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AIDS and Behavior
Published in: AIDS and Behavior 6/2020

01-06-2020 | Mood Disorders | Substantive Review

Technology-Delivered Psychotherapeutic Interventions in Improving Depressive Symptoms Among People with HIV/AIDS: A Systematic Review and Meta-analysis of Randomised Controlled Trials

Authors: Ling Jie Cheng, P. Arun Kumar, Suei Nee Wong, Ying Lau

Published in: AIDS and Behavior | Issue 6/2020

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Abstract

With the increasing popularity of advanced technology, technology-delivered psychotherapeutic interventions (TPIs) may play a promising role in improving depressive symptoms among PLWHA. However, its effectiveness remains unclear. We aimed to synthesise the evidence of the effectiveness of TPIs in improving depressive symptoms of PLWHA using a meta-analytic approach. Seven databases were systematically searched for randomised controlled trials (RCTs) from the inception until August 14, 2018. Random-effects meta-analysis was adopted to assess effect size. Cochran’s Q test and I2 were used to investigate the problem of heterogeneity. Sensitivity, subgroup analyses and meta-regression were performed. Of the 43,048 records identified, 14 RCTs were included. The meta-analysis revealed a small effect on reducing depressive symptom scores (d = 0.23, 95% CI − 0.39 to − 0.06) after TPIs. Random-effects meta-regression showed that publication year was a significant moderator (p = 0.013), whereby the latest trials had larger effect size in reducing the depressive symptoms than earlier trials. Our review suggested a possible future approach of utilising TPIs by means of mobile applications and internet-based interventions for PLWHA to reduce their depressive symptoms. This review highlighted the essential key features in designing future TPIs. The overall low-quality evidence suggested the need to conduct further high-quality.
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Literature
1.
2.
Bhatia M, Munjal S. Prevalence of depression in people living with HIV/AIDS undergoing ART and factors associated with it. J Clin Diagn Res. 2014;8(10):WC01.PubMedPubMedCentral
3.
Nanni MG, Caruso R, Mitchell AJ, Meggiolaro E, Grassi L. Depression in HIV infected patients: a review. Curr Psychiatry Rep. 2015;17(1):530.PubMed
4.
Kempf M-C, Huang C-H, Savage R, Safren SA. Technology-delivered mental health interventions for people living with HIV/AIDS (PLWHA): a review of recent advances. Curr HIV/AIDS Rep. 2015;12(4):472–80.PubMedPubMedCentral
5.
Bengtson AM, Pence BW, O’Donnell J, Thielman N, Heine A, Zinski A, et al. Improvements in depression and changes in quality of life among HIV-infected adults. AIDS Care. 2015;27(1):47–53.PubMed
6.
7.
Rasoolinajad M, Abedinia N, Noorbala AA, Mohraz M, Badie BM, Hamad A, et al. Relationship among HIV-related stigma, mental health and quality of life for HIV-positive patients in Tehran. AIDS Behav. 2018;22:3773–82.PubMed
8.
Bengtson AM, Pence BW, Powers KA, Weaver MA, Mimiaga MJ, Gaynes BN, et al. Trajectories of depressive symptoms among a population of HIV-infected men and women in routine HIV care in the United States. AIDS Behav. 2018;22:3176–87.PubMedPubMedCentral
9.
Lu H-F, Hsiao F-H, Sheng W-H, Liao S-C, Wu P-Y, Yang Y-L, et al. Prevalence and predictors of depression among people living With HIV/AIDS: a National Study. Nurs Res. 2018;67(5):379–86.PubMed
10.
Wu Y-L, Yang H-Y, Wang J, Yao H, Zhao X, Chen J, et al. Prevalence of suicidal ideation and associated factors among HIV-positive MSM in Anhui, China. Int J STD AIDS. 2015;26(7):496–503.PubMed
11.
Zeng C, Li L, Hong YA, Zhang H, Babbitt AW, Liu C, et al. A structural equation model of perceived and internalized stigma, depression, and suicidal status among people living with HIV/AIDS. BMC Public Health. 2018;18(1):138.PubMedPubMedCentral
