tool will be tailored to the review objectives. The findings will be presented using a descriptive and narrative approach.

Keywords

Patient adherence; cognitive behavioural therapy; chronic physical disorders; comorbid mental health disorders

Corresponding author: Almas Khan

Competing interests: No competing interests were disclosed.

Grant information: This project has received funding through the MHAINTAIN Collaborative Doctoral Awards - Health Research Board Ireland [CDA-2021-008].
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright: © 2024 Khan A et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Khan A, O’Leary OF, Corcoran P et al. Examining patterns of patient adherence to Cognitive Behavioural Therapy in chronic physical illnesses and comorbid mental health disorders: a scoping review protocol [version 1; peer review: 1 approved]. HRB Open Res 2024, 7:8 (https://doi.org/10.12688/hrbopenres.13791.1) First published: 19 Feb 2024, 7:8 (https://doi.org/10.12688/hrbopenres.13791.1) Latest published: 19 Feb 2024, 7:8 (https://doi.org/10.12688/hrbopenres.13791.1)

Introduction

The phenomenon of suffering with multiple diseases at the same time or comorbid conditions has shown an increasing trend over the last few decades¹. Approximately one in three adults suffer from multiple chronic conditions (MCCs) globally^1,2. Chronic or long-term conditions account for 41 million deaths each year which is equivalent to 74% of all deaths globally¹.

The definition of the term ‘comorbidity’ and its related constructs like multimorbidity has been found to differ in the literature³. Comorbidity has been widely used to define or “convey the notion of burden of an illness or a disease”³. Feinstein in his seminal work defined comorbidity as “any distinct additional entity that has existed or may occur during the clinical course of a patient who has the index disease under study”⁴.

The presence of long- term/ chronic physical disorders with comorbid mental health conditions have increased alarmingly not only in the older populations, but in younger age groups as well⁵. Comorbidities do not just follow their own separate trajectories but complicate and worsen the prognosis of other diseases as well⁶. Mental illnesses, especially, are often neglected if they co-exist with physical disorders⁶ making treatment outcomes difficult to achieve. A population- based cross sectional study undertaken in Estonia found presence of at least one mental health disorder (MHD) with any chronic physical condition and positively correlated with the number of physical disorders where depression and anxiety were the most common MHDs⁷.

With the advancement in medicine, psychological methods of treatment such as Cognitive Behavioural Therapy (CBT), Dialectical Behavioural Therapy (DBT), and other psychosocial interventions like Acceptance and Commitment Therapy (ACT) have shown positive results in various mental illnesses^8,9. Psychological interventions are non-pharmacological interventions “aimed at promoting a better adaptation of the individual to a given situation and thereby optimising his or her personal resources in relation to autonomy, self-knowledge and self-help and produce a personal change leading to higher functional results.”¹⁰. These interventions are aimed to optimise the healthcare needs of complex patients or improve the management of their chronic illnesses^11,12 Traditionally these therapies have been used majorly for mental health conditions and typically their objective is not to treat or control the disorder itself, but rather to address factors make these interventions more acceptable and feasible to administer in these individuals.

Amongst many widely used psychological interventions, CBT has been described as the gold standard of psychotherapy¹³ and has been used in various mental health conditions¹⁴. CBT is a “time- limited, problem- focused psychotherapy”¹⁵ and works on the principle of exploring the links between thoughts, emotions, and behaviour¹⁶. A review of 269 meta- analysis undertaken by Hofmann and colleagues reported the use of CBT for issues like depression, schizophrenia, and other psychotic disorders¹⁷. The importance of CBT has also been researched in physical illnesses like chronic pain¹⁸. However, the use of CBT in physical health conditions and co-occurring with mental disorders is under- studied¹⁹.

