Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review

JMIR Mental Health, Год журнала: 2022, Номер 9(5), С. e35159 - e35159

Опубликована: Март 2, 2022

Background The COVID-19 pandemic has shifted mental health care delivery to digital platforms, videoconferencing, and other mobile communications. However, existing reviews of interventions are narrow in scope focus on a limited number conditions. Objective To address this gap, we conducted comprehensive systematic meta-review the literature assess state for treatment Methods We searched MEDLINE secondary published between 2010 2021 use, efficacy, appropriateness care. Results Of 3022 records identified, 466 proceeded full-text review 304 met criteria inclusion study. A majority (52%) research involved substance use disorders, 29% focused mood, anxiety, traumatic stress >5% each remaining Synchronous asynchronous communication, computerized therapy, cognitive training appear be effective but require further examination understudied Similarly, virtual reality, apps, social media web-based forums novel technologies that have potential improve higher quality evidence. Conclusions Digital offer promise In context pandemic, provide safer alternative face-to-face treatment. applications conditions is needed. Additionally, evidence needed effectiveness tools patients who marginalized may lack access interventions.

Язык: Английский

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Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review

Current Neuropharmacology, Год журнала: 2023, Номер 22(4), С. 557 - 635

Опубликована: Май 3, 2023

Abstract: This narrative state-of-the-art review paper describes the progress in understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over last four decades, scientific landscape has matured, with many interdisciplinary contributions to its diagnosis, etiology, epidemiology. Advances genetics, neurobiology, stress pathophysiology, brain imaging have made it apparent that chronic PTSD is a systemic disorder high allostatic load. The current state includes wide variety pharmacological psychotherapeutic approaches, which are evidence-based. However, myriad challenges inherent disorder, such as individual barriers good outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, trauma-related guilt shame, often render response suboptimal. These discussed drivers for emerging novel including early interventions Golden Hours, interventions, medication augmentation use psychedelics, well targeting nervous system. All this aims improve symptom relief clinical outcomes. Finally, phase orientation recognized tool strategize position step progression pathophysiology. Revisions guidelines systems care will be needed incorporate innovative treatments evidence emerges they become mainstream. generation well-positioned address devastating disabling impact traumatic events through holistic, cutting-edge efforts research.

Язык: Английский

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Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review

Journal of Medical Internet Research, Год журнала: 2023, Номер 25, С. e48000 - e48000

Опубликована: Июль 25, 2023

Background Digital therapeutics are patient-facing digital health interventions that can significantly alter the care landscape. Despite being used to successfully treat a range of conditions, their uptake in systems remains limited. Understanding full spectrum factors is essential identify ways which policy makers and providers facilitate adoption effective within system, as well steps developers take assist deployment products. Objective In this review, we aimed map most frequently discussed determine integration into practical use by patients professionals. Methods A scoping review was conducted MEDLINE, Web Science, Cochrane Database Systematic Reviews, Google Scholar. Relevant data were extracted synthesized using thematic analysis. Results We identified 35,541 academic 221 gray literature reports, with 244 (0.69%) included covering 35 countries. Overall, 85 impact pooled 5 categories: patient characteristics, properties therapeutics, characteristics professionals, outcomes. The need for regulatory framework stated factor at level. Demographic formed iterated patient-related factor, whereas literacy considered important Among interoperability across broader system emphasized. Finally, ability expand access outcome measure. Conclusions developed offers multistakeholder approach recognizing pathway provides an analytical tool assess system’s readiness therapeutics.

Язык: Английский

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Digital health for quality healthcare: A systematic mapping of review studies

Digital Health, Год журнала: 2022, Номер 8, С. 205520762210858 - 205520762210858

Опубликована: Янв. 1, 2022

Objective To systematically catalogue review studies on digital health to establish extent of evidence quality healthcare and illuminate gaps for new understanding, perspectives insights evidence-informed policies practices. Methods We searched PubMed database using sensitive search strings. Two reviewers independently conducted two-phase selection via title abstract, followed by full-text appraisal. Consensuses were derived any discrepancies. A standardized data extraction tool was used reliable mining. Results total 54 reviews from year 2014 2021 included with notable increase in trend publications. Systematic constituted the majority (61.1%, (37.0% meta-analyses)) scoping (38.9%). Domains being reviewed include effectiveness (75.9%), accessibility (33.3%), patient safety (31.5%), efficiency (25.9%), patient-centred care (20.4%) equity (16.7%). Mobile apps computer-based commonest (79.6%) modalities. Strategies effective intervention engineering improved behaviour (50.0%), better clinical assessment (35.1%), treatment compliance (33.3%) enhanced coordination (24.1%). Psychiatry discipline most topics (20.3%). Conclusion Digital reported findings that skewed towards improving mHealth applications, predominantly related mental behavioural therapies. There considerable cost efficiency, equitable care. Future empirical may investigate association between fields practice tendency adopt research use improve

Язык: Английский

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A network meta-analysis of psychosocial interventions for refugees and asylum seekers with PTSD

