The effectiveness and cost-effectiveness of e-health interventions for depression and anxiety in primary care: a systematic review and meta-analysis

Massoudi, Btissame; Holvast, Floor; Bockting, Claudi L.H.; Burger, Huibert; Blanker, Marco H.

doi:10.1016/j.jad.2018.11.050

Cited by 101Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

The effectiveness and cost-effectiveness of e-health interventions for depression and anxiety in primary care: a systematic review and meta-analysis

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Massoudi, Btissame, Holvast, Floor, Bockting, Claudi L.H., Burger, Huibert, Blanker, Marco H.·2019·Journal of Affective Disorders

DOI 10.1016/j.jad.2018.11.050

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Abstract

Purpose Psychological interventions are labor-intensive and expensive, but e-health interventions may support them in primary care. In this study, we systematically reviewed the effectiveness and cost-effectiveness of e-health interventions for depressive and anxiety symptoms and disorders in primary care.Methods We searched MEDLINE, Cochrane library, Embase, and PsychINFO until January 2018, for randomized controlled trials of e-health interventions for depression or anxiety in primary care. Two reviewers independently screened the identified publications, extracted data, and assessed risk of bias using the Cochrane Collaboration's tool.Results Out of 3617 publications, we included 14 that compared 33 treatments in 4183 participants. Overall, the methodological quality was poor to fair. The pooled effect size of e-health interventions was small (standardized mean difference = -0.19, 95%CI -0.31 to -0.06) for depression compared to control groups in the short-term, but this was maintained in the long-term (standardized mean difference = -0.22, 95%CI -0.35 to -0.09). Further analysis showed that e-health for depression had a small effect compared to care as usual and a moderate effect compared to waiting lists. One trial on anxiety showed no significant results. Four trials reported on cost-effectiveness.Limitations The trials studied different types of e-health interventions and had several risks of bias. Moreover, only one study was included for anxiety.Conclusions E-health interventions for depression have a small effect in primary care, with a moderate effect compared to waiting lists. The approach also appeared to be cost-effective for depression. However, we found no evidence for its effectiveness for anxiety.

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Offering online MBIs may have unique benefits of increased accessibility and scalability, thereby lowering the threshold for participation and potential cost-effectiveness.
“However, offering these interventions in an online format may have unique benefits of increased accessibility and scalability, thereby lowering the threshold for participation [136] and potential cost-effectiveness [137].”
From New evidence in the booming field of online mindfulness: An updated meta-analysis of randomized controlled trials (2021) · cites this paper as [137]
The Summary of main findings (§4.1; page unavailable) reports initial evidence that e-health interventions in primary care may be cost-effective, supporting the point attached to citation [137]. The review concerns e-health interventions for depression and anxiety, not online mindfulness-based interventions specifically, so it does not establish their cost-effectiveness. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Despite internet interventions' attested efficacy in treating various mental health conditions and potential cost-effectiveness, internet interventions targeting cancer survivors are scant.
“Nevertheless, despite internet interventions’ attested efficacy [21] in treating various mental health conditions and its potential cost-effectiveness [22,23], internet interventions targeting cancer survivors are scant [24].”
From Development and Evaluation of the Usefulness, Usability, and Feasibility of iNNOV Breast Cancer: Mixed Methods Study (2022) · cites this paper as [22]
The dependence of care as usual on health care system and setting contributes to extensive heterogeneity between trials.
“This contributes to extensive heterogeneity between trials. 595”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [595]

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Herrman, H., Patel, V., Kieling, C., Berk, M., Buchweitz, C., Cuijpers, P., Furukawa, T. A., Kessler, R. C., Kohrt, B. A., Maj, M., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)02141-3 · Cited by 1,104 · see citing works
Evidence synthesis of digital interventions to mitigate the negative impact of the COVID-19 pandemic on public mental health: Rapid meta-review
Rauschenberg, C., Schick, A., Hirjak, D., Seidler, A., Paetzold, I., Apfelbacher, C., Riedel-Heller, S. G., & Reininghaus, U. (2021) · Journal of Medical Internet Research · doi:10.2196/23365 · Cited by 205 · see citing works
“There is some evidence on the cost-effectiveness of eHealth interventions for depression and anxiety in primary care settings when compared to care as usual and waiting list control conditions [51] as well as for a range of mental disorders when compared to conventional CBT [112,113].”