Another important aspect of any treatment is attributed to how much a patient adheres to treatment interventions, including pharmacological and non-pharmacological plans. WHO defines adherence as, “the extent to which a person’s behaviour – taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider”²⁰. Historically, different terminologies for treatment fidelity have existed such as compliance, adherence etc.²¹. Adherence to prescribed treatments has been documented to enhance patient safety, improved health outcomes and quality of life while its absence has been attributed to treatment inefficacy, increased patient morbidity, and mortality²¹. Approximately 50% of persons living with chronic conditions are estimated to be non- adherent to their treatment regimen²¹.

In terms of psychological interventions, such as CBT, treatment fidelity can be measured in terms of therapist adherence, therapist competence and treatment differentiation²². These measurements are considered vital for testing effectiveness and implementation of psychosocial interventions²². Adherence to CBT in mental health disorders like obsessive compulsive disorders (OCD) showed that about 15.6% patients refused CBT while 15.9% dropped out of the treatment²³. A meta- analysis found dropouts to be significantly associated with diagnosis of depression, format, and settings of treatment delivery²⁴. Adherence to variants of CBT such as individual versus group, internet versus face-to-face sessions also differ in literature. Some studies report higher adherence to individually provided CBT, while others show higher attrition in group CBTs^23,25,26. Factors such as educational levels, extraversion, technical difficulties specific to internet- based CBT were found to influence adherence.

Need for a review

An exploration of scholarly databases including PubMed and PROSPERO in the domain of adherence to psychological interventions like CBT, revealed a dearth of recent or ongoing systematic reviews or scoping reviews pertaining to the subject and population at hand which are individuals with physical illnesses with comorbid or co-occurring mental health illnesses. While a considerable body of literature exists on treatment adherence, it predominantly focuses on pharmacological treatments²⁷, with limited attention given to CBT-like psychological therapy-related interventions. Furthermore, much of the literature on treatment adherence is disease or therapy specific and there is limited information on adherence patterns in co-morbid populations in general^11,27,28. Considering the increasing prevalence of physical and comorbid mental disorders, there is a need to comprehensively examine the adherence patterns associated with CBT like psychotherapeutic interventions irrespective of specific illnesses. The objective of the present literature review is to elucidate the significance of adherence in this context using a scoping review methodology²⁹. A deeper understanding of adherence patterns will explain if patients with chronic physical illness and co-morbid mental illness/disorder have lower adherence compared to standalone disorders. Additionally, this review will shed light to understand if this population face unique challenges adhering to CBT based on cognitive element of living with a physical illness, difference in demographic profile of the participants such as younger mental illness cohort being more receptive to CBT compared to older population in chronic physical illness. Insights regarding these aspects will possibly aid to tailor interventions more effectively for individuals living with comorbid mental disorders or those at risk of severe consequences such as self harm and suicide.

Objectives

Examine the patterns of patient adherence to cognitive behavioural therapy in physical and comorbid or co-occurring mental health conditions.
Examine the barriers and facilitators influencing adherence to CBT in this population.
Assess the impact of adherence to CBT on health outcomes, symptom management, quality of life, and functional status.

Methods

The current protocol has been drafted based on the Joanna Briggs Institute (JBI) guidelines for scoping review protocols and has been registered on the Open Science Framework. The full scoping review will subsequently be reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR checklist)³⁰ and will be registered on the HRB Open Research.

This scoping review will follow the framework developed by Arksey and O'Malley³¹ and further updated and refined by Peters et al.³². The review will include the following stages:

Identification of the research question and relevant literature
Selection of relevant studies
Charting the data
Collating, summarizing, and reporting the results.
Consultation with stakeholders

Eligibility criteria

The eligibility criteria of the protocol will be outlined utilising the Population, Concept, Context (PCC) framework, as per the scoping review methodology. Subsequent sections elaborate on these components with brief definitions of PCC included in the study (Table 1) followed by detailed inclusion and exclusion criteria provided in Table 2.

Table 1. Definitions used for the components of the PCC framework.

