Efficacy Data from a Randomised Control Trial Evaluating a Digital Mental Health Support Intervention for People with Parkinson’s, 2023-2024

We developed a web application (PACT app) based on Acceptance and Commitment Therapy (ACT) to support mental health for people with Parkinson’s. Here, we assess the acceptability of the PACT app and the feasibility of conducting a randomised controlled trial to evaluate the effectiveness of using the app. This was a two-armed parallel groups design with 2:1 allocation to the PACT app or waiting-list control and a single, post-intervention follow-up. Feasibility outcomes included recruitment and retention rate, intervention engagement and satisfaction. Secondary outcomes included measures of anxiety, depression, quality of life, and cost-effectiveness. Intention-to-treat principle was used for secondary outcomes analysis. Treatment effects were estimated using linear regression. Fifty-seven people with Parkinson’s reporting mild or moderate psychological distress were randomised to 4 weeks of an ACT based app (n=38) or waiting-list control (n=19). Recruitment, retention rate, intervention use, and acceptability met our progression criteria. Intervention effects were largest for measures of depression (Hedges g = -0.96) and committed action (Hedges g = 0.87) and in the expected direction for all other outcome measures. PACT is acceptable to people with Parkinson’s and with efficacy signal. A future larger trial to fully evaluate efficacy is needed.

Objectives. We developed a web application (PACT app) based on Acceptance and Commitment Therapy (ACT) to support mental health for people with Parkinson’s. Here, we assess the acceptability of the PACT app and the feasibility of conducting a randomised controlled trial to evaluate the effectiveness of using the app. Methods. This was a two-armed parallel groups design with 2:1 allocation to the PACT app or waiting-list control and a single, post-intervention follow-up. Feasibility outcomes included recruitment and retention rate, intervention engagement and satisfaction. Secondary outcomes included measures of anxiety, depression, quality of life, and cost-effectiveness. Intention-to-treat principle was used for secondary outcomes analysis. Treatment effects were estimated using linear regression. Results: Fifty-seven people with Parkinson’s reporting mild or moderate psychological distress were randomised to 4 weeks of an ACT-based app (n=38) or waiting-list control (n=19). Recruitment, retention rate, intervention use, and acceptability met our progression criteria. Intervention effects were largest for measures of depression (Hedges g = -0.96) and committed action (Hedges g = 0.87) and in the expected direction for all other outcome measures. Conclusions: PACT is acceptable to people with Parkinson’s and with an efficacy signal. A future larger trial to fully evaluate efficacy is needed.