Effect of an eHealth intervention on older adults’ quality of life and health-related outcomes: a randomized clinical trial

Gustafson, David H.; Kornfield, Rachel; Mares, Marie Louise; Johnston, Darcie C; Cody, Olivia; Yang, Ellie Fan; Hwang, Juwon; Mahoney, Jane; Curtin, John J.; Tahk, Alexander; Shah, Dhavan V.

doi:10.1007/s11606-021-06888-1

Cited by 29 publications

(39 citation statements)

References 38 publications

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“…A total of 11 themes and 2 individual observations were identified by the reviewers for a total of 48 occurrences in the literature, whereas 11 themes and 7 observations were noted for a total of 95 observations. In the 33 studies analyzed, 26 (79%) showed an improvement in symptoms of depression [25,26,[28][29][30][31][32][33][35][36][37][40][41][42][43][44][46][47][48][49][50][51][52][54][55][56], while 19 (58%) showed an improvement in anxiety [26][27][28][29][30][31][32][33]36,[38][39][40][44][45][46][53][54][55][56]. Only 11/33 (33%) reported that at least one symptom was not statistically significant when compared with results from the control group, but the improvement was still noted [25]…”

Section: Results Of Interventions Compared With the Control Groupsmentioning

confidence: 99%

“…The following observations only occurred once in the literature: decrease in anger [26], decrease in decision conflict [30], decrease in decision regret [30], decreased digestive disturbance [26], decreased pain [26], increased medication adherence [41], and the intervention had no effect on self-efficacy [34]. [25,26,[28][29][30][31][32][33][35][36][37][40][41][42][43][44][46][47][48][49][50][51][52][54][55][56] 19 Reduced anxiety [26][27][28][29][30][31][32][33]36,[38][39][40][44][45][46][53]…”

Section: Results Of Interventions Compared With the Control Groupsmentioning

confidence: 99%

“…Following the PRISMA checklist [20] and the Kruse protocol [21], we extracted the following data fields: participants, intervention, comparison with the control or other group, medical outcomes, and study design (PICOS; Table 1) as a way to summarize study characteristics, as required by PRISMA. Of the 33 studies analyzed over the 1-year period, 17 were from 2021 [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] and 16 were from 2022 [42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]. All studies were RCTs involving adults, and 48% (16/33) involved an average age of 50 years or above.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The only difference was 1 study [34] reported no effect on depression or anxiety. [36,41,44,49,54,56,57] 5 Increased mental well-being/cognitive flexibility [45][46][47]49,57] 4 Decreased distress [30,36,43,53] 4 Increased sleep [26,45,47,50] 4 Increased self-efficacy [41,42,44,57] 2 Decreased fatigue/increased resilience [45,46] 1 Decreased anger [26] 1 Decreased decision conflict [30] 1 Decreased decision regret [30] 1 Decreased digestive disturbance [26] 1 Decreased pain [26] 1 Increased medication adherence [41] 1 None [34]…”

Section: Medical Outcomes Commensurate With the Use Of Mhealthmentioning

confidence: 99%

“…Two studies reported no effects on mental health from the intervention [34,57]. [25,26,[28][29][30][31][32][33][35][36][37][40][41][42][43][44][46][47][48][49][50][51][52][54][55][56] 19 Reduced anxiety [26][27][28][29][30][31][32][33]36,[38][39][40][44][45][46][53][54][55][56] 7 Increased quality of life [36,41,44,49,…”

Section: Effectiveness Of Mhealth To Manage Mental Healthmentioning

confidence: 99%

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Leveraging Mobile Health to Manage Mental Health/Behavioral Health Disorders: Systematic Literature Review

Kruse¹,

Betancourt²,

Gonzales³

et al. 2022

JMIR Ment Health

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Background Mental health is a complex condition, highly related to emotion. The COVID-19 pandemic caused a significant spike in depression (from isolation) and anxiety (event related). Mobile Health (mHealth) and telemedicine offer solutions to augment patient care, provide education, improve symptoms of depression, and assuage fears and anxiety. Objective This review aims to assess the effectiveness of mHealth to provide mental health care by analyzing articles published in the last year in peer-reviewed, academic journals using strong methodology (randomized controlled trial). Methods We queried 4 databases (PubMed, CINAHL [Cumulative Index to Nursing and Allied Health Literature], Web of Science, and ScienceDirect) using a standard Boolean search string. We conducted this systematic literature review in accordance with the Kruse protocol and reported it in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 2020 checklist (n=33). Results A total of 4 interventions (mostly mHealth) from 14 countries identified improvements in primary outcomes of depression and anxiety as well as in several secondary outcomes, namely, quality of life, mental well-being, cognitive flexibility, distress, sleep, self-efficacy, anger, decision conflict, decision regret, digestive disturbance, pain, and medication adherence. Conclusions mHealth interventions can provide education, treatment augmentation, and serve as the primary modality in mental health care. The mHealth modality should be carefully considered when evaluating modes of care. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42022343489; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=343489

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Section: Results Of Interventions Compared With the Control Groupsmentioning

confidence: 99%

Section: Results Of Interventions Compared With the Control Groupsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Medical Outcomes Commensurate With the Use Of Mhealthmentioning

confidence: 99%

Section: Effectiveness Of Mhealth To Manage Mental Healthmentioning

confidence: 99%

See 3 more Smart Citations

Leveraging Mobile Health to Manage Mental Health/Behavioral Health Disorders: Systematic Literature Review

