Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 12, 2024
Date Accepted: Oct 17, 2024
Behavioral Therapy-Based Digital Intervention for Treating Osteoarthritis: A Systematic Review and Meta-analysis
ABSTRACT
Background:
Osteoarthritis (OA) is characterized by pain, functional impairment(s), muscle weakness, joint stiffness, and reduced health-related quality of life (HRQoL) . Since its heightened reliance on healthcare resources and exacerbates socioeconomic burden, remote OA rehabilitation using digital technologies is rapidly evolving.
Objective:
To analyse the efficacy of psychotherapy-based digital intervention(s) in patients with osteoarthritis (OA).
Methods:
Design: Systematic review of randomized controlled trials (RCTs). Data sources: The Web of Science, Embase, Cochrane Library, Ovid, and PubMed databases were searched from inception to June 2023. Eligibility criteria: RCTs that assessed the effects of psychotherapy-based digital intervention tools on OA.
Results:
Eleven eligible RCTs comprising 2108 patients with OA were included. Digital tools based on either cognitive behavioural therapy (CBT) or behavioural change technique (BCT) were investigated. All studies demonstrated low-to-moderate effects on pain reduction in the short term (standardised mean difference [SMD] -0.18 [95% CI -0.33 to -0.04) . Eight studies reported improvement in physical function (SMD -0.18 [95% CI -0.34 to -0.01]) and five confirmed increased pain self-efficacy (SMD 0.22 [95% CI 0.02 to 0.42]). In subgroup analysis, compared with CBT, BCT-based digital interventions demonstrated their effects on pain reduction (SMD-0.23 [95% CI -0.44 to -0.03]) and physical function (SMD-0.26 [95% CI -0.47 to -0.04]) in the short term. In addition, physiotherapist involvement in treatment had a positive effect on pain control (SMD-0.14 [95% CI -0.27 to -0.02]) and physical function (SMD -0.16 [95% CI -0.31 to -0.01]) in the short term. Furthermore, website-based digital tools improved physical function in the short term (SMD -0.21 [95% CI -0.41 to -0.01]).
Conclusions:
Moderate- and low-quality evidence supported that psychotherapy-based digital tools improved pain intensity, physical function, and self-efficacy in the short term. However, affective interactions between patients and professionals may affect clinical outcomes. Clinical Trial: CRD42023430716
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