JMIR Publications

ABSTRACT

Objective:

We conducted a systematic review and meta-analysis on the effectiveness and feasibility of internet- and mobile-based interventions against symptoms of grief after bereavement.

Methods:

Systematic literature searches of randomized controlled trials or feasibility studies published before 9th of January 2020 following the PRISMA-guidelines were conducted in PubMed, PsycInfo, Web of Science Core Collection and the Cochrane Library. Quality of evidence was assessed using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) system; we further assessed aspects of feasibility and rated quality of interventions using criteria suggested by an expert panel on mental health care (German Association for Psychiatry, Psychotherapy and Psychosomatics; DGPPN). Random effects meta-analysis was conducted, assessing between-group effect sizes.

Results:

Nine trials were included, comprising a total of 1.349 individuals. Of these, seven studies were analyzed meta-analytically. Significant effects were found for symptoms of grief (g = 0.54; 95% CI = 0.32.; 0.77), depression (g = 0.44; 95% CI = 0.20; 0.68) and posttraumatic stress (g = 0.82; 95% CI = 0.63; 1.01). Heterogeneity was moderate for grief and depression (I² = 48.75% and 55.19%, respectively) and low for posttraumatic stress symptoms (I²=0.00%). Overall-quality of evidence was graded low (grief, depression) to moderate (posttraumatic stress). User satisfaction with interventions was high, as was quality of interventions assessed using objective quality criteria.

Conclusions:

Internet- or mobile-based interventions might constitute an effective treatment approach against symptoms of grief in bereaved adults. However, small sample sizes and limited numbers of studies included in the review warrant further investigations. Registration: The systematic review was registered with PROSPERO (registration number: CRD42012002100).