12.
Stratton E, Lampit A, Choi I, Calvo RA, Harvey SB, Glozier N. Effectiveness of eHealth interventions for reducing mental health conditions in employees: a systematic review and meta-analysis. PLoS ONE. 2017;12(12):e0189904.PubMedPubMedCentral
13.
Mohr DC, Schueller SM, Riley WT, Brown CH, Cuijpers P, Duan N, et al. Trials of intervention principles: evaluation methods for evolving behavioral intervention technologies. J Med Internet Res. 2015;17(7):166.
14.
Deady M, Choi I, Calvo R, Glozier N, Christensen H, Harvey S. eHealth interventions for the prevention of depression and anxiety in the general population: a systematic review and meta-analysis. BMC Psychiatry. 2017;17(1):310.PubMedPubMedCentral
15.
Charova E, Dorstyn D, Tully P, Mittag O. Web-based interventions for comorbid depression and chronic illness: a systematic review. J Telemed Telecare. 2015;21(4):189–201.PubMed
16.
Henny KD, Wilkes AL, McDonald CM, Denson DJ, Neumann MS. A rapid review of eHealth Interventions Addressing the Continuum of HIV Care (2007–2017). AIDS Behav. 2018;22(1):43–63.PubMedPubMedCentral
17.
Cooper V, Clatworthy J, Whetham J. Mobile health (mHealth) interventions to support self-management in HIV: a systematic review. HIV Med. 2018;19:S105.
18.
Menon V, Rajan TM, Sarkar S. Psychotherapeutic applications of mobile phone-based technologies: a systematic review of current research and trends. Indian J Psychol Med. 2017;39(1):4.PubMedPubMedCentral
19.
Wells A. Metacognitive therapy for anxiety and depression. New York: Guilford Press; 2011.
20.
Wells A. Metacognitive therapy: cognition applied to regulating cognition. Behav Cognit Psychother. 2008;36(6):651–8.
21.
Fisher WA, Fisher JD, Shuper PA. Social psychology and the fight against AIDS: an information–motivation–behavioral skills model for the prediction and promotion of health behavior change. Advances in experimental social psychology. Amsterdam: Elsevier; 2014. p. 105–93.
22.
Graham LJ. Integration of the interaction model of client health behavior and transactional model of stress and coping as a tool for understanding retention in HIV care across the lifespan. J Assoc Nurses AIDS Care. 2015;26(2):100–9.PubMed
23.
Nideröst S, Gredig D, Roulin C, Rickenbach M, Study SHC, Group ES. Predictors of HIV-protection behaviour in HIV-positive men who have sex with casual male partners: a test of the explanatory power of an extended information–motivation–behavioural Skills model. AIDS care. 2011;23(7):908–19.PubMed
24.
Mohr DC, Vella L, Hart S, Heckman T, Simon G. The effect of telephone-administered psychotherapy on symptoms of depression and attrition: a meta-analysis. Clin Psychol Sci Pract. 2008;15(3):243–53.
25.
Gurevitch J, Koricheva J, Nakagawa S, Stewart G. Meta-analysis and the science of research synthesis. Nature. 2018;555:175.PubMed
26.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.PubMed
27.
Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions version 5.1. 0. The Cochrane Collaboration. 2011. (2015).
28.
Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.PubMedPubMedCentral
29.
Guyatt GH, Oxman AD, Schünemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011;64(4):380–2.PubMed
30.
Review Manager (RevMan) [Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration (2014).
31.
Sawilowsky SS. New effect size rules of thumb. J Mod Appl Stat Methods. 2009;8:597–9.
32.
Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. A basic introduction to fixed-effect and random-effects models for meta-analysis. Res Synth Methods. 2010;1(2):97–111.PubMed
33.
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.PubMed
34.
Borenstein M, Hedges L, Higgins J, Rothstein H. Comprehensive meta-analysis (Version 3.3.070) [Computer software]. Englewood, NJ: Biostat; 2014.
35.
