Efficacy of Smartphone Apps in Patients With Depressive Disorders: A Systematic Review

Hernández-Gómez, Alba; Valdés-Florido, María José; Lahera, Guillermo; Andrade-González, Nelson

doi:10.3389/fpsyt.2022.871966

Cited by 3 publications

(5 citation statements)

References 43 publications

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“…After checking these protocols, thirteen were rated as incomplete as they missed information on the search terms defining the search strategy (item 2) 17 , 19 , 34 , 38 , 40 , 41 , 47 , 48 , 51 , 54 , 56 , 60 , 62 . All reviews searched at least two databases and provided their full search strategy in the final report, but 25 reviews 16 , 17 , 19 , 21 , 22 , 27 – 29 , 33 , 38 , 39 , 41 , 43 , 45 , 47 – 50 , 52 – 55 , 58 , 59 , 61 failed to justify publication restrictions, for example regarding language, entailing a “no” on item 4. Six reviews provided a list of studies excluded at full-text screening stage (item 7) 26 , 37 , 42 , 48 , 56 , 57 .…”

Section: Resultsmentioning

confidence: 99%

“…4 . Most reviews targeted specific indications, including type 2 diabetes (T2DM) ( n = 5) 19 , 20 , 22 , 23 , 26 , hypertension ( n = 4) 15 , 27 , 31 , 38 , depression ( n = 3) 33 , 53 , 61 , overweight/obesity ( n = 3) 40 , 41 , 52 , chronic obstructive pulmonary disease (COPD) ( n = 2) 35 , 39 , urinary incontinence ( n = 2) 56 , 62 , asthma ( n = 1) 57 , autism spectrum disorders ( n = 1) 32 , post-traumatic stress disorder (PTSD) ( n = 1) 59 , type 1 diabetes ( n = 1) 47 , Parkinson’s disease ( n = 1) 45 , knee arthroplasty ( n = 1) 46 and lower back pain ( n = 1) 51 . Twenty-two reviews covered multiple conditions within their scope, such as diabetes of various types ( n = 7) 18 , 21 , 24 , 25 , 36 , 37 , 50 , chronic non-communicable diseases ( n = 2) 55 , 58 , anxiety and depression ( n = 2) 43 , 49 , conditions requiring rehabilitation ( n = 2) 42 , 44 , pediatric diseases ( n = 1) 54 , diseases requiring medication ( n = 2) 17 , 34 , cardiovascular diseases ( n = 2) 16 , 30 , pain conditions ( n = 2) 48 , 60 , mental illnesses ( n = 1) 28 , or a combination of diabetes and hypertension ( n = 1) 29 ...…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Reviews focusing on patients with depression measured improvements of depressive symptoms 33 , 53 , 61 , and self-esteem and QoL 53 , 61 . Two reviews additionally reported results for medication adherence 17 , 61 , one 61 on psychiatric admissions, medication adherence and side effects, resilience, attitudes, sleep disturbances and further psychological and behavioral outcomes 61 . Further reviews reported on depressive 28 , 43 , 49 , mania and psychotic symptoms as well as adverse events 28 and anxiety symptoms 43 , 49 in samples that did include depression patients, however not exclusively.…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 41 out of the 48 reviews concluded that app-based health interventions were effective in improving health outcomes. The seven systematic reviews which did not conclude that app-based health interventions were effective reported inconclusive results as some studies showed effectiveness and others did not 35 , 51 , 53 , 54 , 57 , 61 , or reported clinically irrelevant improvements 41 . Reported synthesized outcomes, types of effect estimates, and number of underlying individual studies were heterogeneous.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

An umbrella review of effectiveness and efficacy trials for app-based health interventions

Chong,

Pedron,

Abdelmalak

et al. 2023

npj Digit. Med.

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Health interventions based on mobile phone or tablet applications (apps) are promising tools to help patients manage their conditions more effectively. Evidence from randomized controlled trials (RCTs) on efficacy and effectiveness of such interventions is increasingly available. This umbrella review aimed at mapping and narratively summarizing published systematic reviews on efficacy and effectiveness of mobile app-based health interventions within patient populations. We followed a pre-specified publicly available protocol. Systematic reviews were searched in two databases from inception until August 28, 2023. Reviews that included RCTs evaluating integrated or stand-alone health app interventions in patient populations with regard to efficacy/effectiveness were considered eligible. Information on indications, outcomes, app characteristics, efficacy/effectiveness results and authors’ conclusions was extracted. Methodological quality was assessed using the AMSTAR2 tool. We identified 48 systematic reviews published between 2013 and 2023 (35 with meta-analyses) that met our inclusion criteria. Eleven reviews included a broad spectrum of conditions, thirteen focused on diabetes, five on anxiety and/or depression, and others on various other indications. Reported outcomes ranged from medication adherence to laboratory, anthropometric and functional parameters, symptom scores and quality of life. Fourty-one reviews concluded that health apps may be effective in improving health outcomes. We rated one review as moderate quality. Here we report that the synthesized evidence on health app effectiveness varies largely between indications. Future RCTs should consider reporting behavioral (process) outcomes and measures of healthcare resource utilization to provide deeper insights on mechanisms that make health apps effective, and further elucidate their impact on healthcare systems.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

An umbrella review of effectiveness and efficacy trials for app-based health interventions

Chong,

Pedron,

Abdelmalak

et al. 2023

npj Digit. Med.