Background
New evidence in the booming field of online mindfulness: An updated meta-analysis of randomized controlled trials
Sommers-Spijkerman, M., Austin, J., Bohlmeijer, E., & Pots, W. (2021) · JMIR Mental Health · doi:10.2196/28168 · Cited by 179 · see citing works
A pragmatic randomized waitlist-controlled effectiveness and cost-effectiveness trial of digital interventions for depression and anxiety
Richards, D., Enrique, A., Eilert, N., Franklin, M., Palacios, J., Duffy, D., Earley, C., Chapman, J., Jell, G., Sollesse, S., et al. (2020) · npj Digital Medicine · doi:10.1038/s41746-020-0293-8 · Cited by 154 · see citing works
Rapid Review and Meta-Meta-Analysis of Self-Guided Interventions to Address Anxiety, Depression, and Stress During COVID-19 Social Distancing
Fischer, R., Bortolini, T., Karl, J. A., Zilberberg, M., Robinson, K., Rabelo, A., Gemal, L., Wegerhoff, D., Nguyễn, T. B. T., Irving, B., et al. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.563876 · Cited by 153 · see citing works
The effectiveness of peer support for individuals with mental illness: systematic review and meta-analysis
Smit, D., Miguel, C., Vrijsen, J. N., Groeneweg, B. F., Spijker, J., & Cuijpers, P. J. (2022) · Psychological Medicine · doi:10.1017/s0033291722002422 · Cited by 149 · see citing works
Depression and Suicide Risk Screening
O’Connor, E., Perdue, L. A., Coppola, E. L., Henninger, M. L., Thomas, R. G., & Gaynes, B. N. (2023) · JAMA · doi:10.1001/jama.2023.7787 · Cited by 100 · see citing works
Using Artificial Intelligence to Enhance Ongoing Psychological Interventions for Emotional Problems in Real- or Close to Real-Time: A Systematic Review
Gual-Montolio, P., Jaén, I., Martínez-Borba, V., Castilla, D., & Suso-Ribera, C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19137737 · Cited by 93 · see citing works
“…on the effectiveness of CBT delivered through a computer or mobile device (iCBT). iCBT has already demonstrated its efﬁcacy in more than 100 randomized trials [36,37], even when compared with active face-to-face treatments, revealing that both options are generally just as effective [38–41].”
Background
Effectiveness of Telehealth Interventions for Women With Postpartum Depression: Systematic Review and Meta-analysis
Zhao, L., Chen, J., Lan, L., Deng, N., Liao, Y., Yue, L., Chen, I., Wen, S. W., & Xie, R. (2021) · JMIR mhealth and uhealth · doi:10.2196/32544 · Cited by 92 · see citing works
iHealth: The ethics of artificial intelligence and big data in mental healthcare
Rubeis, G. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100518 · Cited by 101 · see citing works
“…of e-mental health applications regarding various endpoints like prevention (Sander et al., 2016), symptom reduction (Firth et al., 2017), adherence (Pihlaja et al., 2017), reduction of hospitalization and total hospital days (Bell et al., 2017), and cost-effectiveness (Massoudi et al., 2019).”
Background
A Mobile App for Self-management of Urgency and Mixed Urinary Incontinence in Women: Randomized Controlled Trial
Wadensten, T., Nyström, E., Franzén, K., Lindam, A. P., Wasteson, E., & Samuelsson, E. C. (2021) · Journal of Medical Internet Research · doi:10.2196/19439 · Cited by 60 · see citing works
“Web-based platforms and smartphone apps represent an increasingly common way of supporting self-management or providing treatment for various conditions [14-16].”