Population	Persons living chronic physical illness and comorbid mental health disorders/ symptoms	a person living with more than one disease or condition at the same time where the principal or primary diagnosis is a chronic medical condition, and the secondary illness is a mental health disorder/ symptom(s).
Concept	Adherence to Cognitive Behavioural Therapy	Adherence to protocol, and/ or attendance to prescribed number of therapy sessions to Cognitive behavioural therapy which is a “type of psychotherapeutic treatment that helps people to identify and change destructive or disturbing thought patterns that have a negative influence on their behavior and emotions”⁴⁰.
Context	Settings	Studies undertaken in any setting such as hospital, community, primary care settings in High, middle, or/ and low- income countries.

Table 2. Eligibility Criteria.

Inclusion Criteria

Exclusion Criteria

Studies will be included if they:
•  reported on any type of physical or medical
disorder(s) and comorbid/ co-occurring mental
health condition(s) including self- harm/ suicidal
behaviours.
•  examine CBT and its variants including- individual,
group, face-to face, internet-based type intervention.
•  report on any measure of treatment fidelity/
dropout rate/ attrition/ adherence including
adherence to model of care and/ or to number of
sessions of CBT
•  are published in English.
•  are published till 30^th of October 2023.
•  use any quantitative, qualitative, or mixed methods,
evidence synthesis research study designs.
•  unpublished grey literature like dissertations,
reports etc which have followed a research paper
structure.

Studies will be excluded if they:
•  don't report on dual diagnosis of physical and mental health illness or report
only on co-occurrence of similar type of disorders i.e. either physical or mental illness
•  report on physical conditions related to alcohol/ drug/ substance use and/or
abuse, addiction, obesity, violence.
•  report on mental health conditions associated with alcohol/ drug/ substance
use and/or abuse, addiction, or violence.
•  focus on medical, surgical, or pharmacological treatment or interventions.
•  examine any other psychotherapeutic/psychosocial intervention(s) other than
CBT such as Dialectical behaviour therapy (DBT), Operant Behavioural Therapy
(OBT), Acceptance and Commitment Therapy (ACT), hypnotherapy, mindfulness,
exercise etc.
•  don’t report anything related to adherence/drop-out/ therapy fidelity.
•  are published after 30^th October 2023
•  are books, book chapters, cases studies, case- series, commentaries,
protocols/plan/ proposals, and opinion papers or studies that don’t follow a
research paper structure.

Participants

The scoping review study population will consist of people who are diagnosed or/ and living with chronic physical illness co-existing with a mental health condition irrespective of the demographic traits. CDC describes chronic diseases as conditions lasting for more than a year requiring ongoing medical attention and limit activities of daily living or both³³. Presence of mental health issues and psychological distress is well documented in the literature and are mostly associated with chronic illnesses like cancer, chronic obstructive pulmonary disease (COPD), asthma, neurological disorders, long-term pain, rheumatoid arthritis^34–38.

For the current review, conditions or phenomena that can be reversed/ or cured with treatment/ therapy/ lifestyle modifications related to addiction to alcohol/ substance use and/ or abuse, obesity will be excluded. However, if the studies report on the long- term health issues related to these conditions/ behaviours, they will be included. Furthermore, sleep disorders such as insomnia will be considered as both physical and mental illnesses. Existing literature indicates that insomnia and similar sleep disorders are symptoms associated with both mental and physical conditions, rather than being standalone disorders³⁹.

Concept

This review will focus primarily on adherence to CBT as key psychological intervention for addressing comorbid health issues. These adherence patterns will be analysed with respect to various factors, including demographic characteristics, severity of illness, barriers, and facilitators of adherence etc.

Literature reports various types of CBT interventions including brief/ long- term, personalised, individual/ family/ group or face- to face/ online based. For this review, studies reporting on any type of CBT or following the principles of CBT, will be included.

Any treatment modality other than CBT, will be excluded. Studies that do not report on any information regarding dropouts, treatment adherence/ compliance will not be considered as well.

Context

The review will encompass studies conducted in diverse healthcare settings, including long-term care, tertiary, in-patient, outpatient, or private and community healthcare settings in high, middle, low- income countries.

