BACKGROUND
Post-stroke depression (PSD) is the most common psychiatric disorder after stroke and affects recovery of neurological function, ability to return to society, and quality of life of the survivors. Telehealth has been shown to improve depressive symptoms and quality of life of post-stroke patients. However, evidence from clinical trials has not been systematically synthesized.
OBJECTIVE
This study aims to systematically evaluate the effectiveness of telehealth interventions in reducing depression and anxiety symptoms of post-stroke depression.
METHODS
The Cochrane Library, PubMed, CINAHL, PsycINFO, CNKI and Wanfang Database were searched to identify randomized controlled trials (RCTs) on effectiveness of telehealth interventions for post-stroke depression from inception to November 30, 2021.The quality of included studies was assessed using the Cochrane risk of bias tool. Data extraction and quality assessment were conducted by two reviewers independently. RevMan 5.4 software was used for Meta-analysis. Data would be synthesized by either the fixed-effect (I2≤50%) or random-effect (I2>50%) model according to a heterogeneity test.
RESULTS
A total of 10 studies with 1717 participants were included, of which 8
were eligible for meta-analysis. Compared with the control group, the anxiety score of the telemedicine group was lower, with statistical significance (SMD=-1.05, 95%CI-1.22 to -0.89, P<.001), while no significant differences in scores in depression (SMD=-0.16, 95%CI-0.67 to 0.36, P=.54), quality of life (SMD=0.00, 95%CI-0.18 to 0.18, P=.99), limb function (SMD=0.46, 95%CI-0.26 to 1.18, P=.21), and daily living ability (SMD=1.95, 95%CI-1.39 to 2.29, P=.67) were observed.
CONCLUSIONS
Telehealth interventions could availably reduce anxiety symptoms in post-stroke patients, while it had equal salutary effects on depression with the conventional nursing. Therefore large-scale, high-quality randomized controlled trials are needed to further explore the potential of telehealth interventions in terms of mental health for post-stroke patients.
CLINICALTRIAL
PROSPERO CRD42021291311