Digital interventions in mental health: Evidence syntheses and economic modelling
Gega, L., Jankovic, D., Saramago, P., Marshall, D., Dawson, S., Brabyn, S., Nikolaidis, G. F., Melton, H., Churchill, R., & Bojke, L. (2022) · Health Technology Assessment · doi:10.3310/rcti6942 · Cited by 48 · see citing works
Effectiveness of digital health interventions for chronic conditions management in European primary care settings: Systematic review and meta-analysis
Ambrosi, E., Mezzalira, E., Canzan, F., Leardini, C., Vita, G., Marini, G., & Longhini, J. (2025) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2025.105820 · Cited by 50 · see citing works
Promoting Mental Health in Parents of Young Children Using eHealth Interventions: A Systematic Review and Meta-analysis
MacKinnon, A., Silang, K., Penner, K. E., Zalewski, M., Tomfohr‐Madsen, L. M., & Roos, L. E. (2022) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-022-00385-5 · Cited by 49 · see citing works
“Similarly, metaanalyses of eHealth interventions for general mental health indicate small to moderate effects for depression (Massoudi et al., 2019).”
Background
Workforce challenges in digital health implementation: How are clinical psychology training programmes developing digital competences?
Pote, H. L., Rees, A., Holloway-Biddle, C., & Griffith, E. (2021) · Digital Health · doi:10.1177/2055207620985396 · Cited by 46 · see citing works
“In primary care clinical samples these results were supported, with a systematic review of digital interventions for depression and anxiety including over 4000 patients finding small positive, statistically significant effects of digital interventions compared to control groups, and, promisingly, this was maintained a…”
Result
Impact of digital services on healthcare and social welfare: An umbrella review
Härkönen, H., Lakoma, S., Verho, A., Torkki, P. M., Leskelä, R., Pennanen, P., Laukka, E., & Jansson, M. M. (2024) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2024.104692 · Cited by 39 · see citing works
Digital empowerment in mental health: A meta-analysis of internet-based interventions for enhancing mental health literacy
Chen, Q., Zhao, Z., Bao, J., Lin, J., Li, W., & Zang, Y. (2024) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2024.100489 · Cited by 49 · see citing works
“In recent years, there has been a growing interest in utilizing the Internet to deliver MHL interventions due to their cost-effectiveness and accessibility (Donker et al., 2015; Massoudi et al., 2019).”
Background
Effectiveness of online mindfulness-based interventions for cancer patients: a systematic review and meta-analysis
Fan, M., Wang, Y., Zheng, L., Cui, M., Zhou, X., & Liu, Z. (2023) · Japanese Journal of Clinical Oncology · doi:10.1093/jjco/hyad101 · Cited by 36 · see citing works
Efficacy of Three Low-Intensity, Internet-Based Psychological Interventions for the Treatment of Depression in Primary Care: Randomized Controlled Trial
Gili, M., Castro, A., García‐Palacios, A., García‐Campayo, J., Mayoral, F., Botella, C., Roca, M., Barceló‐Soler, A., Hurtado, M. M., Navarro, M., et al. (2020) · Journal of Medical Internet Research · doi:10.2196/15845 · Cited by 36 · see citing works
“Care as usual is not a clearly defined treatment, entailing different interventions [52].”
Background
Effects of a Self-Guided Transdiagnostic Smartphone App on Patient Empowerment and Mental Health: Randomized Controlled Trial
Kerber, A., Beintner, I., Burchert, S., & Knaevelsrud, C. (2023) · JMIR Mental Health · doi:10.2196/45068 · Cited by 32 · see citing works
“Besides within-intervention guidance, guidance-related aspects of the study design such as the conduct of clinical interviews [14], use of automated reminders [15], or treatment setting in which the intervention is used [16] seem to be associated with greater effects.”
Background
oVRcome – Self-guided virtual reality for specific phobias: A randomised controlled trial
Lacey, C. J., Frampton, C. M., & Beaglehole, B. (2022) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/00048674221110779 · Cited by 29 · see citing works
“Selfguided mobile or digital health interventions have been shown to be effective for depression in primary care, although there is less evidence for their place in the treatment of anxiety (Massoudi et al., 2019).”