Types of Sources

This scoping review will consider study designs such experimental study designs including randomised controlled trials, non-randomised controlled trials, pre- and post- intervention studies. Additionally, analytical observational studies including prospective and retrospective cohort studies, case-control studies and analytical cross-sectional, mixed methods studies and descriptive observational study designs including descriptive cross-sectional studies will be included as well.

Qualitative studies and evidence synthesis studies like systematic reviews and meta-analysis will also be considered depending on the research question. Furthermore, grey literature including dissertations, reports will be considered as well.

Case studies, case series, book chapters, texts, commentaries, and opinion papers will be excluded in this scoping review or studies that do not follow any conventional research paper structure. We will also exclude research proposals, protocols as well since they are plans of how studies are being conducted. This review will not limit studies for language in title/abstract screening however full versions of studies published only in English, Spanish, Hindi, Polish will be included.

Search strategy

The search will be conducted in electronic research databases including PubMed, CINAHL Plus with full text, Academic search premier (EBSCO host) (includes PsychInfo and Medline), EMBASE, the Cochrane library, Scopus for published studies.

This will be followed by grey literature search to locate for unpublished work. First ten pages of Google Scholar will be searched for grey literature using appropriate search strategy. University College Cork library’s ‘one search’ engine which contains a wide range of unpublished dissertation, conference proceedings, reports, will be searched with various combinations of the search strategy⁴¹ (first 100 results).

The search strategy, including all identified keywords and index terms, will be adapted for each included database and/or information source. Table 3 displays the search terms on which the detailed search strategy is developed. Finally, the university librarian has also been consulted for development and refining the search strategy.

Table 3. Planned search strategy which will be developed using the PCC framework.

Population (P)	comorbid* OR "co-exist" OR "co-occur" OR "multimorbidity”
Concept (C)	“cognitive behaviour* therapy” OR “cognitive behavior* therapy” OR CBT
Concept 2 (C)	adherence or compliance or "patient compliance” OR fidelity
Context	-no specific context

Study/Source of evidence selection

The selected studies will be stored and managed in Mendeley Reference Manager, Version 2.43.0 and duplicates will be removed using appropriate software function.

Two researchers will independently search the studies based on search strategy without any language restriction. A two-part study selection process will be followed: 1. a title and abstract review and 2. full text review. A third or fourth researcher’s advice will be taken if there is a disagreement⁴². For title/ abstract screening, Rayyan—a web and mobile app for systematic reviews will be used⁴³. The second reviewer will have access to this software for a ready access to the studies for cross- examination. The reviewers will be blinded about each-other’s decisions while screening. Subsequently, researchers will independently examine the full texts of the studies after the preliminary searches of titles and abstracts.

PRISMA flowchart will be used to illustrate stepwise approach of inclusion of studies and studies that do not meet the same will be removed with due explanation.

Data Extraction

The current review will use the JBI standard data form to obtain the information like author, year of publication, title, study design and PCC⁴⁴.

This standard data charting tool will be updated along with the second author to capture data suited for the current review such as, type of physical disorder and mental illness (population), participant characteristics/ demographics (number, age, gender) (population), country where the study was applied (context), risk factors, type of physical illness, co-occurring mental health disorder, type of intervention (concept), adherence factors and key conclusion (Table 4).

Table 4. Data extraction plan.

Study characteristics	• Author(s) and publication year • Study design (e.g., observational, qualitative, mixed methods, RCTs) • Sample size and participant demographics (age, gender, etc.) • Setting (e.g., primary care, hospital, community, IPD/OPD) • Type of country (High, middle, low- income)
Physical disorders	• Type of chronic physical conditions.
Comorbid mental health disorders	• Type of comorbid mental health disorder
Type of CBT	• Individual/ group/ long- term/ brief/ tailored/ personalised CBT
Adherence measures and definition	• Types of adherence measures used in the studies (e.g., self-report, objective measures, clinician assessment)
Adherence patterns, effects, factors, and outcomes	• Adherence patterns and rates across different conditions and interventions • Identification of factors (barriers and facilitators) influencing adherence (e.g., individual/ patient-related, intervention-related, socio-economic factors) • Reported outcomes associated with adherence (e.g., improvement in symptoms, quality of life, treatment success)