Sterne JA, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Lau J, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ. 2011;343:d4002.PubMed
36.
Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34.PubMedPubMedCentral
37.
Zwetsloot P-P, Van Der Naald M, Sena ES, Howells DW, IntHout J, De Groot JA, et al. Standardized mean differences cause funnel plot distortion in publication bias assessments. Elife. 2017;6:e24260.PubMedPubMedCentral
38.
Drozd F, Skeie LG, Kraft P, Kvale D. A web-based intervention trial for depressive symptoms and subjective well-being in patients with chronic HIV infection. AIDS Care. 2014;26(9):1080–9.PubMed
39.
Guo Y, Xu Z, Qiao J, Hong YA, Zhang H, Zeng C, et al. Development and feasibility testing of an mHealth (Text Message and WeChat) intervention to improve the medication adherence and quality of life of people living with HIV in China: pilot randomized controlled trial. JMIR mHealth uHealth. 2018;6(9):e10274.PubMedPubMedCentral
40.
Heckman TG, Barcikowski R, Ogles B, Suhr J, Carlson B, Holroyd K, et al. A telephone-delivered coping improvement group intervention for middle-aged and older adults living with HIV/AIDS. Ann Behav Med. 2006;32(1):27–38.PubMed
41.
Heckman TG, Carlson B. A randomized clinical trial of two telephone-delivered, mental health interventions for HIV-infected persons in rural areas of the United States. AIDS Behav. 2007;11(1):5–14.PubMed
42.
Heckman TG, Heckman BD, Anderson T, Lovejoy TI, Mohr D, Sutton M, et al. Supportive-expressive and coping group teletherapies for HIV-infected older adults: a randomized clinical trial. AIDS Behav. 2013;17(9):3034–44.PubMed
43.
Heckman TG, Heckman BD, Anderson T, Lovejoy TI, Markowitz JC, Shen Y, et al. Tele-interpersonal psychotherapy acutely reduces depressive symptoms in depressed HIV-infected rural persons: a randomized clinical trial. Behav Med. 2017;43(4):285–95.PubMed
44.
Heckman TG, Markowitz JC, Heckman BD, Woldu H, Anderson T, Lovejoy TI, et al. A randomized clinical trial showing persisting reductions in depressive symptoms in HIV-infected rural adults following brief telephone-administered interpersonal psychotherapy. Ann Behav Med. 2018;52(4):299–308.PubMedPubMedCentral
45.
Ransom D, Heckman TG, Anderson T, Garske J, Holroyd K, Basta T, et al. Telephone-delivered, interpersonal psychotherapy for HIV-infected rural persons with depression: a pilot trial. Psychiatr Serv. 2008;59(8):871–7.PubMed
46.
Himelhoch S, Medoff D, Maxfield J, Dihmes S, Dixon L, Robinson C, et al. Telephone based cognitive behavioral therapy targeting major depression among urban dwelling, low income people living with HIV/AIDS: results of a randomized controlled trial. AIDS Behav. 2013;17(8):2756–64.PubMed
47.
Kraaij V, van Emmerik A, Garnefski N, Schroevers MJ, Lo-Fo-Wong D, van Empelen P, et al. Effects of a cognitive behavioral self-help program and a computerized structured writing intervention on depressed mood for HIV-infected people: a pilot randomized controlled trial. Patient Educ Couns. 2010;80(2):200–4.PubMed
48.
van Luenen S, Garnefski N, Spinhoven P, Kraaij V. Guided internet-based intervention for people with HIV and depressive symptoms: a randomised controlled trial in the Netherlands. Lancet HIV. 2018;5(9):e488–97.PubMed
49.
Lovejoy TI. Telephone-delivered motivational interviewing targeting sexual risk behavior reduces depression, anxiety, and stress in HIV-positive older adults. Ann Behav Med. 2012;44(3):416–21.PubMed
50.
Schnall R, Cho H, Mangone A, Pichon A, Jia H. Mobile health technology for improving symptom management in low income persons living with HIV. AIDS Behav. 2018;22:3373–83.PubMedPubMedCentral
51.
Stein MD, Herman DS, Bishop D, Anderson BJ, Trisvan E, Lopez R, et al. A telephone-based intervention for depression in HIV patients: negative results from a randomized clinical trial. AIDS Behav. 2007;11(1):15–23.PubMed
52.