BMJ Global Health, Год журнала: 2021, Номер 6(6), С. e005029 - e005029

Опубликована: Июнь 1, 2021

Introduction Refugees and asylum seekers are vulnerable to common mental disorders, including post-traumatic stress disorder (PTSD). Using a network meta-analysis (NMA) approach, the present systematic review compared ranked psychosocial interventions for treatment of PTSD in adult refugees seekers. Methods Randomised studies with were systematically identified. symptoms at postintervention was primary outcome. Standardised mean differences (SMDs) ORs pooled using pairwise NMA. Study quality assessed Cochrane Risk Bias (RoB) tool, certainty evidence through Confidence Network Meta-Analysis application. Results A total 23 2308 participants included. Sixteen conducted high-income countries, seven low-income or middle-income countries. Most low risk bias according RoB tool. NMA on showed that cognitive behavioural therapy (CBT) (SMD=−1.41; 95% CI −2.43 −0.38) eye movement desensitisation reprocessing (EMDR) (SMD=−1.30; −2.40 −0.20) significantly more effective than waitlist (WL). CBT also associated higher decrease as usual (TAU) (SMD −1.51; −2.67 −0.36). For all other interventions, difference WL TAU not significant. EMDR best surface under cumulative ranking. Regarding acceptability, no intervention had less dropouts inactive interventions. Conclusion appeared have greatest effects reducing refugees. This should be considered guidelines implementation packages facilitate dissemination uptake refugee settings.

Язык: Английский

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Adjusting to a new reality: Consensual qualitative research on therapists' experiences with teletherapy

Journal of Clinical Psychology, Год журнала: 2023, Номер 79(5), С. 1293 - 1313

Опубликована: Янв. 27, 2023

In the wake of COVID-19 pandemic, use teletherapy has become more pervasive than ever. Many therapists faced this move to a remote setting with little experience or training. We aimed qualitatively examine therapists' subjective providing teletherapy, including changes in technique, therapeutic relationship, and process.Thirty-one psychotherapists participated semistructured interviews. Interviews were recorded, then transcribed analyzed using Consensual Qualitative Research method.Therapists typically reported change relationship terms an increased sense disconnection as well shifts various aspects relational dynamics, they also experienced differences therapy process due patient therapist engagement work. Additionally, some that became active directive sessions, took informal, personal, relaxed approach interacting patients, while emotional connection changed missed energy intimacy in-person telesessions felt authentic human for some, provided way discuss new dimensions process.Overall, these results suggest great variability experiences present distinct format many aspects. Further process-level research subsequent training is needed better equip navigate teletherapy's challenges harness its unique opportunities.

Язык: Английский

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A digital self-help tool to promote mental well-being for Ukrainians affected by war - Assessing predictors of stress

Neuroscience Applied, Год журнала: 2024, Номер 3, С. 104089 - 104089

Опубликована: Янв. 1, 2024

Язык: Английский

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Exploring the Perspectives of Canadian Clinicians Regarding Digitally Delivered Psychotherapies Utilized for Trauma-Affected Populations

International Journal of Environmental Research and Public Health, Год журнала: 2025, Номер 22(1), С. 81 - 81

Опубликована: Янв. 9, 2025

Many clinical sites shifted towards digital delivery of mental health services during the COVID-19 pandemic. There is still much to learn regarding tailoring digitally delivered interventions for trauma-affected populations. The current study examined perceptions Canadian clinicians who provided psychotherapies utilized Specifically, we explored shift use, what changed with this rapid shift, needs, problems, and solutions arose, important future considerations associated delivering trauma-focused adjunct treatments digitally. Survey data were collected from 12 clinician participants. Surveys adapted Alberta Quality Matrix Health Unified Theory Acceptance Use Technology model. As a follow-up, participants invited participate in either semi-structured qualitative interview or focus group further explore their perspectives on therapies. Twenty-four partook an group. supported use populations, sharing that these appeared offer similar quality care in-person delivery. Further research required address clinicians' concerns (e.g., patient safety) identify other avenues which populations can be engaged improved upon.

Язык: Английский

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Pilot Study Exploring the Perspectives of Canadian Clients Who Received Digitally Delivered Psychotherapies Utilized for Trauma-Affected Populations

International Journal of Environmental Research and Public Health, Год журнала: 2025, Номер 22(2), С. 220 - 220

Опубликована: Фев. 4, 2025

The digital delivery of mental health services became increasingly common following the onset COVID-19 pandemic. There is still much to learn regarding tailoring interventions for trauma-affected populations (military members, Veterans, public safety personnel). Through current pilot study, we explored perceptions digitally delivered psychotherapies utilized populations, as reported by Canadian military and personnel who completed such interventions. Quantitative data were collected from 11 clients with posttraumatic stress injury). Survey questions based on Alberta Quality Matrix Health Unified Theory Acceptance Use Technology model. As a follow-up, invited partake in semi-structured interview further explore their perspectives trauma-focused adjunct therapies. Four participated an interview. client participants that trauma therapies offered similar treatment effectiveness in-person while also improving access. indicated several unique advantages delivery, including increased accessibility treatment, cost-effectiveness, more efficient use resources, although small sample size limits generalizability our findings. Further research larger, diverse population required corroborate results identify other avenues which can be engaged improved upon.

Язык: Английский

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Evaluating Effectiveness of Telerehabilitation Among Workers Admitted to a Posttraumatic Stress Injury Rehabilitation Program

Journal of Occupational Rehabilitation, Год журнала: 2025, Номер unknown

Опубликована: Март 10, 2025

Язык: Английский

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