Can web-based interventions help improve well-being in type 2 diabetes? A systematic review and meta-analysis

  • M. Hadjiconstantinou
  • J. Byrne
  • D. Bodicoat
  • N. Robertson
  • H. Eborall
  • K. Khunti
  • M. Davies


Background: Web-based interventions are commonly used as an additional platform to conventional interventions to provide emotional support in chronic conditions. Despite their use, evidence of their impact on psychological well-being remains unclear. This systematic review sought to review the impact of web-based interventions on improving well-being outcomes in type 2 diabetes. Methods: The electronic databases: MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Library, were searched and reference lists hand-searched. A meta-analysis was conducted for two emotional constructs: depression and distress. Sixteen randomised controlled studies met the inclusion criteria for the systematic review and 9 for the meta-analyses. Findings: The most common behaviour change techniques comprised “General information” and “Tracking/monitoring.” Most interventions were theory-based, however no common theory was evident. Professional-led interventions, with asynchronous and synchronous communication, and with a duration of 2-6 months were linked to significant well-being outcomes. Pooled mean (95% confidence interval) differences between the intervention and control arms at follow-up were -0.31 (-0.73 to 0.11) for depression and-0.11 (-0.38 to 0.16) for distress. The meta-analyses showed no significant improvements in depression (P=.15) or distress (P=.43). Discussion: Despite the meta-analyses demonstrating non-significant results for depression and distress scores, there is growing potential for the use of web-based interventions to improve well-being outcomes in type 2 diabetes. Further research is required to assess well-being outcomes as primary outcomes in order to identify the impact of web-based interventions on well-being in type 2 diabetes.
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