Background
Prevalence and related factors of depression and anxiety in a cohort of Chinese elderly caregivers in the nursing home
Yang, Z. Y., Jia, H.-H., Lü, Y., Liu, S., Dai, M., & Zhang, H. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.09.026 · Cited by 28 · see citing works
An Evaluation of 5-Year Web Analytics for HeadsUpGuys: A Men’s Depression E-Mental Health Resource
Ogrodniczuk, J. S., Beharry, J., & Oliffe, J. L. (2021) · American Journal of Men s Health · doi:10.1177/15579883211063322 · Cited by 29 · see citing works
“…have been few sustained efforts for developing eHealth programs specifically oriented to men with depression (Fogarty et al., 2017; Murphy et al., 2018), despite reviews concluding that eHealth interventions for depression show promise (Deady et al., 2017; Luo et al., 2020; Massoudi et al., 2019).”
Background
Effectiveness of Telecare Interventions on Depression Symptoms Among Older Adults: Systematic Review and Meta-Analysis
Wu, M., Li, C., Hu, T., Zhao, X., Qiao, G., Gao, X., Zhu, X., & Yang, F. (2023) · JMIR mhealth and uhealth · doi:10.2196/50787 · Cited by 24 · see citing works
The effectiveness of self-guided interventions in adults with depressive symptoms: a systematic review and meta-analysis
Tong, L., Panagiotopoulou, O.-M., Cuijpers, P. J., & Karyotaki, E. (2024) · EBioMedicine · doi:10.1016/j.ebiom.2024.105208 · Cited by 22 · see citing works
Digital Health Interventions for Depression and Anxiety in Low- and Middle-Income Countries: Rapid Scoping Review
Chau, L. W., Lam, R. W. M., Minas, H., Hayashi, K., Nguyen, V. C., & O’Neil, J. (2025) · JMIR Mental Health · doi:10.2196/68296 · Cited by 30 · see citing works
“For example, 2 systematic reviews of mobile apps (both self-guided and hybrid models) demonstrated their effectiveness in reducing depression symptoms [16,139].”
Development and Evaluation of the Usefulness, Usability, and Feasibility of iNNOV Breast Cancer: Mixed Methods Study
Mendes-Santos, C., Nunes, F., Weiderpass, E., Santana, R., & Andersson, G. (2022) · JMIR Cancer · doi:10.2196/33550 · Cited by 19 · see citing works
“Nevertheless, despite internet interventions’ attested efficacy [21] in treating various mental health conditions and its potential cost-effectiveness [22,23], internet interventions targeting cancer survivors are scant [24].”
Background
The effectiveness of E-health interventions promoting physical activity in cancer survivors: a systematic review and meta-analysis of randomized controlled trials
Xiao, K.-H., Tang, L., Chen, Y., Zhou, J., Yang, Q., & Wang, R. (2024) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/s00432-023-05546-9 · Cited by 19 · see citing works
“E-health E-health interventions have been verified to be effective in a variety of health behavior promotion, including weight loss (Podina and Fodor 2018), depression and anxiety reduction (Massoudi et al. 2019), and PA promotion (Yu et al. 2023).”
Background
Overcoming treatment gaps in the management of depression with non-pharmacological adjunctive strategies
Purebl, G., Schnitzspahn, K. M., & Zsák, É. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1268194 · Cited by 20 · see citing works
Health-economic evaluation of psychological interventions for depression prevention: Systematic review
Cerón, S. C., Lokkerbol, J., Moreno-Peral, P., Wijnen, B. F. M., Fernández, A., Mendive, J. M., Smit, F., & Bellón, J. Á. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102064 · Cited by 20 · see citing works
Digital interventions in adult mental healthcare settings: recent evidence and future directions
Dülsen, P., Bendig, E., Küchler, A., Christensen, H. M., & Baumeister, H. (2020) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000614 · Cited by 18 · see citing works
“The authors of a meta-analysis focusing on IMI used to treat PTSD patients found medium effect sizes CI & the effectiveness of IMI for in healthcare samples was examined [34 && ].”
Background
E-mental health applications for depression: an evidence-based ethical analysis
Rubeis, G. (2021) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-019-01093-y · Cited by 17 · see citing works
Impact of Depression in Sickle Cell Disease Hospitalization-Related Outcomes: An Analysis of the National Inpatient Sample (NIS)
Onyeaka, H., Queeneth, U., Rashid, W., Ahmad, N., Rajan, S. K., Jaladi, P. R., & Patel, R. S. (2019) · Medicina · doi:10.3390/medicina55070385 · Cited by 17 · see citing works
“There is evidence that mobile health technologies [13], electronic-health [36], faith-based [37], and community-based therapies [38] can improve patient outcomes.”