Data Analysis and Presentation

According to the 2020 JBI scoping review guidelines, synthesis of the results is out of its scope⁴⁵. The outcomes of this scoping review will be presented in various formats that align with the objectives of the study, utilising suitable formats such as tabular summaries, or descriptive formats. These presentation formats will be chosen to effectively convey the key findings and meet the specific goals of the scoping review. Following this, the results will be presented using a descriptive and narrative approach in two phases^45,46. Firstly, descriptive statistics and table/ graphs will be used to present the frequencies of variables like sample age group and gender, country of origin, study types, type of chronic illness, type of comorbid mental illness etc. In the second phase thematic analysis using UCC licensed NVIVO software will be undertaken which will accompany the tabulated and/or charted results and will describe how the results relate to the reviews objective and question/s. The process of thematic analysis will be adopted from Braun and Clarke, 2006 guide⁴⁷.

Quality appraisal

According to the updated scoping reviews guidelines, quality appraisal of the studies is contraindicated⁴⁵. However, in the current review, some information regarding the quality of the included studies will be indicated.

Plan for dissemination

Upon completion of the scoping review, we aim to effectively disseminate the findings to a wider group of stakeholders and the broader academic community.

We will submit the findings for publication in peer-reviewed journals within the field of interest. By leveraging established academic platforms such as ResearchGate, we will seek to reach scholars, researchers, and practitioners who can benefit from and contribute to the knowledge generated by the scoping review. The findings will also be communicated via presentations through seminars/ webinars and social media space like LinkedIn and X (formerly Twitter). To enhance the accessibility and outreach of the findings, we will consider developing visual summaries (like poster) that effectively communicate the main results to a broader audience.

Data availability

Underlying data

No data are associated with this article.

Extended data

The current scoping review protocol registered at Open Science Framework (OSF): http://doi.org/10.17605/OSF.IO/VR3QU⁴⁸ titled: Examining patterns of patient adherence to Cognitive Behavioural Therapy in chronic physical illnesses and comorbid mental health disorders: a scoping review protocol.

PubMed search strategy for the scoping review can also be found on OSF.

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

Acknowledgements

We acknowledge Virginia Conrick for her contributions in developing and reviewing the search strategy for the scoping review protocol.

