Maisto Marta, Diana Barbara, Di Tella Sonia, Matamala-Gomez Marta, Montana Jessica Isbely, Rossetto Federica, Mavrodiev Petar Aleksandrov, Cavalera Cesare, Blasi Valeria, Mantovani Fabrizia, Baglio Francesca, Realdon Olivia
Center for Studies in Communication Sciences "Luigi Anolli", Department of Human Sciences for Education "Riccardo Massa", University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy.
IRCCS Fondazione don Carlo Gnocchi ONLUS, Via Capecelatro 66, 20148 Milan, Italy.
J Pers Med. 2021 Jan 6;11(1):30. doi: 10.3390/jpm11010030.
Chronic diseases represent one of the main causes of death worldwide. The integration of digital solutions in clinical interventions is broadly diffused today; however, evidence on their efficacy in addressing psychological comorbidities of chronic diseases is sparse. This systematic review analyzes and synthesizes the evidence about the efficacy of digital interventions on psychological comorbidities outcomes of specific chronic diseases. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of PubMed, PsycInfo, Scopus and Web of Science databases was conducted. Only Randomized Controlled Trials (RCTs) were considered and either depression or anxiety had to be assessed to match the selection criteria. Of the 7636 identified records, 17 matched the inclusion criteria: 9 digital interventions on diabetes, 4 on cardiovascular diseases, 3 on Chronic Obstructive Pulmonary Disease (COPD) and one on stroke. Of the 17 studies reviewed, 14 found digital interventions to be effective. Quantitative synthesis highlighted a moderate and significant overall effect of interventions on depression, while the effect on anxiety was small and non-significant. Design elements making digital interventions effective for psychological comorbidities of chronic diseases were singled out: (a) implementing a communication loop with patients and (b) providing disease-specific digital contents. This focus on "how" to design technologies can facilitate the translation of evidence into practice.
慢性病是全球主要死因之一。如今，数字解决方案在临床干预中的整合已广泛普及；然而，关于其在解决慢性病心理合并症方面功效的证据却很稀少。本系统综述分析并综合了有关数字干预对特定慢性病心理合并症结局功效的证据。根据系统评价和Meta分析的首选报告项目（PRISMA）指南，对PubMed、PsycInfo、Scopus和Web of Science数据库进行了系统检索。仅纳入随机对照试验（RCT），且必须评估抑郁或焦虑情况以符合选择标准。在7636条检索到的记录中，17条符合纳入标准：9项针对糖尿病的数字干预、4项针对心血管疾病的、3项针对慢性阻塞性肺疾病（COPD）的以及1项针对中风的。在纳入综述的17项研究中，14项发现数字干预有效。定量综合分析突出了干预对抑郁有中度且显著的总体效果，而对焦虑的效果较小且不显著。确定了使数字干预对慢性病心理合并症有效的设计要素：（a）与患者建立沟通循环，以及（b）提供针对特定疾病的数字内容。这种对“如何”设计技术的关注能够促进将证据转化为实践。
