Effectiveness of Telehealth Interventions for Women With Postpartum Depression: Systematic Review and Meta-analysis

Abstract

Background Postpartum depression (PPD) is a prevalent mental health problem with serious adverse consequences for affected women and their infants. Clinical trials have found that telehealth interventions for women with PPD result in increased accessibility and improved treatment effectiveness. However, no comprehensive synthesis of evidence from clinical trials by systematic review has been conducted. Objective The aim of this study is to evaluate the effectiveness of telehealth interventions in reducing depressive symptoms and anxiety in women with PPD. To enhance the homogeneity and interpretability of the findings, this systematic review focuses on PPD measured by the Edinburgh Postnatal Depression Scale (EPDS). Methods PubMed, The Cochrane Library, CINAHL, PsycINFO, CNKI, and Wanfang were electronically searched to identify randomized controlled trials (RCTs) on the effectiveness of telehealth interventions for women with PPD from inception to February 28, 2021. Data extraction and quality assessment were performed independently by two researchers. The quality of included studies was assessed using the Cochrane risk-of-bias tool, and meta-analysis was performed using RevMan 5.4 software. Results Following the search, 9 RCTs with a total of 1958 women with PPD were included. The EPDS (mean difference=–2.99, 95% CI –4.52 to –1.46; P<.001) and anxiety (standardized mean difference=–0.39, 95% CI –0.67 to –0.12; P=.005) scores were significantly lower in the telehealth group compared with the control group. Significant subgroup differences were found in depressive symptoms according to the severity of PPD, telehealth technology, specific therapy, and follow-up time (P<.001). Conclusions Telehealth interventions could effectively reduce the symptoms of depression and anxiety in women with PPD. However, better designed and more rigorous large-scale RCTs targeting specific therapies are needed to further explore the potential of telehealth interventions for PPD. Trial Registration PROSPERO CRD42021258541; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=258541

Promoting Mental Health in Parents of Young Children Using eHealth Interventions: A Systematic Review and Meta-analysis

“…To date there have been only a few eHealth-related meta-analyses, including four looking at online or technology-assisted parenting programs (Florean et al, 2020 ; Harris et al, 2020 ; Spencer et al, 2020 ; Thongseiratch et al, 2020 ) and one of telehealth family therapy programs (McLean et al, 2021 ), all with parent mental health as secondary outcomes. Some recent meta-analyses have also examined eHealth interventions for postpartum mental health (Feng et al, 2021 ; Zhao et al, 2021 ; Zhou et al, 2020 ), which represents a distinct period with unique challenges and care provisions where treatment needs and content would differ from that after infancy. However, there have been no systematic reviews or meta-analyses of the literature that identifies the effectiveness of a broader range of eHealth programs on mental health among parents of young children, specifically.…”

Effects of eHealth Interventions on Quality of Life and Psychological Outcomes in Cardiac Surgery Patients: Systematic Review and Meta-analysis

“…Two articles [ 51 , 57 ] reported that electronic intervention was ineffective in relieving anxiety, and another [ 59 ] showed mixed views. Electronic intervention was reported to be ineffective for depression in 2 studies [ 51 , 60 ], whereas 3 articles [ 54 , 55 , 59 ] provided mixed conclusions. There were mixed results regarding the effect of pain relief, with some studies [ 50 , 51 ] indicating no effect on pain relief, and others [ 55 , 61 ] reporting the opposite.…”

“…In terms of quality of life, 3 studies [49][50][51] reported that electronic interventions were ineffective, but 7 [52][53][54][55][56][57][58] reported improvement in quality of life. Two articles [51,57] reported that electronic intervention was ineffective in relieving anxiety, and another [59] showed mixed views. Electronic intervention was reported to be ineffective for depression in 2 studies [51,60], whereas 3 articles [54,55,59] provided mixed conclusions.…”

Telemental health for clinical assessment and treatment

“…38 In addition to the limited inclusion of studies among child/adolescent populations, there were few studies conducted in populations with psychotic disorders that were included in the meta-analyses. All reviews limited their searches to publications in English, apart from Zhao et al, 41 which also included Chinese language publications. Table 1 shows additional characteristics of the included meta-analytic reviews.…”