Effectiveness of technology-based interventions on psychological morbidities, quality of life for informal caregivers of stroke survivors: A systematic review and meta-analysis

Aims: To evaluate the effectiveness of technology-based interventions in reducing psychological morbidities such as depressive symptomology, anxiety, burden and improving quality of life and self-efficacy in informal caregivers of stroke survivors. Design: A systematic review and meta-analysis. Data Sources: An extensive search was systematically undertaken at CENTRAL, PubMed, Embase, Scopus, CINHAL, Web of Science and PsycInfo until January 2021. Grey literature and dissertations were searched in Google Scholar, ProQuest & Scholarbank@NUS. Studies involving registered trials were retrieved from Clinicaltrials.gov and CENTRAL, respectively. Review Methods: Two reviewers independently screened the trials, conducted quality appraisal and extracted the data. Quality of the studies included in the review was assessed using Cochrane Risk of bias tool. Meta-analysis was conducted using RevMan 5.4. Narrative synthesis was performed for studies where results could not be pooled statistically. The results were reported abiding Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: This review included 15 trials with a total of 1276 informal caregivers of stroke survivors. Eleven trials were included in the meta-analysis. Subgroup analyses revealed that technology-based interventions with structured educational programs were statistically significant in reducing depressive symptoms (d = −0.27, 95% CI [−0.49 to −0.05], p =.02). Technology-based interventions with structured educational programs <3-month revealed significant effects (d = −0.31, 95% CI [−0.49 to −0.13], p =.0009). Results of narrative synthesis reported technology-based intervention with face-to-face training minimized depressive symptoms of informal caregivers. Notably, there were no statistically significant effects on anxiety, burden, quality of life and self-efficacy outcomes. Conclusion: Technology-based interventions had beneficial effects in alleviating depressive symptoms among informal caregivers. Impact: Technology-based interventions serve as a support mechanism for informal caregivers of stroke survivors who face time-constrains. Further high-quality randomized controlled trials are warranted to elucidate sustainability, optimal format and dosage of intervention.