JMIR Publications

ABSTRACT

Background:

Depression and anxiety disorders are common, and treatment often includes psychological interventions. Digital health interventions, delivered via technologies such as web-based programs and mobile apps, are increasingly used in mental health treatment. Acceptability, the extent to which an intervention is viewed positively, has been identified as contributing to patient adherence and engagement with digital health interventions. Acceptability therefore impacts the benefit that can be derived from using digital health interventions in treatment. Understanding the acceptability of digital mental health interventions among patients with depression and/or anxiety disorders is essential to maximize the effectiveness of their treatment.

Objective:

This review investigates the acceptability of technology-based interventions among patients with depression and/or anxiety disorders.

Methods:

A systematic review was performed based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and PROSPERO (International Prospective Register of Systematic Reviews) guidelines. We searched PubMed, Web of Science, and Ovid. Studies were included if they evaluated digital interventions for the treatment of depression and/or anxiety disorders and investigated their acceptability among adult patients. Studies were excluded if they targeted only specific populations (e.g., those with specific physical health conditions), investigated acceptability in healthy individuals or patients under the age of 18, involved no direct interaction between patients and technologies, used technology only as a platform for traditional care (e.g., videoconferencing), had patients using technologies only in clinical or laboratory settings, or involved virtual reality technologies.

Results:

One hundred forty-three articles met the inclusion criteria, comprising 67 articles on interventions for depression, 65 articles on interventions for anxiety disorders, and 11 articles on interventions for both. Ninety were randomized controlled trials, 50 were quantitative studies other than randomized controlled trials, and three were qualitative studies. The interventions used web-based programs, mobile apps, and computer programs. Cognitive behavioural therapy was the basis of 71% of the interventions. Digital mental health interventions were generally found to be acceptable among patients with depression and/or anxiety disorders, with 88% indicating positive acceptability, 8% mixed results, and 4% insufficient information to categorize the direction of acceptability. The available research evidence was of moderate quality.

Conclusions:

Digital mental health interventions appear acceptable to patients with depression and/or anxiety disorders. Consistent use of validated measures for acceptability would enhance quality of evidence. Careful design of acceptability as an evaluation outcome can further improve quality of evidence.