JMIR Publications

ABSTRACT

Background:

Chronic conditions are characterized by their long duration (1 year or more), need for ongoing medical attention, and limitations on activities of daily living. These can often co-occur, with depression and anxiety as particularly common and detrimental comorbidities among the growing population living with chronic conditions. Digital health interventions (DHIs) hold promise in overcoming barriers to accessing mental health support for these individuals; however, the design and implementation of DHIs for depression and/or anxiety for people with chronic conditions is yet to be explored.

Objective:

To explore what is known in the literature about DHIs for the prevention, detection, or treatment of depression and/or anxiety among people with chronic conditions.

Methods:

A scoping review of the literature was conducted using the Arksey & O’Malley framework. Searches of the literature published in five databases between 1990 and 2019 were conducted in April 2019 and updated in March 2021. To be included, studies must have described a DHI tested with, or designed for, the prevention, detection, or treatment of depression and/or anxiety in people with common chronic conditions (arthritis, asthma, diabetes mellitus, heart disease, chronic obstructive pulmonary disease, cancer, stroke, Alzheimer’s disease and/or dementia). Studies were independently screened by two reviewers against the inclusion and exclusion criteria. Both quantitative and qualitative data were extracted, charted, and synthesized to provide a descriptive summary of the trends and considerations for future research.

Results:

Database searches yielded a total of 11,422 articles across the initial and update searches, 53 of which were included in this review. DHIs predominantly sought to provide treatment (n=44), followed by detection (n=5) and prevention (n=4). Most DHIs were focused on depression (n=36), guided (n=32), tailored to the chronic physical condition (n=19), and delivered through web-based platforms (n=20). Only two studies described the implementation of a DHI.

Conclusions:

As a growing research area, DHIs offer the potential to address the gap in care for depression and anxiety among people with chronic conditions; however, their implementation in standard care is scarce. While stepped care was identified as a promising model to implement efficacious DHIs, few studies have investigated the use of DHIs for depression and anxiety among chronic conditions with such models. In developing stepped care, we outline DHI tailoring, guidance, and intensity as key considerations requiring further research.