Hennemann Severin, Farnsteiner Sylvia, Sander Lasse
Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Germany.
Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany.
BMJ Open. 2017 Jun 26;7(6):e016696. doi: 10.1136/bmjopen-2017-016696.
Mental disorders are characterised by a high likelihood of symptom recurrence or chronicity. Thus, in the vulnerable post-discharge phase, aftercare and follow-up aim at stabilising treatment effects, promoting functionality and preventing relapse or readmission. Internet- and mobile-based interventions may represent low threshold and effective extensions to aftercare in tertiary prevention of mental disorders.
The planned systematic review and meta-analysis aims to synthesise and analyse existing evidence on the effectiveness of psychological internet- and mobile-based aftercare or follow-up in maintaining treatment effects and/or preventing recurrence in adults with mental disorders.
Electronic databases (PsycInfo, MEDLINE and Cochrane Central Register of Controlled trials) will be searched systematically, complemented by a hand-search of ongoing trials and reference lists of selected studies. Data extraction and evaluation will be conducted by two independent researchersand quality will be assessed with the Cochrane risk of bias tool. Eligibility criteria for selecting studies will be: randomised controlled trials of internet-based and mobile-based, psychological aftercare and follow-up for the tertiary prevention of mental disorders in an adult population. Primary outcome will be symptom severity. Secondary outcomes will be symptom or disorder recurrence rate, rehospitalisation rate, functionality, quality of life or adherence to primary treatment. Further data items to be extracted will be: study design, intervention and technical characteristics, type of mental disorder or clinical symptom to be treated, target population items, setting, treatment engagement and assessment of additional outcome variables. Meta-analytic pooling will be conducted when data of included studies are comparable in terms of study design, intervention type, endpoints, assessments and target mental disorder. Cumulative evidence will be evaluated according to the Grading of Recommendations Assessment, Development and Evaluation framework.
Ethics approval is not required. Results from this review will be published in peer-reviewed journals and presented at international conferences.
PROSPERO CRD42017055289.
精神障碍的特点是症状复发或慢性化的可能性很高。因此，在易受影响的出院后阶段，后续护理和随访旨在稳定治疗效果、促进功能恢复并预防复发或再次入院。基于互联网和移动设备的干预措施可能是精神障碍三级预防中后续护理的低门槛且有效的扩展方式。
计划进行的系统评价和荟萃分析旨在综合和分析现有证据，以探讨基于互联网和移动设备的心理后续护理或随访在维持精神障碍成年患者治疗效果和/或预防复发方面的有效性。
将系统检索电子数据库（PsycInfo、MEDLINE和Cochrane对照试验中央注册库），并辅以手工检索正在进行的试验以及所选研究的参考文献列表。数据提取和评估将由两名独立研究人员进行，质量将使用Cochrane偏倚风险工具进行评估。选择研究的纳入标准将是：针对成年人群精神障碍三级预防的基于互联网和移动设备的心理后续护理和随访的随机对照试验。主要结局将是症状严重程度。次要结局将是症状或障碍复发率、再次住院率、功能、生活质量或对初始治疗的依从性。要提取的其他数据项将包括：研究设计、干预和技术特征、待治疗的精神障碍或临床症状类型、目标人群项目、环境、治疗参与情况以及其他结局变量的评估。当纳入研究的数据在研究设计、干预类型、终点、评估和目标精神障碍方面具有可比性时，将进行荟萃分析合并。将根据推荐分级评估、制定和评价框架对累积证据进行评估。
无需伦理批准。本评价的结果将发表在同行评审期刊上，并在国际会议上展示。
PROSPERO CRD42017055289。
