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The effectiveness and cost-effectiveness of e-health interventions for depression and anxiety in primary care: A systematic review and meta-analysis

Massoudi, B., Holvast, F., Bockting, C. L. H., Burger, H. & Blanker, M. H., 15-Feb-2019, In : Journal of Affective Disorders. 245, p. 728-743 16 p.

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  • The effectiveness and cost-effectiveness of e-health interventions for depression and anxiety in primary care: A systematic review and meta-analysis☆

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PURPOSE: Psychological interventions are labor-intensive and expensive, but e-health interventions may support them in primary care. In this study, we systematically reviewed the effectiveness and cost-effectiveness of e-health interventions for depressive and anxiety symptoms and disorders in primary care.

METHODS: We searched MEDLINE, Cochrane library, Embase, and PsychINFO until January 2018, for randomized controlled trials of e-health interventions for depression or anxiety in primary care. Two reviewers independently screened the identified publications, extracted data, and assessed risk of bias using the Cochrane Collaboration's tool.

RESULTS: Out of 3617 publications, we included 14 that compared 33 treatments in 4183 participants. Overall, the methodological quality was poor to fair. The pooled effect size of e-health interventions was small (standardized mean difference = -0.19, 95%CI -0.31 to -0.06) for depression compared to control groups in the short-term, but this was maintained in the long-term (standardized mean difference = -0.22, 95%CI -0.35 to -0.09). Further analysis showed that e-health for depression had a small effect compared to care as usual and a moderate effect compared to waiting lists. One trial on anxiety showed no significant results. Four trials reported on cost-effectiveness.

LIMITATIONS: The trials studied different types of e-health interventions and had several risks of bias. Moreover, only one study was included for anxiety.

CONCLUSIONS: E-health interventions for depression have a small effect in primary care, with a moderate effect compared to waiting lists. The approach also appeared to be cost-effective for depression. However, we found no evidence for its effectiveness for anxiety.

Original languageEnglish
Pages (from-to)728-743
Number of pages16
JournalJournal of Affective Disorders
Volume245
Publication statusPublished - 15-Feb-2019
EventENMESH congress - Groningen, Netherlands
Duration: 5-Oct-20177-Oct-2017

Event

ENMESH congress

05/10/201707/10/2017

Groningen, Netherlands

Event: Conference

    Keywords

  • E-Health, Depression, Anxiety, Primary care, Effectiveness, Cost-effectiveness, COGNITIVE-BEHAVIOR THERAPY, RANDOMIZED CONTROLLED-TRIAL, PSYCHOLOGICAL TREATMENT, INTERNET, DISORDERS, COMORBIDITY, OUTCOMES, EPIDEMIOLOGY, PREVALENCE, SEVERITY

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