View full text Add to dashboard Cite

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Digitally managing depression: a fully remote randomized attention-placebo controlled trial

Kandola

Edwards²,

Muller³

et al. 2023

Preprint

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Background Depression is a common and disabling condition. Digital apps may augment or facilitate care, particularly in under-served populations. We tested the efficacy of juli, a digital self-management app for depression in a fully remote randomized controlled trial. Methods We completed a pragmatic single-blind trial of juli for depression. We included participants aged over 18 who self-identified as having depression and scored 5 or more on the Patient Health Questionnaire-8 (PHQ-8). Participants were randomly assigned (1:1) to receive juli for 8 weeks or a limited attention-placebo control version of the app. Our primary outcome was the difference in PHQ-8 scores at 8 weeks. Secondary outcomes were remission, minimal clinically important difference, worsening of depression, and health-related quality of life. Analyses were per protocol (primary) and modified intention-to-treat (secondary). The trial was registered at the ISRCTN registry (ISRCTN12329547). Results Between May 2021 and January 2023, we randomised 908 participants. 662 completed the week 2 outcome assessment and were included in the modified intention-to-treat analysis, and 456 completed the week 8 outcome assessments (per protocol). The mean baseline PHQ-8 score was consistent with a diagnosis of moderately severe depression. In the per-protocol analysis, the juli group had a lower mean PHQ-8 score (10.78, standard deviation 6.26) than the control group (11.88, standard deviation 5.73) by week 8 (baseline adjusted beta-coefficient -0.94, 95%CI -1.87 to -0.22, p=0.045). Remission and minimal clinically important difference were increased in the juli group at 8 weeks (adjusted odds ratio 2.22, 95%CI 1.45-3.39, p<0.001 and adjusted odds ratio 1.56, 95%CI 1.08 to 2.27, p=0.018). There were no between-group differences in health-related quality of life physical or mental component scores or worsening of depression. Conclusion Use of juli reduced symptoms of depression at 8 weeks compared with an attention-placebo control. The juli app is a digital self-management tool that could increase accessibility of evidence-based depression treatments.

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Digitally managing depression: A fully remote randomised attention-placebo controlled trial

Kandola,

Edwards,

Muller

et al. 2024

DIGITAL HEALTH

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Background Depression is a common and disabling condition. Digital apps may augment or facilitate care, particularly in under-served populations. We tested the efficacy of juli, a digital self-management app for depression in a fully remote randomised controlled trial. Methods A pragmatic randomised controlled trial that included participants aged > 18 who self-identified as having depression and scored > 5 on the Patient Health Questionnaire-8. Participants were randomly assigned (1:1) to receive juli for 8 weeks or a limited attention-placebo control app. Our primary outcome was the difference in Patient Health Questionnaire-8 scores at 8 weeks. Secondary outcomes were remission, minimal clinically important difference, worsening of depression, and health-related quality of life. Analyses were per-protocol (primary), and modified and full intention-to-treat (secondary). The trial was registered at ISRCTN (ISRCTN12329547). Results Between May 2021 and January 2023, we randomised 908 participants. 662 completed the week 2 outcome assessment and were included in the modified intention-to-treat analysis, and 456 completed the week 8 outcome assessments (per-protocol). In the per-protocol analysis, the juli group had a greater reduction in Patient Health Questionnaire-8 score (10.78, standard deviation 6.26) than the control group (11.88, standard deviation 5.73) by week 8 (baseline adjusted β-coefficient −0.94, 95% CI: −1.87 to −0.22, p = 0.045). Achieving remission and a minimal clinically important difference was more likely in the juli group at 8 weeks (adjusted odds ratios 2.22, 95% CI: 1.45–3.39, p < 0.001 and 1.56, 95% CI: 1.08–2.27, p = 0.018, respectively). There were no between-group differences in health-related quality of life or worsening of depression. Modified and full intention-to-treat analyses found similar results, but the primary outcome was non-significant. Conclusion The use of juli for 8 weeks resulted in a small reduction in symptoms of depression compared with an attention-placebo control. The juli app is a digital self-management tool that could increase the accessibility of evidence-based depression treatments.

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Efficacy of Smartphone Apps in Patients With Depressive Disorders: A Systematic Review

Cited by 3 publications

References 43 publications

An umbrella review of effectiveness and efficacy trials for app-based health interventions

An umbrella review of effectiveness and efficacy trials for app-based health interventions

Digitally managing depression: a fully remote randomized attention-placebo controlled trial

Digitally managing depression: A fully remote randomised attention-placebo controlled trial

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