Evaluating the effectiveness of "Agoraphobia Free": A novel mobile application for treating Agoraphobia

ISRCTN ISRCTN98453199
DOI https://doi.org/10.1186/ISRCTN98453199
Secondary identifying numbers N/A
Submission date
05/02/2016
Registration date
10/02/2016
Last edited
28/11/2017
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Agoraphobia is a type of anxiety disorder where a person fears being in situations and places where they feel trapped or in danger, often because of openness or crowdedness. Although many believe it is just a fear of open or public places, it is much more complex and usually involves a range of different fears. In general, it can render people unable to function and the condition traps sufferers in a vicious cycle, preventing them from leaving home to seek the support or to attend treatment that might end the condition. Depending on how severe the condition is treatment may require one-to-one therapy in a patient's home and for the person to be escorted around the surrounding area, but this is often expensive and time-consuming. "Agoraphobia Free" is a new therapeutic app which aims to break this cycle by putting the two components of traditional treatment, namely education and exposure therapy (gradually exposing someone to their fear until it no longer scares them), in the hands of the users themselves via their phones or tablets. This study aims to look at the effectiveness of using the app for six weeks on the severity of symptoms in self-reported agoraphobia sufferers.

Who can participate?
Adults who suffer from agoraphobia.

What does the study involve?
Participants are randomly allocated to one of two groups. Those in the first group are given access to the “Agoraphobia Free” app, which is designed specifically to help people with agoraphobia, for a total of 12 weeks. The app features game play to make therapy sessions as engaging as possible, exposing users to virtual environments likely to trigger their fears. They are also taught ways of dealing with their fears within the app so that they are no longer as frightening. Those in the second group are given access to a more generalized app called “Stress Free”, which is designed to help people with anxiety in general, for a total of 12 weeks. This app involves teaching the user techniques such as calm breathing, relaxation and meditation, designed to lower anxiety levels. At the start of the study and then again after six and 12 weeks, participants in both groups complete a number of questionnaires in order to assess the severity of their agoraphobia symptoms.

What are the possible benefits and risks of participating?
Participants may benefit from an improvement to their feelings of anxiety as well as increased knowledge about their condition. There are no notable risks of taking part in the study.

Where is the study run from?
University of Roehampton (UK)

When is the study starting and how long is it expected to run for?
September 2014 to April 2015

Who is funding the study?
Nominet Trust (UK)

Who is the main contact?
Dr Elias Tsakanikos

Contact information

Dr Elias Tsakanikos
Scientific

Centre of Research in Individual Differences (CRID)
Department of Psychology
Roehampton University
Holybourne Avenue
London
SW15 4JD
United Kingdom

ORCiD logoORCID ID 0000-0002-7792-5402

Study information

Study designWeb-based assessor-blind randomised parallel trial
Primary study designInterventional
Secondary study designRandomised parallel trial
Study setting(s)Internet/virtual
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet.
Scientific titleClinical effectiveness of a mobile phone application to treat agoraphobia with and without panic disorder (PD) in a community-based sample
Study acronymEvaluation of Agoraphobia Free
Study hypothesisThe aim of this study is to examine whether the agoraphobia-specific mobile intervention ("agoraphobia-free") is more effective than the generic, control intervention ("stress free").
Ethics approval(s)Roehampton University Ethics Committee, 21/05/2014, ref: PSYC 14/ 117
ConditionAgoraphobia/Agoraphobic anxiety
InterventionAdults that self-identified with agoraphobia were randomised to the two treatment arms. Block randomisation was applied to ensure equal numbers of participants in each group (ratio 1:1).

Group 1: Participants are given access to the “Agoraphobia Free” app developed by Health e-Living Partnership Ltd. (HeLP) for iOS and Android. The app involves an interactive game-based intervention utilising cognitive-behavioural techniques that target agoraphobia.

Group 2: Participants are given access to a generic stress-reduction application (“Stress Free”), which does not specifically address agoraphobic symptoms. The app aims to help to lower anxiety levels through techniques such as calm breathing, differential deep muscle relaxation, self-hypnosis and meditation

Participants in both groups are given access to the application for a total of 12 weeks, and complete self-reported assessments at baseline, midpoint (6 weeks) and endpoint (12 weeks) of the trial.
Intervention typeDevice
Pharmaceutical study type(s)
Phase
Drug / device / biological / vaccine name(s)
Primary outcome measureSeverity of agoraphobic and panic symptoms are measured using the Panic and Agoraphobia Scale at baseline, 6 and 12 weeks.
Secondary outcome measures1. Degree of subjective distress experienced because of agoraphobia is measured by using a single item (“How much distress have you experienced because of agoraphobia in the past week?”), which is rated from 1 (“No distress”) to 5 (“Extreme distress”) at baseline, 6 and 12 weeks
2. Completion of the intervention is measured as 1 (completion of the tasks) or 0 (non-completion of the tasks) at 6 and 12 weeks
3. Engagement with the apps is measured using app usage data (i.e. total number of times that users engaged with the app) at 6 and 12 weeks
Overall study start date24/09/2014
Overall study end date23/04/2015

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants170
Participant inclusion criteria1. Aged 18 or above
2. Identify themselves as suffering from agoraphobia
3. Willing and able to provide informed consent to participate
Participant exclusion criteria1. Inability to give informed consent due to significant cognitive or intellectual impairment
2. No adequate understanding of English as a first language
3. Not having a mobile device than can run the application as designed
4. Any significant disease or disorder which, in the opinion of the Investigators, may either put the person at risk because of participation in the trial.
Recruitment start date22/09/2014
Recruitment end date28/04/2015

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

University of Roehampton
Whitelands College
Holybourne Avenue
London
SW15 4JD
United Kingdom

Sponsor information

University of Roehampton
University/education

Department of Psychology
University of Roehampton
Holybourne Avenue
London
SW15 4JD
England
United Kingdom

ROR logo "ROR" https://ror.org/043071f54

Funders

Funder type

Charity

Nominet Trust

No information available

Results and Publications

Intention to publish date31/03/2016
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication of study results.
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article Results 24/11/2017 Yes No

Editorial Notes

28/11/2017: Publication reference added