Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials.

Mobile phone-based interventions have been proposed as a means for reducing the burden of disease associated with mental illness. While numerous randomized controlled trials and meta-analyses have investigated this possibility, evidence remains unclear. We conducted a systematic meta-review of meta-...

Full description

Bibliographic Details
Main Authors: Simon B Goldberg, Sin U Lam, Otto Simonsson, John Torous, Shufang Sun
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLOS Digital Health
Online Access:https://doi.org/10.1371/journal.pdig.0000002
_version_ 1797725862624231424
author Simon B Goldberg
Sin U Lam
Otto Simonsson
John Torous
Shufang Sun
author_facet Simon B Goldberg
Sin U Lam
Otto Simonsson
John Torous
Shufang Sun
author_sort Simon B Goldberg
collection DOAJ
description Mobile phone-based interventions have been proposed as a means for reducing the burden of disease associated with mental illness. While numerous randomized controlled trials and meta-analyses have investigated this possibility, evidence remains unclear. We conducted a systematic meta-review of meta-analyses examining mobile phone-based interventions tested in randomized controlled trials. We synthesized results from 14 meta-analyses representing 145 randomized controlled trials and 47,940 participants. We identified 34 effect sizes representing unique pairings of participants, intervention, comparisons, and outcome (PICO) and graded the strength of the evidence as using umbrella review methodology. We failed to find convincing evidence of efficacy (i.e., n > 1000, p < 10-6, I2 < 50%, absence of publication bias); publication bias was rarely assessed for the representative effect sizes. Eight effect sizes provided highly suggestive evidence (i.e., n > 1000, p < 10-6), including smartphone interventions outperforming inactive controls on measures of psychological symptoms and quality of life (ds = 0.32 to 0.47) and text message-based interventions outperforming non-specific controls and active controls for smoking cessation (ds = 0.31 and 0.19, respectively). The magnitude of effects and strength of evidence tended to diminish as comparison conditions became more rigorous (i.e., inactive to active, non-specific to specific). Four effect sizes provided suggestive evidence, 14 effect sizes provided weak evidence, and eight effect sizes were non-significant. Despite substantial heterogeneity, no moderators were identified. Adverse effects were not reported. Taken together, results support the potential of mobile phone-based interventions and highlight key directions to guide providers, policy makers, clinical trialists, and meta-analysts working in this area.
first_indexed 2024-03-12T10:37:19Z
format Article
id doaj.art-2f1575c0f89c494fb5d8e89059ed1443
institution Directory Open Access Journal
issn 2767-3170
language English
last_indexed 2024-03-12T10:37:19Z
publishDate 2022-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLOS Digital Health
spelling doaj.art-2f1575c0f89c494fb5d8e89059ed14432023-09-02T08:33:27ZengPublic Library of Science (PLoS)PLOS Digital Health2767-31702022-01-0111e000000210.1371/journal.pdig.0000002Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials. Simon B GoldbergSin U LamOtto SimonssonJohn TorousShufang SunMobile phone-based interventions have been proposed as a means for reducing the burden of disease associated with mental illness. While numerous randomized controlled trials and meta-analyses have investigated this possibility, evidence remains unclear. We conducted a systematic meta-review of meta-analyses examining mobile phone-based interventions tested in randomized controlled trials. We synthesized results from 14 meta-analyses representing 145 randomized controlled trials and 47,940 participants. We identified 34 effect sizes representing unique pairings of participants, intervention, comparisons, and outcome (PICO) and graded the strength of the evidence as using umbrella review methodology. We failed to find convincing evidence of efficacy (i.e., n > 1000, p < 10-6, I2 < 50%, absence of publication bias); publication bias was rarely assessed for the representative effect sizes. Eight effect sizes provided highly suggestive evidence (i.e., n > 1000, p < 10-6), including smartphone interventions outperforming inactive controls on measures of psychological symptoms and quality of life (ds = 0.32 to 0.47) and text message-based interventions outperforming non-specific controls and active controls for smoking cessation (ds = 0.31 and 0.19, respectively). The magnitude of effects and strength of evidence tended to diminish as comparison conditions became more rigorous (i.e., inactive to active, non-specific to specific). Four effect sizes provided suggestive evidence, 14 effect sizes provided weak evidence, and eight effect sizes were non-significant. Despite substantial heterogeneity, no moderators were identified. Adverse effects were not reported. Taken together, results support the potential of mobile phone-based interventions and highlight key directions to guide providers, policy makers, clinical trialists, and meta-analysts working in this area.https://doi.org/10.1371/journal.pdig.0000002
spellingShingle Simon B Goldberg
Sin U Lam
Otto Simonsson
John Torous
Shufang Sun
Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials.
PLOS Digital Health
title Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials.
title_full Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials.
title_fullStr Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials.
title_full_unstemmed Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials.
title_short Mobile phone-based interventions for mental health: A systematic meta-review of 14 meta-analyses of randomized controlled trials.
title_sort mobile phone based interventions for mental health a systematic meta review of 14 meta analyses of randomized controlled trials
url https://doi.org/10.1371/journal.pdig.0000002
work_keys_str_mv AT simonbgoldberg mobilephonebasedinterventionsformentalhealthasystematicmetareviewof14metaanalysesofrandomizedcontrolledtrials
AT sinulam mobilephonebasedinterventionsformentalhealthasystematicmetareviewof14metaanalysesofrandomizedcontrolledtrials
AT ottosimonsson mobilephonebasedinterventionsformentalhealthasystematicmetareviewof14metaanalysesofrandomizedcontrolledtrials
AT johntorous mobilephonebasedinterventionsformentalhealthasystematicmetareviewof14metaanalysesofrandomizedcontrolledtrials
AT shufangsun mobilephonebasedinterventionsformentalhealthasystematicmetareviewof14metaanalysesofrandomizedcontrolledtrials