Background
Efectividad de las intervenciones basadas en telemedicina sobre resultados en salud en pacientes con multimorbilidad en atención primaria: revisión sistemática
de la Pisa, B. P., Lobato, M. P., Calzada, C. M., & García-Lozano, M. J. (2019) · Atención Primaria · doi:10.1016/j.aprim.2019.08.004 · Cited by 19 · see citing works
“Intervención/Post 53 (52) 28 (39,4) 67 (12,8)”
Adherence to Established Treatment Guidelines Among Unguided Digital Interventions for Depression: Quality Evaluation of 28 Web-Based Programs and Mobile Apps
Bubolz, S., Mayer, G., Gronewold, N., Hilbel, T., & Schultz, J. (2020) · Journal of Medical Internet Research · doi:10.2196/16136 · Cited by 17 · see citing works
“Criticisms of web-based interventions include poor methodological quality of effectiveness studies such as by comparing interventions with wait-list control groups or by showing evidence only through analysis of short-term effects [23,39].”
A Direct-to-Public Peer Support Program (Big White Wall) Versus Web-Based Information to Aid the Self-management of Depression and Anxiety: Results and Challenges of an Automated Randomized Controlled Trial
Morriss, R. K., Kaylor‐Hughes, C., Rawsthorne, M., Coulson, N., Simpson, S., Guo, B., James, M., Lathe, J., Moran, P., Tata, L. J., et al. (2020) · Journal of Medical Internet Research · doi:10.2196/23487 · Cited by 17 · see citing works
“However, it is unclear if and under what circumstances they would be feasible or acceptable to participants [17].”
Ecological momentary intervention to enhance emotion regulation in healthcare workers via smartphone: a randomized controlled trial protocol
Castilla, D., Navarro-Haro, M., Suso-Ribera, C., Díaz-García, A., Zaragozá, I., & García-Palacios, A. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03800-x · Cited by 15 · see citing works
Effectiveness of telemedicine on common mental disorders: An umbrella review and meta-meta-analysis
Chen, J., Li, C., An, K., Dong, X., Liu, J., & Wu, H. Y. (2024) · Computers in Human Behavior · doi:10.1016/j.chb.2024.108325 · Cited by 16 · see citing works
Mental health specialist video consultations versus treatment as usual in patients with depression or anxiety disorders in primary care: study protocol for an individually randomised superiority trial (the PROVIDE-C trial)
Haun, M. W., Tönnies, J., Brinster, R., Kronsteiner, D., Wensing, M., Szécsényi, J., Vomhof, M., Icks, A., Wild, B., Hartmann, M., et al. (2021) · Trials · doi:10.1186/s13063-021-05289-3 · Cited by 16 · see citing works
Cost-effectiveness of Web-Based and Home-Based Postnatal Psychoeducational Interventions for First-time Mothers: Economic Evaluation Alongside Randomized Controlled Trial
Zheng, Q., Shi, L., Zhu, L., Jiao, N., Chong, Y. S., Chan, S. W., Chan, Y. H., Luo, N., Wang, W., & He, H. G. (2022) · Journal of Medical Internet Research · doi:10.2196/25821 · Cited by 14 · see citing works
“Another systematic review and meta-analysis reporting the effectiveness and cost-effectiveness of eHealth interventions for depression and anxiety in primary care demonstrated that eHealth was only cost-effective for depression, but there was no evidence for its effectiveness for anxiety [35].”
Background
Working alliance in low-intensity internet-based cognitive behavioral therapy for depression in primary care in Spain: A qualitative study
Barceló‐Soler, A., García‐Campayo, J., Araya, R., Doukani, A., Gili, M., García‐Palacios, A., Mayoral, F., & Montero‐Marín, J. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1024966 · Cited by 14 · see citing works
Experiences with telemedicine-based follow-up of chronic conditions: the views of patients and health personnel enrolled in a pragmatic randomized controlled trial
Sten-Gahmberg, S., Pedersen, K., Harsheim, I. G., Løyland, H. I., & Abelsen, B. (2024) · BMC Health Services Research · doi:10.1186/s12913-024-10732-7 · Cited by 13 · see citing works
“The latter is a relatively common finding in the literature [12–14 , 33 Our analysis sheds light on the importance of using dedicated resources to develop and implement a new telemedicine-based service, and to involve other health-care services.”