Horvath KJ, Danilenko GP, Williams ML, Simoni J, Amico KR, Oakes JM, et al. Technology use and reasons to participate in social networking health websites among people living with HIV in the US. AIDS Behav. 2012;16(4):900–10.PubMedPubMedCentral
53.
Schnall R, Bakken S, Rojas M, Travers J, Carballo-Dieguez A. mHealth technology as a persuasive tool for treatment, care and management of persons living with HIV. AIDS Behav. 2015;19(2):81–9.PubMedPubMedCentral
54.
Muessig KE, Nekkanti M, Bauermeister J, Bull S, Hightow-Weidman LB. A systematic review of recent smartphone, Internet and Web 2.0 interventions to address the HIV continuum of care. Curr HIV/AIDS Rep. 2015;12(1):173–90.PubMedPubMedCentral
55.
Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687.PubMed
56.
Rana AI, van den Berg JJ, Lamy E, Beckwith CG. Using a mobile health intervention to support HIV treatment adherence and retention among patients at risk for disengaging with care. AIDS Pat Care STDs. 2016;30(4):178–84.
57.
Quintiliani LM, Mann DM, Puputti M, Quinn E, Bowen DJ. Pilot and feasibility test of a mobile health-supported behavioral counseling intervention for weight management among breast cancer survivors. JMIR Cancer. 2016;2(1):e4.PubMed
58.
Carroll A, Gordon K, Haynes M, Houghton S. Goal setting and self-efficacy among delinquent, at-risk and not at-risk adolescents. J Youth Adolesc. 2013;42(3):431–43.PubMed
59.
Gil PJ, Carter SL. Graphic feedback, performance feedback, and goal setting increased staff compliance with a data collection task at a large residential facility. J Organ Behav Manag. 2016;36(1):56–70.
60.
Pellowski JA, Kalichman SC. Recent advances (2011–2012) in technology-delivered interventions for people living with HIV. Curr HIV/AIDS Rep. 2012;9(4):326–34.PubMedPubMedCentral
61.
Dobson R, Whittaker R, Jiang Y, Maddison R, Shepherd M, McNamara C, et al. Effectiveness of text message based, diabetes self management support programme (SMS4BG): two arm, parallel randomised controlled trial. BMJ. 2018;361:k1959.PubMedPubMedCentral
62.
Mohr DC, Burns MN, Schueller SM, Clarke G, Klinkman M. Behavioral intervention technologies: evidence review and recommendations for future research in mental health. Gen Hosp Psychiatry. 2013;35(4):332–8.PubMed
63.
Spies G, Konkiewitz EC, Seedat S. Incidence and persistence of depression among women living with and without HIV in South Africa: a longitudinal study. AIDS Behav. 2018;22:3155–65.PubMedPubMedCentral
64.
van den Brink RHS, Schutter N, Hanssen DJC, Elzinga BM, Rabeling-Keus IM, Stek ML, et al. Prognostic significance of social network, social support and loneliness for course of major depressive disorder in adulthood and old age. Epidemiol Psychiatr Sci. 2018;27(3):266–77.PubMed
65.
Cooper H, Patall EA. The relative benefits of meta-analysis conducted with individual participant data versus aggregated data. Psychol Methods. 2009;14(2):165.PubMed
66.
Schulz KF, Altman DG, Moher D, Group tC. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMC Med. 2010;8(1):18.PubMedPubMedCentral
67.
Borglin G, Richards A. Bias in experimental nursing research: strategies to improve the quality and explanatory power of nursing science. Int J Nursing Stud. 2010;47(1):123–8.
68.
Chan A-W, Tetzlaff JM, Altman DG, Dickersin K, Moher D. SPIRIT 2013: new guidance for content of clinical trial protocols. Lancet. 2013;381(9861):91–2.PubMed
Metadata
Title
Technology-Delivered Psychotherapeutic Interventions in Improving Depressive Symptoms Among People with HIV/AIDS: A Systematic Review and Meta-analysis of Randomised Controlled Trials
Authors
Ling Jie Cheng
P. Arun Kumar
Suei Nee Wong
Ying Lau
Publication date
01-06-2020
Publisher
Springer US
Published in
AIDS and Behavior / Issue 6/2020
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-019-02691-6

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