Effectiveness of Telehealth Interventions for Women With Postpartum Depression: Systematic Review and Meta-analysis

JMIR mHealth and uHealth - Tập 9 Số 10 - Trang e32544
Liuhong Zhao1, Jingfen Chen1, Liuying Lan1, Ni Deng2, Yan Liao3, Liqun Yue4, Innie Chen3,5,6, Shi Wu Wen3,5,6, Ri‐hua Xie1
1Department of Nursing, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
2Department of Obstetrics and Gynecology, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
3Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
4Department of Nursing, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
5Department of Obstetrics & Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
6School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

Tóm tắt

Background Postpartum depression (PPD) is a prevalent mental health problem with serious adverse consequences for affected women and their infants. Clinical trials have found that telehealth interventions for women with PPD result in increased accessibility and improved treatment effectiveness. However, no comprehensive synthesis of evidence from clinical trials by systematic review has been conducted. Objective The aim of this study is to evaluate the effectiveness of telehealth interventions in reducing depressive symptoms and anxiety in women with PPD. To enhance the homogeneity and interpretability of the findings, this systematic review focuses on PPD measured by the Edinburgh Postnatal Depression Scale (EPDS). Methods PubMed, The Cochrane Library, CINAHL, PsycINFO, CNKI, and Wanfang were electronically searched to identify randomized controlled trials (RCTs) on the effectiveness of telehealth interventions for women with PPD from inception to February 28, 2021. Data extraction and quality assessment were performed independently by two researchers. The quality of included studies was assessed using the Cochrane risk-of-bias tool, and meta-analysis was performed using RevMan 5.4 software. Results Following the search, 9 RCTs with a total of 1958 women with PPD were included. The EPDS (mean difference=–2.99, 95% CI –4.52 to –1.46; P<.001) and anxiety (standardized mean difference=–0.39, 95% CI –0.67 to –0.12; P=.005) scores were significantly lower in the telehealth group compared with the control group. Significant subgroup differences were found in depressive symptoms according to the severity of PPD, telehealth technology, specific therapy, and follow-up time (P<.001). Conclusions Telehealth interventions could effectively reduce the symptoms of depression and anxiety in women with PPD. However, better designed and more rigorous large-scale RCTs targeting specific therapies are needed to further explore the potential of telehealth interventions for PPD. Trial Registration PROSPERO CRD42021258541; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=258541

Từ khóa


Tài liệu tham khảo

10.1016/j.jpsychires.2018.08.001

10.1016/j.jad.2014.12.041

10.1001/jamapsychiatry.2017.4363

10.1016/j.jad.2021.05.010

10.1146/annurev-med-041217-011106

10.1080/14740338.2018.1491546

10.1111/jmwh.12104

10.1016/j.midw.2018.05.009

10.1111/hsc.12479

10.1111/jocn.15378

10.1097/NMD.0000000000001096

10.3390/ijerph17113887

10.1002/phar.2071

10.2340/16501977-2297

10.1177/1357633X17700552

10.1177/1479972317724570

10.2196/16218

10.1016/j.ogc.2020.05.003

10.1007/s00404-012-2465-5

10.1007/s11065-017-9349-1

10.2196/mhealth.5284

10.1001/jama.282.18.1737

Beck, AT, 1996, Manual for the Beck Depression Inventory-II

10.1097/00006199-200009000-00006

10.1192/bjp.150.6.782

10.1192/bjp.172.5.433

10.1136/bmj.b2700

HigginsJThomasJChandlerJCumpstonMLiTPageMCochrane Handbook for Systematic Reviews of Interventions, version 6.220212021-08-30Cochranehttp://www.training.cochrane.org/handbook

10.1177/070674370304800209

10.1136/bmj.a3064

10.1192/bjp.2019.275

10.1016/j.beth.2019.09.007

10.1016/j.ijmedinf.2020.104145

10.1159/000430449

10.1016/j.jad.2013.03.005

10.1017/S0033291713002092

10.2196/12410

10.1016/j.ijnurstu.2019.07.002

10.1016/j.midw.2020.102906

10.1016/j.jad.2018.11.050

10.1186/s12884-016-0831-1

10.1111/birt.12553

10.2196/17011

10.2196/10007

Thông tin
Thông tin xuất bản

JMIR mHealth and uHealth

Tập 9 Số 10

e32544

Thông tin tác giả