Background
Effectiveness of the SAFE eHealth Intervention for Women Experiencing Intimate Partner Violence and Abuse: Randomized Controlled Trial, Quantitative Process Evaluation, and Open Feasibility Study
van Gelder, N. E., Ligthart, S. A., van Rosmalen-Nooijens, K. A. W. L., Prins, J. B., & Oertelt‐Prigione, S. (2023) · Journal of Medical Internet Research · doi:10.2196/42641 · Cited by 12 · see citing works
“Nevertheless, they can be helpful and meaningful for health outcomes in the general population [77,78].”
A Novel Integrative Framework for Depression: Combining Network Pharmacology, Artificial Intelligence, and Multi-Omics with a Focus on the Microbiota–Gut–Brain Axis
Zhang, L., Chen, K., Li, S., Liu, S. K., & Wang, Z. (2025) · Current Issues in Molecular Biology · doi:10.3390/cimb47121061 · Cited by 11 · see citing works
“…for multi-omics data acquisition, model development, and validation must be justified by demonstrating long-term cost-effectiveness, potentially through reducing ineffective treatment trials and enabling preventative care, as evidenced in health-economic analyses of digital interventions [161].”
Maintaining Outcomes of Internet-Delivered Cognitive-Behavioral Therapy for Depression: A Network Analysis of Follow-Up Effects
Kaiser, T., Boschloo, L., Berger, T., Meyer, B., Späth, C., Schröder, J., Hohagen, F., Moritz, S., & Klein, J. P. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.598317 · Cited by 11 · see citing works
Use of Telemedicine in Depression Care by Physicians: Scoping Review
Echelard, J.-F. (2021) · JMIR Formative Research · doi:10.2196/29159 · Cited by 11 · see citing works
“The study selection process is detailed in Figure 1 [10-37].”
Background
Cost-Effectiveness of Computer-Assisted Cognitive Behavioral Therapy for Depression Among Adults in Primary Care
Ali, S., Alemu, F. W., Owen, J. J., Eells, T. D., Antle, B. F., Lee, J. T., & Wright, J. H. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.44599 · Cited by 9 · see citing works
The experience of participating in an internet-based cognitive behavioral therapy program among patients with cardiovascular disease and depression: a qualitative interview study
Westas, M., Mourad, G., Andersson, G., Neher, M., Lundgren, J., & Johansson, P. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03939-7 · Cited by 10 · see citing works
“A possible solution could be internet-based CBT (iCBT) which, compared to face-to-face CBT, has been found to be equally effective and also a cost-efficient treatment option for depression in other populations [11, 12].”
Background
Mental Health of People Under Isolation During the covid-19 Outbreak: An Exploratory Study
Díaz, C. M. C., García, N. B., Alba‐Marrugo, M. A., Escudero, J. P. S., Marín-Cortés, A., & Tungjitcharoen, W. (2022) · Revista Colombiana de Psicología · doi:10.15446/rcp.v31n2.89960 · Cited by 9 · see citing works
“To achieve this, we suggest the use of teletherapy, the clinical efficacy of which has been proven to treat depression (Deady et al., 2017; Kim et al., 2019; Massoudi et al., 2019; McCall et al., 2019) and stress (Glassman et al., 2019; McLean et al., 2020; Morland et al., 2020).”
Method
Forensic Psychiatric Outpatients’ and Therapists’ Perspectives on a Wearable Biocueing App (Sense-IT) as an Addition to Aggression Regulation Therapy: Qualitative Focus Group and Interview Study
ter Harmsel, J. F., Smulders, L. M., Noordzij, M. L., Swinkels, L. T. A., Goudriaan, A. E., Popma, A., & van der Pol, T. M. (2022) · JMIR Formative Research · doi:10.2196/40237 · Cited by 9 · see citing works
“Positive influences on health care outcomes and cost-effectiveness have been reported for specific populations [8].”
