Key result
eHealth psychological interventions significantly reduced depressive symptoms compared to controls (SMD -0.30) in patients with or at high risk of cardiovascular diseases.
Why the study?
Psychological distress is an independent risk factor for CVDs contributing to increased morbidity and mortality, but the effectiveness of psychological eHealth interventions for these patients remains unclear.
Do psychological eHealth interventions reduce depressive symptoms and improve psychological well-being in patients with cardiovascular diseases?
Meta-Analysis (n=2,319)
Do psychological eHealth interventions reduce depressive symptoms and improve psychological well-being in patients with cardiovascular diseases?
Psychological eHealth interventions, particularly internet-based cognitive behavioral therapy, significantly reduce depressive symptoms in patients with cardiovascular diseases.
Supports incorporating eHealth psychological interventions into CVD care to reduce depression; extends evidence for iCBT in this population.
BACKGROUND Psychological distress is recognized as an independent risk factor for cardiovascular diseases (CVDs), contributing to increased morbidity and mortality. While eHealth is increasingly used to deliver psychological interventions, their effectiveness for patients with CVDs remains unclear. OBJECTIVE This meta-analysis aimed to evaluate the effects of eHealth psychological interventions for patients with CVDs. METHODS Eligible studies were retrieved from 5 databases (Embase, Medline, PubMed, CINAHL, and Cochrane Library), covering the period from database inception to December 2024. Randomized controlled trials (RCTs) investigating the effect of evidence-based psychological eHealth interventions to improve psychosocial well-being and cardiovascular outcomes for people with CVDs were included. The Cochrane Risk of Bias tool (version 2) was used to judge the methodological quality of reviewed studies. RevMan (version 5.3) was used for meta-analysis. RESULTS A total of 12 RCTs, comprising 2319 participants from 10 countries, were included in the review. The results demonstrated significant alleviation of depressive symptoms for patients receiving psychological eHealth intervention compared to controls (number of paper included in that particular analysis, n=7; standardized mean difference=–0.30, 95% CI –0.47 to –0.14; I²=57%; P<.001). More specifically, in 6 trials where internet-based cognitive behavioral therapy was delivered, a significant alleviation of depressive symptoms was achieved (standardized mean difference=–0.39, 95% CI –0.56 to –0.21; I²=53%; P<.001). There was no significant change in anxiety or quality of life. Synthesis without meta-analysis regarding stress, adverse events, and cardiovascular events showed inconclusive findings. CONCLUSIONS Psychological eHealth interventions, particularly internet-based cognitive behavioral therapy, can significantly reduce depressive symptoms among patients with CVDs. A multidisciplinary approach is crucial for comprehensively improving psychological and cardiovascular outcomes. Future studies should explore integrating persuasive design features into eHealth and involving mental health professionals for intervention delivery. CLINICALTRIAL PROSPERO CRD42023452276; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023452276
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Su et al. (2024) conducted a meta-analysis in Cardiovascular diseases or high risk of cardiovascular diseases (n=2,319). eHealth psychological interventions vs. Standard care, waitlist control, placebo, or other active controls was evaluated on Depressive symptoms (SMD -0.30, 95% CI -0.47, -0.14, p=<0.001). eHealth psychological interventions significantly reduced depressive symptoms compared to controls (SMD -0.30) in patients with or at high risk of cardiovascular diseases.
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