Cover: The Use of Technology to Augment Clinical Care in Depression and Anxiety Disorders

The Use of Technology to Augment Clinical Care in Depression and Anxiety Disorders

An Evidence Map

Published Aug 15, 2019

by Alicia Ruelaz Maher, Eric Apaydin, Laura Raaen, Aneesa Motala, Roberta M. Shanman, Susanne Hempel

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Research Questions

  1. What is the research volume evaluating the use of technology to augment depression and anxiety care?
  2. What are the types of evaluated technologies?
  3. What are the functions of the evaluated technologies?
  4. What is the level of ongoing provider involvement in the evaluated technology?
  5. What is the direction of effect in studies evaluating the technology?
  6. What is the extent of treatment adherence and reported study dropouts?
  7. What is the acceptability of the technology to patients and providers?
  8. What are the types of potential adverse effects of the technology?

Depression and anxiety are highly prevalent clinical conditions. The use of telehealth and online interventions might increase the reach of clinical services for these disorders and support more comprehensive treatment. This evidence map provides an overview of the existing research on technological approaches in depression and anxiety care. Comprehensive figures and tables document published and upcoming research to evaluate the role of technology to support clinical care. An online, interactive visualization provides direct access to the included studies. The evidence map presents the volume, nature, and characteristics of research in this field and should be of interest to health policymakers and practitioners who oversee or implement treatment for those conditions.

Key Findings

  • A large evidence base is dedicated to the use of technology in clinical care. The evidence map identified 280 relevant randomized controlled trials (RCTs), a strong research design to determine the effects of interventions on patients.
  • The existing research reports on the use of different technologies to augment care, predominantly computer, phone, and smartphone applications as well as combinations of technologies. The greatest amount of research for psychotherapy was by computer (99/280 RCTs).
  • The technology in the identified studies served different functions in care delivery, including exposure therapy, autoreminders, peer support, self-therapy, provider support, provider feedback, provider therapy, and multiple functions. Most common was using multiple functions within the technology type, such as patient self-directed psychotherapy with provider support.
  • Existing technology approaches are centered around self- or provider-directed treatments, and a large number of studies used a combination of different administration formats.
  • Regardless of the technology or type of treatment, 91 percent of studies reported that the intervention had a positive outcome of symptom improvements compared with baseline.
  • Across treatments delivered by computer, phone, smartphone, and multiple technologies, the highest rates of participants completing the modules of the treatment and follow-up assessments were phone applications.

This research was sponsored by the Office of the Secretary of Defense and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.

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