Background
Enhancing Internet-based psychotherapy for adults with emotional disorders using ecological momentary assessments and interventions: Study protocol of a feasibility trial with “My EMI, Emotional Well-being” app
Gual-Montolio, P., Suso-Ribera, C., García-Palacios, A., Castilla, D., Zaragozá, I., & Bretón-López, J. (2023) · Internet Interventions · doi:10.1016/j.invent.2023.100601 · Cited by 7 · see citing works
Predictors of Adherence in Three Low-Intensity Intervention Programs Applied by ICTs for Depression in Primary Care
Castro, A., García‐Palacios, A., del Hoyo, Y. L., Mayoral, F., Pérez-Ara, M. Á., Baños, R. M., García‐Campayo, J., Hurtado, M. M., Botella, C., Barceló‐Soler, A., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18041774 · Cited by 9 · see citing works
Feasibility of mHealth interventions for depressive symptoms in Latin America: a systematic review
Escobar-Viera, C. G., Cernuzzi, L., Miller, R. S., Rodríguez-Marín, H. J., Vieta, E., Toñánez, M. G., Marsch, L. A., & Hidalgo‐Mazzei, D. (2021) · International Review of Psychiatry · doi:10.1080/09540261.2021.1887822 · Cited by 11 · see citing works
“Hence, there is a major need of pragmatic, real-world studies evaluating not only efficacy and retention of stand-alone and independent mHealth platforms, but also effectiveness and retention when implemented in community health care systems (Massoudi et al., 2019).”
Background
Economic evaluation of remote patient monitoring and organizational analysis according to patient involvement: a scoping review
Goff-Pronost, M. L., & Bongiovanni-Delarozière, I. (2023) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462323002581 · Cited by 9 · see citing works
“The study by Massoudi (83) concerned the use of e-health interventions for patients with depressive symptoms or depressive disorders treated in primary care.”
Background
Effectiveness and acceptance of technology-based psychological interventions for the acute treatment of unipolar depression: a systematic review and meta-analysis (Preprint)
Köhnen, M., Kriston, L., Härter, M. C., Baumeister, H., & Liebherz, S. (2020) · Journal of Medical Internet Research · doi:10.2196/24584 · Cited by 10 · see citing works
“Our results are in line with 2 previous meta-analyses that found a small effect favoring TBIs in comparison with TAU [101,102].”
Result
Technology innovation to improve SMEs sustainability
Gimin, G., Caska, C., Indrawati, H., & Yasin, M. (2024) · Journal of Science and Technology Policy Management · doi:10.1108/jstpm-12-2023-0237 · Cited by 7 · see citing works
Costs and Cost-Effectiveness of mCME Version 2.0: An SMS-Based Continuing Medical Education Program for HIV Clinicians in Vietnam
Sabin, L., Mešić, A., Le, B. N., Halim, N., Hue, C. C. T., Bonawitz, R. E., Nguyen, H. V., Williams, A. L., Nguyen, T. T. T., Le, A. N., et al. (2022) · Global Health Science and Practice · doi:10.9745/ghsp-d-22-00008 · Cited by 7 · see citing works
Acceptability and feasibility of SUCCEAT, an intervention for parents of adolescents with anorexia nervosa
Philipp, J., Franta, C., Zeiler, M. D., Truttmann, S., Wittek, T., Schöfbeck, G., Mairhofer, D., Mitterer, M., Laczkovics, C., Treasure, J. L., et al. (2024) · European Eating Disorders Review · doi:10.1002/erv.3080 · Cited by 7 · see citing works
A mixed methods exploration of “Creativity in Mind”, an online creativity-based intervention for low mood and anxiety
Tribe, R. H., Alcock, K., Scior, K., & Huddy, V. C. (2021) · Journal of Mental Health · doi:10.1080/09638237.2021.1922641 · Cited by 7 · see citing works
“…over the last decade and reviews have suggested that online interventions are effective in treating anxiety and depression and that those who use the interventions are satisfied with them (Andersson et al., 2019; Lal & Adair, 2014, Massoudi et al., 2019; Meurk et al., 2016; Zhou et al., 2016).”
