Effectiveness of eHealth‐based cognitive behavioural therapy on depression: A systematic review and meta‐analysis

• Published in: Journal of clinical nursing 2022-11, Vol.31 (21-22), p.3021-3031
• Main Authors: Chan, Ming, Jiang, Ying, Lee, Cheuk Yiu Charlotte, Ramachandran, Hadassah Joann, Teo, Jun Yi Claire, Seah, Chuen Wei Alvin, Lin, Yanjun, Wang, Wenru
• Format: Article
• Language: English
• Subjects: Anxiety; Behavior modification; cognitive behavioural therapy; Cognitive therapy; depression; eHealth; Mental depression; Meta-analysis; Quality of life; Systematic review
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.16212

Aims and objectives To systematically appraise the effects of eHealth cognitive behavioural therapy on depression and anxiety severity, quality of life, adherence and attrition rates observed in adults with clinically diagnosed depression. Background eHealth‐based cognitive behavioural therapy is an increasingly popular intervention on depression, but current reviews investigating the effects of eHealth interventions on depression are not exclusive to the clinically depressed. Design A systematic review and meta‐analysis. Methods Following the PRISMA guidelines, a systematic search of randomised controlled trials related to eHealth cognitive behavioural therapy published from inception from six databases and three trial registries was undertaken. Results A total of 15 studies were included in this systematic review. The meta‐analysis revealed that, when compared to passive comparators, eHealth cognitive behavioural therapy had a statistically significant effect on depression (d = −0.62, 95% CI: −0.96 to −0.28, p = .0003) and anxiety severity (d = −0.65, 95% CI: −1.10 to −0.21, p = .004) but not for quality of life (d = 0.30, 95% CI: −0.09 to 0.07, p = .13). When compared to active comparators, a statistically significant effect on depression (d = −0.31, 95% CI: −0.55 to −0.07, p = .01) and anxiety severity (d = −0.50, 95% CI: −0.81 to −0.19, p = .002) was observed, but not for quality of life (d = 0.22, 95% CI: −0.04 to 0.48, p = .10). Weighted averages for adherence and attrition rates were low. Conclusion eHealth cognitive behavioural therapy showed effectiveness in reducing depression and anxiety severity, but not quality of life. Further research is required to culturally adapt CBT interventions and explore the long‐term benefits of eHealth cognitive behavioural therapy. Relevance to clinical practice The use of eHealth‐based cognitive behavioural therapy could potentially bridge treatment gaps and serve as an adjunct to active treatment plans or an alternative for those without access to treatment.