Faculty Opinions recommended

References

1. Noncommunicable diseases. [cited 2023 Jun 26]. Reference Source
2. Hajat C, Stein E: The global burden of multiple chronic conditions: A narrative review. Prev Med Rep. 2018; 12: 284–293. PubMed Abstract | Publisher Full Text | Free Full Text
3. Defining Comorbidity: Implications for Understanding Health and Health Services.
4. Feinstein AR: The pre-therapeutic classification of co-morbidity in chronic disease. J Chron Dis. Pergamon Press, 1970; 23(7): 455–468. PubMed Abstract | Publisher Full Text
5. Surís JC, Parera N, Puig C: Chronic Illness and Emotional Distress in Adolescence. J Adolesc Health. 1996; 19(2): 153–6. PubMed Abstract | Publisher Full Text
6. Sartorious N: Comorbidity of mental and physical diseases: a main challenge for medicine of the 21st century. Shanghai Arch Psychiatry. 2013; 25(2): 68–9. PubMed Abstract | Publisher Full Text | Free Full Text
7. Jürisson M, Pisarev H, Uusküla A, et al.: Physical-mental health comorbidity: A population-based cross-sectional study. PLoS One. 2021; 16(12): e0260464. PubMed Abstract | Publisher Full Text | Free Full Text
8. Ballenger JC: Anxiety and Depression: Optimizing Treatments. Prim Care Companion J Clin Psychiatry. 2000; 2(3): 71–79. PubMed Abstract | Publisher Full Text | Free Full Text
9. Yiu HW, Rowe S, Wood L: A systematic review and meta-analysis of psychosocial interventions aiming to reduce risks of suicide and self-harm in psychiatric inpatients. Psychiatry Res. 2021; 305: 114175. PubMed Abstract | Publisher Full Text
10. Ricou M, Marina S, Vieira PM, et al.: Psychological intervention at a primary health care center: Predictors of success. BMC Fam Pract. 2019; 20(1): 116. PubMed Abstract | Publisher Full Text | Free Full Text
11. Akintola AA, Achterberg WP, Caljouw MAA: Non-pharmacological interventions for improving quality of life of long-term care residents with dementia: a scoping review protocol. BMJ Open. 2019; 9(12): e032661. PubMed Abstract | Publisher Full Text | Free Full Text
12. Castellano-Tejedor C: Non-Pharmacological Interventions for the Management of Chronic Health Conditions and Non-Communicable Diseases. Int J Environ Res Public Health. 2022; 19(14): 8536. PubMed Abstract | Publisher Full Text | Free Full Text
13. David D, Cristea I, Hofmann SG: Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Front Psychiatry. 2018; 9: 4. PubMed Abstract | Publisher Full Text | Free Full Text
14. Hofmann SG, Smits JAJ: Cognitive-Behavioral Therapy for Adult Anxiety Disorders: A Meta-Analysis of Randomized Placebo-Controlled Trials.
15. Thoma Nathan, Pilecki Brian, McKay Dean: Contemporary Cognitive Behavior Therapy: A Review of Theory, History, and Evidence. Psychodyn Psychiatry. 2023; 43(3): 423–461. PubMed Abstract | Publisher Full Text
16. Fenn MK, Byrne DM: The key principles of cognitive behavioural therapy. 2013; 6(9): 579–85. Publisher Full Text
17. Hofmann SG, Asnaani A, Vonk IJJ, et al.: The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognit Ther Res. Springer New York LLC; 2012; 36(5): 427-40. PubMed Abstract | Publisher Full Text | Free Full Text
18. Psychological Interventions for the Treatment of Chronic Pain in Adults. Association for Psychological Science - APS, [cited 2023 Jul 30]. Reference Source
19. Halford J, Brown T: Cognitive-behavioural therapy as an adjunctive treatment in chronic physical illness. Advances in Psychiatric Treatment. 2009; 15(4): 306–17. Publisher Full Text
20. Evidence for action. 2003.
21. Ahmed R, Aslani P: What is patient adherence? A terminology overview.
22. Schoenwald SK, Garland AF: A Review of Treatment Adherence Measurement Methods. Psychol Assess. 2013; 25(1): 146–156. PubMed Abstract | Publisher Full Text | Free Full Text
23. Leeuwerik T, Cavanagh K, Strauss C: Patient adherence to cognitive behavioural therapy for obsessive-compulsive disorder: A systematic review and meta-analysis. J Anxiety Disord. 2019; 68: 102135. PubMed Abstract | Publisher Full Text
24. Fernandez E, Salem D, Swift JK, et al.: Meta-analysis of dropout from cognitive behavioral therapy: Magnitude, timing, and moderators. J Consult Clin Psychol. 2015; 83(6): 1108–22. PubMed Abstract | Publisher Full Text
