Abstract
Background: Dermatological conditions can have a substantial impact on psychological as well as physical health yet dedicated face-to-face psychological support for patients is lacking. Thus, individuals may require additional support to self-manage dermatological conditions effectively. Digital technology can contribute to long-term condition management, but knowledge of the effectiveness of digital interventions addressing psychological (cognitive, emotional, and behavioural) aspects of dermatological conditions is limited.
Objectives: To identify, determine the effectiveness, and explore people’s views and experiences of digital interventions supporting the psychological health of people with dermatological conditions.
Methods: A mixed methods systematic review informed by JBI methodology. The protocol was registered on PROSPERO. Eight electronic databases were searched for papers written between January 2002 and October 2021. Data screening and extraction were conducted in Covidence. The methodological quality of studies were scrutinised against JBI critical appraisal tools. Intervention characteristics were captured using the Template for Intervention Description and Replication checklist and guide. Data were synthesised using a convergent segregated approach. The results were reported in a narrative summary.
Results: Twenty-three papers were identified from 4,883 references, including 15 randomised controlled trials. Nineteen interventions were condition-specific, 13 were delivered online, 16 involved an educational component, and 7 endorsed established, evidence-based therapeutic approaches. Improvements in knowledge, mood, quality of life, the therapeutic relationship, and reduced disease severity in the short to medium term, were reported, although there was substantial heterogeneity within the literature. Thirteen studies captured feedback from users, who considered various digital interventions as convenient and helpful for improving knowledge, emotion regulation, and personal control, but technical and individual barriers to use were reported. Use of established qualitative methodologies was limited and, in some cases, poorly reported.
Conclusion: Some web-based digital psychological interventions seem to be acceptable to people living with mainly psoriasis and eczema. Whilst some digital interventions benefitted cognitive and emotional factors, heterogeneity and inconsistencies in the literature meant definitive statements about their effectiveness could not be drawn. Interdisciplinary and patient-centred approaches to research are needed to develop and test quality digital interventions supporting the psychological health of adults living with common and rare dermatological conditions.
Systematic review registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=285435], identifier [CRD42021285435].
Objectives: To identify, determine the effectiveness, and explore people’s views and experiences of digital interventions supporting the psychological health of people with dermatological conditions.
Methods: A mixed methods systematic review informed by JBI methodology. The protocol was registered on PROSPERO. Eight electronic databases were searched for papers written between January 2002 and October 2021. Data screening and extraction were conducted in Covidence. The methodological quality of studies were scrutinised against JBI critical appraisal tools. Intervention characteristics were captured using the Template for Intervention Description and Replication checklist and guide. Data were synthesised using a convergent segregated approach. The results were reported in a narrative summary.
Results: Twenty-three papers were identified from 4,883 references, including 15 randomised controlled trials. Nineteen interventions were condition-specific, 13 were delivered online, 16 involved an educational component, and 7 endorsed established, evidence-based therapeutic approaches. Improvements in knowledge, mood, quality of life, the therapeutic relationship, and reduced disease severity in the short to medium term, were reported, although there was substantial heterogeneity within the literature. Thirteen studies captured feedback from users, who considered various digital interventions as convenient and helpful for improving knowledge, emotion regulation, and personal control, but technical and individual barriers to use were reported. Use of established qualitative methodologies was limited and, in some cases, poorly reported.
Conclusion: Some web-based digital psychological interventions seem to be acceptable to people living with mainly psoriasis and eczema. Whilst some digital interventions benefitted cognitive and emotional factors, heterogeneity and inconsistencies in the literature meant definitive statements about their effectiveness could not be drawn. Interdisciplinary and patient-centred approaches to research are needed to develop and test quality digital interventions supporting the psychological health of adults living with common and rare dermatological conditions.
Systematic review registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=285435], identifier [CRD42021285435].
Original language | English |
---|---|
Article number | 1024879 |
Number of pages | 20 |
Journal | Frontiers in Medicine |
Volume | 9 |
DOIs | |
Publication status | Published - 3 Nov 2022 |
Bibliographical note
Funding Information:To our knowledge, this is the first mixed methods systematic review investigating digitally delivered interventions supporting the psychological health of people with dermatological conditions. The TIDieR checklist and guide () provided a comprehensive framework for charting key characteristics of the digital interventions clearly, and identifying gaps in reporting. This review was conducted by a multi-disciplinary team of health and clinical psychologists and a general practitioner, most of whom specialize in dermatology research and practice. It was supported by experts from a JBI Centre of Excellence and followed JBI methodology; JBI is renowned for the conduct of highly rigorous evidence syntheses to promote and implement evidenced-based decisions to improve health and healthcare globally (). The use of JBI critical appraisal tools allowed for a detailed and nuanced assessment of different study designs. In addition, it has been noted by experts in JBI methodology that the step of corroborating and refuting findings is often lacking or missing entirely from mixed methods systematic reviews (). We adopted a convergent segregated approach to data synthesis and as a result were able to triangulate some of the key findings relating to cognitions and emotions specifically, further strengthening the present review.
Funding Information:
This systematic review was funded by Beiersdorf AG.
Funding Information:
RH had received financial support for research from Beiersdorf AG. AT is a Topic Editor of the special article collection title Psychosocial Aspects of Skin Conditions and Diseases in Frontiers in Medicine (Dermatology). He had received workshop and consultancy fees from a number of pharmaceutical companies including UCB (non-specific). He is also receiving research support from Pfizer. He is a scientific advisor for the Vitiligo Society, and a trustee of Changing Faces; and has been psychological advisor to the All-Party Parliamentary Group on Skin. CB had over the last 3 years received funds for research, honoraria or consultancy from the following pharmaceutical companies: Abbvie, Almirall, Amgen (was Celgene), Beiersdorf AG, Janssen, Novartis, Pfizer, UCB. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher Copyright:
Copyright © 2022 Hewitt, Ploszajski, Purcell, Pattinson, Jones, Wren, Hughes, Ridd, Thompson and Bundy.