Efficacy of digital health interventions on depression and anxiety in patients with cardiac disease: a systematic review and meta-analysis

Abstract

Depression and anxiety have a detrimental effect on the health outcomes of patients with heart disease. Digital health interventions (DHIs) could offer a solution to treat depression and anxiety in patients with heart disease, but evidence of its efficacy remains scarce. This review summarizes the latest data about the impact of DHIs on depression/anxiety in patients with cardiac disease. Articles from 2000 to 2021 in English were searched through electronic databases (PubMed, Cochrane Library, and Embase). Articles were included if they incorporated a randomized controlled trial design for patients with cardiac disease and used DHIs in which depression or anxiety was set as outcomes. A systematic review and meta-analysis were performed. A total of 1675 articles were included and the screening identified a total of 17 articles. Results indicated that telemonitoring systems have a beneficial effect on depression [standardized mean difference for depression questionnaire score −0.78 (P=0.07), −0.55 (P<0.001), for with and without involving a psychological intervention, respectively]. Results on PC or cell phone–based psychosocial education and training have also a beneficial influence on depression [standardized mean difference for depression questionnaire score −0.49 (P=0.009)]. Telemonitoring systems for heart failure and PC/cell phone–based psychosocial education and training for patients with heart failure or coronary heart disease had a beneficial effect especially on depression. Regarding telemonitoring for heart failure, this effect was reached even without incorporating a specific psychological intervention. These results illustrate the future potential of DHIs for mental health in cardiology.