JMIR Publications

ABSTRACT

Background:

The prevalence of mental health problems continues to rise with almost 4% of the world population having an anxiety disorder and almost 3.5% having depression in 2017. Despite the high prevalence only one third of people with depression or anxiety receive treatment. Over the last decade the use of digital health interventions has risen rapidly as a means of accessing mental health care and continues to increase. Although there is evidence supporting the effectiveness of digital health interventions (DHIs) for the treatment of mental health conditions, little is known about what aspects are valued by users and how they might be improved.

Objective:

This systematic review aims to identify, appraise and synthesise the qualitative literature available on service-users’ views and experiences regarding the acceptability and usability of DHIs for depressive, anxiety and somatoform disorders.

Methods:

A systematic search strategy was developed and searches were run in seven electronic databases. Qualitative and mixed-methods studies published in English were included. Meta-synthesis was used to interpret and synthesise the findings from the included studies.

Results:

Twenty-four studies were included in the meta-synthesis. Three key themes emerged with descriptive subthemes. The three key themes were; (1) Initial motivations and approaches to DHIs, (2) Personalisation of treatment and (3) The value of receiving personal support in DHIs. The meta-synthesis suggests that participants’ initial beliefs about DHIs can have an important effect on their engagement with these types of interventions. Personal support was valued very highly as a major component of DHIs success or otherwise. The main reason for this was the way it enabled individual personalisation of care.

Conclusions:

Findings from the systematic review have implications for the design of future digital health interventions to improve uptake, retention and outcome to DHIs for depressive, anxiety and somatoform disorders. DHIs need to be personalised to the specific needs of the individual. Future research should explore if the findings could be generalised.