25. Neufeld CB, Palma PC, Caetano KAS, et al.: A randomized clinical trial of group and individual Cognitive-Behavioral Therapy approaches for Social Anxiety Disorder. Int J Clin Health Psychol. 2020; 20(1): 29–37. PubMed Abstract | Publisher Full Text | Free Full Text
26. Guo T, Su J, Hu J, et al.: Individual vs. Group Cognitive Behavior Therapy for Anxiety Disorder in Children and Adolescents: A Meta-Analysis of Randomized Controlled Trials. Front Psychiatry. Frontiers Media S.A, 2021; 12: 674267. PubMed Abstract | Publisher Full Text | Free Full Text
27. Walsh CA, Bennett KE, Wallace E, et al.: Identifying Adherence Patterns Across Multiple Medications and Their Association With Health Outcomes in Older Community-Dwelling Adults With Multimorbidity. Value Health. 2020; 23(8): 1063–1071. Publisher Full Text
28. Marks E, Moghaddam N, De Boos D, et al.: A systematic review of the barriers and facilitators to adherence to mindfulness-based cognitive therapy for those with chronic conditions. Br J Health Psychol. 2023; 28(2): 338–365. PubMed Abstract | Publisher Full Text
29. Munn Z, Peters MDJ, Stern C, et al.: Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018; 18(1): 143. PubMed Abstract | Publisher Full Text | Free Full Text
30. Tricco AC, Lillie E, Zarin W, et al.: PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018; 169(7): 467–473. PubMed Abstract | Publisher Full Text
31. Arksey H, O’malley L: Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005; 8(1): 19–32. Publisher Full Text
32. Peters MDJ, Marnie C, Tricco AC, et al.: Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020; 18(10): 2119–2126. PubMed Abstract | Publisher Full Text
33. About Chronic Diseases | CDC. [cited 2024 Jan 9]. Reference Source
34. Rai D, Stansfeld S, Weich S, et al.: Comorbidity in mental and physical illness. 2016. Reference Source
35. Sturgeon JA, Finan PH, Zautra AJ: Affective disturbance in rheumatoid arthritis: Psychological and disease-related pathways. Nat Rev Rheumatol. 2016; 12(9): 532–42. PubMed Abstract | Publisher Full Text | Free Full Text
36. Golovacheva VA, Golovacheva AA, Parfenov VA: Management of patients with subacute back pain: how to effectively prevent chronicity. Nauchno-Prakticheskaya Revmatologiya. 2022; 14(4): 62–7. Publisher Full Text
37. Deshmukh VM, Toelle BG, Usherwood T, et al.: Anxiety, panic and adult asthma: A cognitive-behavioral perspective. Respir Med. 2007; 101(2): 194–202. PubMed Abstract | Publisher Full Text
38. Wilson I: Depression in the patient with COPD. Int J Chron Obstruct Pulmon Dis. 2006; 1(1): 61–4. PubMed Abstract | Publisher Full Text | Free Full Text
39. Psychiatry.org: What are Sleep Disorders? [cited 2023 Dec 20]. Reference Source
40. Hofmann SG, Asnaani A, Vonk IJJ, et al.: The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res. 2012; 36(5): 427–440. PubMed Abstract | Publisher Full Text | Free Full Text
41. Home - UCC Library Home - UCC Library at University College Cork. [cited 2021 Jul 27]. Reference Source
42. Higgins J, Thomas J: Cochrane Handbook for Systematic Reviews of Interventions. 2021.
43. Ouzzani M, Hammady H, Fedorowicz Z, et al.: Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016; 5(1): 210. PubMed Abstract | Publisher Full Text | Free Full Text
44. Appendix 11.1 JBI template source of evidence details, characteristics and results extraction instrument. JBI Manual for Evidence Synthesis. JBI Global Wiki. [cited 2021 Oct 1]. Reference Source
45. Peters MDJ, Marnie C, Tricco AC, et al.: Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020; 18(10): 2119–2126. PubMed Abstract | Publisher Full Text
46. Ollerenshaw JA, Creswell JW: Narrative Research: A Comparison of Two Restorying Data Analysis Approaches. Qual Inq. 2002; 8(3): 329-347. Publisher Full Text
47. Braun V, Clarke V: Using thematic analysis in psychology. Qual Res Psychol. 2006; 3(2): 77–101. Publisher Full Text
48. Khan A, Corcoran P, O'Leary O, et al.: Examining patterns of patient adherence to Cognitive Behavioural Therapy in chronic physical illnesses and comorbid mental health disorders: a scoping review protocol. 2024. Publisher Full Text

Comments on this article Comments (0)

Version 1

VERSION 1 PUBLISHED 19 Feb 2024