Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 7, 2024
Date Accepted: Mar 3, 2025
Efficacy of E-Health Interventions for Hemodialysis Patients: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Within hemodialysis patient populations, e-health interventions have been considered as an alternative and complementary option to routine care services. However, the effects of e-health interventions on quality of life, treatment adherence, anxiety, and depression among hemodialysis patients remain poorly understood owing to a lack of rigorous quantitative evidence synthesis.
Objective:
To determine the efficacy of e-health interventions on quality of life, treatment adherence, anxiety, and depression among hemodialysis patients.
Methods:
A comprehensive search was performed across PubMed, Web of Science, EMBASE, CINAHL, Cochrane Library, PsycINFO, CNKI, WanFang, VIP, and CBM databases from their inception to 7 September 2024. Randomized controlled trials on e-health interventions for hemodialysis patients published in English or Chinese were included. Critical appraisal was carried out independently by two reviewers to assess the bias risk of the included studies. Quantitative synthesis of the outcomes of interest was conducted using a random-effects model. The quality of evidence for the outcomes was assessed following the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.
Results:
Seventeen randomized controlled trials involving 1728 participants were included. The results of the meta-analysis revealed a significant difference between the e-health interventions and control groups on quality of life (SMD = 0.87, 95 % CI 0.38 to 1.37, low certainty evidence), treatment adherence (SMD = 1.11, 95 % CI 0.30 to 1.91, moderate certainty evidence), anxiety (SMD = -2.11, 95 % CI -3.25 to -0.97, moderate certainty evidence), and depression (SMD = -2.46, 95 % CI -3.68 to -1.25, moderate certainty evidence).
Conclusions:
E-health interventions could be a beneficial approach for improving quality of life and treatment adherence, and reducing anxiety and depression among hemodialysis patients. However, considering the worrying overall methodological quality of the included studies, future high-quality randomized controlled trials are essential to draw more reliable conclusions. Clinical Trial: PROSPERO CRD42024589799; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=589799
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