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Learning/Management Model Effective for Anxiety Treatment

Symptom improvement, response and remission rates beat usual care in primary care clinics

TUESDAY, May 18 (HealthDay News) -- A blended intervention approach to anxiety treatment is superior to usual care for patients treated in primary care clinics, according to research published May 18 in the Journal of the American Medical Association.

Peter Roy-Byrne, M.D., of the University of Washington School of Medicine, Seattle, and colleagues conducted a randomized controlled effectiveness trial of a blended treatment regimen called Coordinated Anxiety Learning and Management (CALM) compared with usual care (UC) for 1,004 primary care clinic patients with an anxiety disorder. CALM treatment involved a choice of cognitive behavioral therapy (CBT), or medication or both. It included real-time outcomes monitoring and a computer-guided program to optimize CBT delivery. Outcome measures included anxiety and somatic symptoms scores from a Brief Symptom Inventory (BSI-12), as well as the proportion of responders and remitters in each group.

There was a significantly greater improvement of BSI-12 scores at 6, 12, and 18 months for CALM treatment vs UC. At 12 months, response and remission rates were 63.66 percent and 51.49 percent, respectively, for CALM and 44.68 percent and 33.28 percent, respectively, for UC. In addition to anxiety symptoms, patients treated with CALM had improvements in depression symptoms and functional disability.

"The flexibility of treatment (e.g., variation in number and type of sessions, and in criteria for continuing further treatment, use of both telephone and in-person contact), the targeting of multiple disorders, and the clinical effectiveness across a range of patients and clinics suggest that the CALM treatment delivery model should be broadly applicable in primary care," the authors write.

Three authors report financial relationships with the pharmaceutical industry.

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