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Two decades of digital interventions for anxiety disorders: a systematic review and meta-analysis of treatment effectiveness
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Two decades of digital interventions for anxiety disorders: a systematic review and meta-analysis of treatment effectiveness
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Journal Article
Two decades of digital interventions for anxiety disorders: a systematic review and meta-analysis of treatment effectiveness
2023
Overview
Digital interventions for anxiety disorders are a promising solution to address barriers to evidence-based treatment access. Precise and powerful estimates of digital intervention effectiveness for anxiety disorders are necessary for further adoption in practice. The present systematic review and meta-analysis examined the effectiveness of digital interventions across all anxiety disorders and specific to each disorder
wait-list and care-as-usual controls.
A systematic search of bibliographic databases identified 15 030 abstracts from inception to 1 January 2020. Forty-seven randomized controlled trials (53 comparisons; 4958 participants) contributed to the meta-analysis. Subgroup analyses were conducted by an anxiety disorder, risk of bias, treatment support, recruitment, location and treatment adherence.
A large, pooled effect size of
= 0.80 [95% Confidence Interval: 0.68-0.93] was found in favor of digital interventions. Moderate to large pooled effect sizes favoring digital interventions were found for generalized anxiety disorder (
= 0.62), mixed anxiety samples (
= 0.68), panic disorder with or without agoraphobia (
= 1.08) and social anxiety disorder (
= 0.76) subgroups. No subgroups were significantly different or related to the pooled effect size. Notably, the effects of guided interventions (
= 0.84) and unguided interventions (
= 0.64) were not significantly different. Supplemental analysis comparing digital and face-to-face interventions (9 comparisons; 683 participants) found no significant difference in effect [
= 0.14 favoring digital interventions; Confidence Interval: -0.01 to 0.30].
The precise and powerful estimates found further justify the application of digital interventions for anxiety disorders in place of wait-list or usual care.
