The Bigger Picture of Digital Interventions for Pain, Anxiety and Stress: A Systematic Review of 1200+ Controlled Trials

Abstract

The aim of this systematic scoping review was to gain a better understanding of research trends in digital mental health care. We focused on comorbid conditions: depression, anxiety, and pain–which continue to affect an estimated 20% of world population and require complex and continuous social and medical care provisions. We searched all randomized controlled trials on PubMed until May 2021 for any articles that used a form of information and communication technology (ICT) in relation to primary outcomes anxiety, pain, depression, or stress. From 1285 articles that satisfied the inclusion criteria, 890 were randomized trials with nearly 70% satisfactory outcomes. For depression and anxiety, the most frequently reported, were web-based, or mobile apps used for self-monitoring, and guided interventions. For pain, VR-based interventions or games were more prevalent, especially as tools for distraction, or as stimuli for mechanistic studies of pain or anxiety. We discuss gaps in knowledge and challenges that relate to the human factors in digital health applications, and underline the need for a practical and conceptual framework for capturing and reporting such variations.