Background
Cost Effectiveness of Digital Interventions for Generalised Anxiety Disorder: A Model-Based Analysis
Janković, D., Saramago, P., Gega, L., Marshall, D. C., Wright, K. E., Hafidh, M., Churchill, R. C., & Bojke, L. (2021) · PharmacoEconomics - Open · doi:10.1007/s41669-021-00318-y · Cited by 8 · see citing works
“Reviews of cost effectiveness of DIs were for mixed mood and anxiety disorders, so they were dominated by DIs for depression and did not report outcomes for GAD populations separately [7, 8].”
Background
Economic evaluations of eHealth interventions targeting mental health problems in the workplace: a systematic review
Peeters, S. B., Hilgersom, M., van Krugten, F. C. W., Olaya, B., Haro, J. M., Feltz-Cornelis, C. M. V. D., & Roijen, L. H. (2024) · Journal of Mental Health · doi:10.1080/09638237.2024.2390371 · Cited by 5 · see citing works
“The results of this study about the potential of eHealth interventions being cost-effectiveness was in line with the literature conducted out of a broader perspective (Deady et al., 2017; Gentili et al., 2022; Massoudi et al., 2019).”
Result
The Feasibility of Providing Remote Functional Family Therapy with Adolescents During the COVID-19 Pandemic: A Mixed-Method Study
Lange, A. M. C., Humayun, S., & Jefford, T. (2022) · Child & Youth Care Forum · doi:10.1007/s10566-022-09692-y · Cited by 5 · see citing works
“Yet, teletherapy has the potential to increase access to therapy and reduce costs (Bennett et al., 2020; Massoudi et al., 2019).”
Reshaping youth mental health care for optimal system-level outcomes: A dynamic modelling analysis
Skinner, A., Perez-Bennetts, E., Iorfino, F., Varidel, M., Richards, M. J., Occhipinti, J., Song, Y. J. C., Rosenberg, S. P., Scott, E. M., & Hickie, I. B. (2025) · PLOS mental health. · doi:10.1371/journal.pmen.0000232 · Cited by 4 · see citing works
“Additionally, we assess the degree to which embedding readily scalable e-health interventions (self-directed online care) [18] in routine clinical practice can help to reduce total rates of illness progression and disengagement from treatment and increase the total rate of recovery (our primary…”
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Additional file 3 of Mental health specialist video consultations versus treatment as usual in patients with depression or anxiety disorders in primary care: study protocol for an individually randomised superiority trial (the PROVIDE-C trial)
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Additional file 2 of Mental health specialist video consultations versus treatment as usual in patients with depression or anxiety disorders in primary care: study protocol for an individually randomised superiority trial (the PROVIDE-C trial)
Haun, M. W., Tönnies, J., Brinster, R., Kronsteiner, D., Wensing, M., Szecsenyi, J., Vomhof, M., Icks, A., Wild, B., Hartmann, M., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14545230
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Additional file 1 of Mental health specialist video consultations versus treatment as usual in patients with depression or anxiety disorders in primary care: study protocol for an individually randomised superiority trial (the PROVIDE-C trial)
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Authors: Massoudi, B., Holvast, F., Bockting, C. L. H., Burger, H., & Blanker, M. H.
Affiliations: University Medical Center Groningen (NL)
University of Groningen (NL)
Corresponding author: Massoudi, Btissame
ORCID: Massoudi, Btissame
Holvast, Floor
Bockting, Claudi L.H.
Burger, Huibert
Blanker, Marco H.
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2019-02
Volume: 245
Pages: 728-743
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/j.jad.2018.11.050
OpenAlex: W2900267347
Cited by: 101
References: 73
Citations by year: 2026: 6 · 2025: 9 · 2024: 19 · 2023: 13 · 2022: 19 · 2021: 21 · 2020: 10 · 2019: 4
FWCI: 1.18
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion, other-oa)
Data Archiving and Networked Services (DANS) (submittedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords: digital health interventions, depression, anxiety, primary care, cost-effectiveness, digital mental health, waiting list comparison, usual care, psychological intervention
MeSH terms: Anxiety, Cost-Benefit Analysis, Depression, Humans, Primary Health Care, Waiting Lists, Randomized Controlled Trials as Topic, Telemedicine

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The effectiveness and cost-effectiveness of e-health interventions for depression and anxiety in primary care: a systematic review and meta-analysis

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