Efficacy of technology-based interventions in psychosis: a systematic review and network meta-analysis

Abstract

Background Technology-based interventions (TBIs) are a useful approach when attempting to provide therapy to more patients with psychosis. Methods Randomized controlled trials of outcomes of TBIs v. face-to-face interventions in psychosis were identified in a systematic search conducted in PubMed/Ovid MEDLINE. Data were extracted independently by two researchers, and standardized mean changes were pooled using a three-level model and network meta-analysis. Results Fifty-eight studies were included. TBIs complementing treatment as usual (TAU) were generally superior to face-to-face interventions (g = 0.16, p ≤ 0.0001) and to specific outcomes, namely, neurocognition (g = 0.13, p ≤ 0.0001), functioning (g = 0.25, p = 0.006), and social cognition (g = 0.32, p ≤ 0.05). Based on the network meta-analysis, the effect of two TBIs differed significantly from zero; these were the TBIs cognitive training for the neurocognitive outcome [g = 0.16; 95% confidence interval (CI) 0.09–0.23] and cognitive behavioral therapy for quality of life (g = 1.27; 95% CI 0.46–2.08). The variables educational level, type of medication, frequency of the intervention, and contact during the intervention moderated the effectiveness of TBIs over face-to-face interventions in neurocognition and symptomatology. Conclusions TBIs are effective for the management of neurocognition, symptomatology, functioning, social cognition, and quality of life outcomes in patients with psychosis. The results of the network meta-analysis showed the efficacy of some TBIs for neurocognition, symptomatology, and quality of life. Therefore, TBIs should be considered a complement to TAU in patients with psychosis.

Implementing Technologies to Enhance Coordinated Specialty Care Framework: Implementation Outcomes From a Development and Usability Study

“…Given that recent meta-analyses show promise that digital technologies can effectively enhance care in psychosis treatment [ 12 ], it is of significance to explore the effectiveness of digital technologies on symptomatic and functional outcomes in concert with implementation outcomes. Assessing these outcomes in concert may shed light on the necessary next steps needed to bring the benefit of digital technologies to the clinical setting.…”

Whispers of progress

“…eMental-health offers new possibilities for the study of voice-hearing and presents new treatment opportunities. Morales-Pillado et al (2023) found in their systematic review and network meta-analysis that digital interventions in general, including computer-and internet-based interventions, as a complement to treatment-as-usual (TAU), were on average slightly more effective in reducing psychotic symptoms than face-to-face interventions (g=0.16) in patients with psychosis. They concluded that digital interventions should be considered to be combined with TAU to patients with psychosis, since these interventions might be more accessible, flexible, and cost-effective than other face-to-face interventions.…”