Kruse¹,

Betancourt²,

Gonzales³

et al. 2022

JMIR Ment Health

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Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map

Welch,

Ghogomu,

Barbeau

et al. 2023

Campbell Systematic Reviews

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BackgroundSocial isolation and loneliness are more common in older adults and are associated with a serious impact on their well‐being, mental health, physical health, and longevity. They are a public health concern highlighted by the COVID‐19 pandemic restrictions, hence the need for digital technology tools to enable remotely delivered interventions to alleviate the impact of social isolation and loneliness during the COVID‐19 restrictions.ObjectivesTo map available evidence on the effects of digital interventions to mitigate social isolation and/or loneliness in older adults in all settings except hospital settings.Search MethodsWe searched the following databases from inception to May 16, 2021, with no language restrictions. Ovid MEDLINE, Embase, APA PsycInfo via Ovid, CINAHL via EBSCO, Web of Science via Clarivate, ProQuest (all databases), International Bibliography of the Social Sciences (IBSS) via ProQuest, EBSCO (all databases except CINAHL), Global Index Medicus, and Epistemonikos.Selection CriteriaTitles and abstracts and full text of potentially eligible articles were independently screened in duplicate following the eligibility criteria.Data Collection and AnalysisWe developed and pilot tested a data extraction code set in Eppi‐Reviewer and data were individually extracted and coded based on an intervention‐outcome framework which was also used to define the dimensions of the evidence and gap map.Main ResultsWe included 200 articles (103 primary studies and 97 systematic reviews) that assessed the effects of digital interventions to reduce social isolation and/or loneliness in older adults. Most of the systematic reviews (72%) were classified as critically low quality, only 2% as high quality and 25% were published since the COVID‐19 pandemic. The evidence is unevenly distributed with clusters predominantly in high‐income countries and none in low‐income countries. The most common interventions identified are digital interventions to enhance social interactions with family and friends and the community via videoconferencing and telephone calls. Digital interventions to enhance social support, particularly socially assistive robots, and virtual pets were also common. Most interventions focused on reducing loneliness and depression and improving quality of life of older adults. Major gaps were identified in community level outcomes and process indicators. No included studies or reviews assessed affordability or digital divide although the value of accessibility and barriers caused by digital divide were discussed in three primary studies and three reviews. Adverse effects were reported in only two studies and six reviews. No study or review included participants from the LGBTQIA2S+ community and only one study restricted participants to 80 years and older. Very few described how at‐risk populations were recruited or conducted any equity analysis to assess differences in effects for populations experiencing inequities across PROGRESS‐Plus categories.Authors' ConclusionsThe restrictions placed on people during the pandemic have shone a spotlight onto social isolation and loneliness, particularly for older adults. This evidence and gap map shows available evidence on the effectiveness of digital interventions for reducing social isolation or loneliness in older adults. Although the evidence is relatively large and recent, it is unevenly distributed and there is need for more high‐quality research. This map can guide researchers and funders to consider areas of major gaps as priorities for further research.

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Efficacy of telemedicine interventions for depression and anxiety in older people: A systematic review and meta‐analysis

Oliveira¹,

Dornelles²,

Gosmann

et al. 2023

Int J Geriat Psychiatry

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Objectives: Anxiety and depression are prevalent in the elderly and lead to loss of functionality and increased mortality. Although the use of antidepressants and faceto-face psychotherapies are indicated, the current context of telemedicine provides an alternative, with the advantage of facilitating access to care. The study aimed to evaluate the efficacy of telemedicine interventions to reduce anxiety and depression in the elderly through a systematic review with meta-analysis. Methods:The systematic review, through a search in 7 databases, included studies that evaluated the use of telemedicine interventions for depressive or anxious symptoms in the elderly, compared with usual care or waiting list or with another telemedicine intervention. Quantitative assessment was performed through metaanalysis.Results: A total of 31 articles identified in the search met the eligibility criteria and four were included for meta-analysis. Studies showed that telemedicine interventions are feasible and several studies demonstrated significant improvement in depressive or anxiety symptoms. Four studies evaluated the efficacy of internetdelivered cognitive behavioral therapy for depression and anxiety in older adults, compared with a waitlist, and found pooled effect sizes of −1.20 (95% CI −1.60 to −0.81) and −1.14 (95% CI −1.56 to −0.72), respectively, with low heterogeneity.Conclusions: Telemedicine interventions can be an alternative for the treatment of mood and anxiety symptoms in the elderly. However, more studies are needed to prove their clinical effectiveness, especially in countries with lower incomes and diverse culture and education.

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Effect of an eHealth intervention on older adults’ quality of life and health-related outcomes: a randomized clinical trial

Cited by 29 publications

References 38 publications

Leveraging Mobile Health to Manage Mental Health/Behavioral Health Disorders: Systematic Literature Review

Leveraging Mobile Health to Manage Mental Health/Behavioral Health Disorders: Systematic Literature Review

Digital interventions to reduce social isolation and loneliness in older adults: An evidence and gap map

Efficacy of telemedicine interventions for depression and anxiety in older people: A systematic review and meta‐analysis

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