Do Web-Based Interventions Improve Well-Being in Type 2 Diabetes? A Systematic Review and Meta-Analysis

Abstract

BackgroundPoor diabetes self-care can have a negative impact on psychological well-being and quality of life. Given the scarcity of traditional psychological support and the barriers to uptake of and attendance at face-to-face education programs, Web-based interventions are becoming a popular approach to provide an additional platform for psychological support in long-term conditions. However, there is limited evidence to assess the effect of Web-based psychological support in people with type 2 diabetes.ObjectiveThis systematic review is the first review to critically appraise and quantify the evidence on the effect of Web-based interventions that aim to improve well-being in people with type 2 diabetes.MethodsSearches were carried out in the following electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Library. Reference lists were hand-searched. A meta-analysis was conducted for depression and distress outcomes.ResultsA total of 16 randomized controlled studies met the inclusion criteria for the systematic review and 9 were included in the meta-analyses. Theories were applied to the majority of the interventions. The most common behavior change techniques were “General information” and “Tracking/monitoring.” Interventions with a duration of 2-6 months providing professional-led support with asynchronous and synchronous communication appeared to be associated with significant well-being outcomes. The pooled mean (95% confidence interval) difference between the intervention and control arms at follow-up on depression score was -0.31 (-0.73 to 0.11). The pooled mean difference on distress scores at follow-up was -0.11 (-0.38 to 0.16). No significant improvements in depression (P=.15) or distress (P=.43) were found following meta-analyses.ConclusionsWhile the meta-analyses demonstrated nonsignificant results for depression and distress scores, this review has shown that there is a potential for Web-based interventions to improve well-being outcomes in type 2 diabetes. Further research is required to confirm the findings of this review.

The Effectiveness of Smartphone Apps for Lifestyle Improvement in Noncommunicable Diseases: Systematic Review and Meta-Analyses

“…Meta-analysis on the effects of mHealth in patients with DM have reported a significant reduction in HbA 1c of 0.33% [ 37 ]. Such interventions may also have a potential to improve well-being in patients with DM type 2, although the results did not reach statistical significance in favor of the intervention [ 38 ], which is in line with our results.…”

The Use of New Digital Information and Communication Technologies in Psychological Counseling during the COVID-19 Pandemic

“…Regarding the effectiveness of these online means, in general, studies allow us to conclude that internet interventions may be efficacious and cost-effective [ 6 , 16 , 17 , 19 , 20 , 32 , 33 , 34 , 35 ]. They seemed to be at least as effective as face-to-face interventions in a large group of clients receiving treatment for psychological disorders, namely, for generalized anxiety and other types of anxiety disorders [ 36 , 37 , 38 , 39 , 40 , 41 , 42 ], depression [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ], and stress [ 53 , 54 ].…”

A Web-Based Public Health Intervention to Reduce Functional Impairment and Depressive Symptoms in Adults With Type 2 Diabetes (The SpringboarD Trial): Randomized Controlled Trial Protocol

“…The personal and economic costs of comorbid type 2 diabetes and depressive symptoms are substantial. However, the development of Internet-delivered interventions offers a potential solution to mitigate these impacts [ 13 - 15 ]. myCompass is a broadly available and efficacious public health intervention that can be delivered at minimal cost [ 45 ].…”

“…Internet delivery of evidence-based psychological therapies is a popular, clinically effective, and cost-effective means of increasing treatment reach; a small number of Web-based diabetes-specific interventions that directly target depression have been evaluated [ 13 ]. These include van Bastelaar et al’s [ 14 ] adaptation of Lewinsohn’s Coping with Depression Program and Nobis et al’s [ 15 ] application of systematic behavioral activation and problem-solving therapy (ie, GesundheitsTraining.Online Mood Enhancer Diabetes [GET.ON MED]).…”