Comparative effectiveness and acceptability of different ACT delivery formats to treat depression: A systematic review and network meta-analysis of randomized controlled trials

BACKGROUNDAcceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of acute depression. However, whether ACT can be effectively delivered in individual, group, internet, and combined delivery format remain unclear. We aimed to examine the most effective delivery format...

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Veröffentlicht in:Journal of affective disorders 2022-09, Vol.313, p.196-203
Hauptverfasser: Sun, Yue, Ji, Mengmeng, Zhang, Xuer, Chen, Ji, Wang, Yang, Wang, Zhiwen
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container_issue
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container_title Journal of affective disorders
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creator Sun, Yue
Ji, Mengmeng
Zhang, Xuer
Chen, Ji
Wang, Yang
Wang, Zhiwen
description BACKGROUNDAcceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of acute depression. However, whether ACT can be effectively delivered in individual, group, internet, and combined delivery format remain unclear. We aimed to examine the most effective delivery format for ACT via a network meta-analysis (NMA). METHODSAn electronic literature search was conducted by two reviewers in the Pubmed, Cochrane library, Embase, PsycINFO, CINAHL, CNKI, Wangfang databases to identify relevant studies that were published up to March 21th, 2021. We conducted pairwise and NMA to evaluate the relative effectiveness and rank the probability of different ACT delivery formats. A series of analyses and assessments, such as the risk of bias, and GRADE were performed concurrently. RESULTSA total of 23 studies were included in our analysis based on a series of rigorous screenings, which comprised 690 depressed patients. The effectiveness of individual, group, internet, and combine ACT did not differ statistically significantly from each other. Compared with control group, individual delivery format (standardized mean difference [SMD] = -1.44, confidence interval (CI) = -2.11 to -0.76 GRADE low), group delivery format (SMD = -1.34, 95 % CI = -1.91 to -0.78 GRADE moderate), and internet delivery format (SMD = -0.66, 95 % CI = -1.25 to -0.06 GRADE low) showed the largest improvement on depressive symptoms, whereas the combined group and individual ACT was less effective. In terms of acceptability (dropout for any reason), all delivery formats did not differ statistically significantly from each other. CONCLUSIONSFor depression symptoms, individual, group, and internet treatment formats appeared to be effective interventions. Applying effective and acceptable ACT in a range of different formats will make ACT easier to implement, disseminate, and deliver across different settings and diverse patient populations. More research is needed to verify the ACT in telephone and combined formats for the management of depression.
doi_str_mv 10.1016/j.jad.2022.06.017
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However, whether ACT can be effectively delivered in individual, group, internet, and combined delivery format remain unclear. We aimed to examine the most effective delivery format for ACT via a network meta-analysis (NMA). METHODSAn electronic literature search was conducted by two reviewers in the Pubmed, Cochrane library, Embase, PsycINFO, CINAHL, CNKI, Wangfang databases to identify relevant studies that were published up to March 21th, 2021. We conducted pairwise and NMA to evaluate the relative effectiveness and rank the probability of different ACT delivery formats. A series of analyses and assessments, such as the risk of bias, and GRADE were performed concurrently. RESULTSA total of 23 studies were included in our analysis based on a series of rigorous screenings, which comprised 690 depressed patients. The effectiveness of individual, group, internet, and combine ACT did not differ statistically significantly from each other. Compared with control group, individual delivery format (standardized mean difference [SMD] = -1.44, confidence interval (CI) = -2.11 to -0.76 GRADE low), group delivery format (SMD = -1.34, 95 % CI = -1.91 to -0.78 GRADE moderate), and internet delivery format (SMD = -0.66, 95 % CI = -1.25 to -0.06 GRADE low) showed the largest improvement on depressive symptoms, whereas the combined group and individual ACT was less effective. In terms of acceptability (dropout for any reason), all delivery formats did not differ statistically significantly from each other. CONCLUSIONSFor depression symptoms, individual, group, and internet treatment formats appeared to be effective interventions. Applying effective and acceptable ACT in a range of different formats will make ACT easier to implement, disseminate, and deliver across different settings and diverse patient populations. More research is needed to verify the ACT in telephone and combined formats for the management of depression.</description><identifier>ISSN: 0165-0327</identifier><identifier>EISSN: 1573-2517</identifier><identifier>DOI: 10.1016/j.jad.2022.06.017</identifier><language>eng</language><ispartof>Journal of affective disorders, 2022-09, Vol.313, p.196-203</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c278t-979876df5822e726a98482e3be3ac2686e265c186405b58f6e8e3a30249215513</citedby><cites>FETCH-LOGICAL-c278t-979876df5822e726a98482e3be3ac2686e265c186405b58f6e8e3a30249215513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Sun, Yue</creatorcontrib><creatorcontrib>Ji, Mengmeng</creatorcontrib><creatorcontrib>Zhang, Xuer</creatorcontrib><creatorcontrib>Chen, Ji</creatorcontrib><creatorcontrib>Wang, Yang</creatorcontrib><creatorcontrib>Wang, Zhiwen</creatorcontrib><title>Comparative effectiveness and acceptability of different ACT delivery formats to treat depression: A systematic review and network meta-analysis of randomized controlled trials</title><title>Journal of affective disorders</title><description>BACKGROUNDAcceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of acute depression. However, whether ACT can be effectively delivered in individual, group, internet, and combined delivery format remain unclear. We aimed to examine the most effective delivery format for ACT via a network meta-analysis (NMA). METHODSAn electronic literature search was conducted by two reviewers in the Pubmed, Cochrane library, Embase, PsycINFO, CINAHL, CNKI, Wangfang databases to identify relevant studies that were published up to March 21th, 2021. We conducted pairwise and NMA to evaluate the relative effectiveness and rank the probability of different ACT delivery formats. A series of analyses and assessments, such as the risk of bias, and GRADE were performed concurrently. RESULTSA total of 23 studies were included in our analysis based on a series of rigorous screenings, which comprised 690 depressed patients. The effectiveness of individual, group, internet, and combine ACT did not differ statistically significantly from each other. Compared with control group, individual delivery format (standardized mean difference [SMD] = -1.44, confidence interval (CI) = -2.11 to -0.76 GRADE low), group delivery format (SMD = -1.34, 95 % CI = -1.91 to -0.78 GRADE moderate), and internet delivery format (SMD = -0.66, 95 % CI = -1.25 to -0.06 GRADE low) showed the largest improvement on depressive symptoms, whereas the combined group and individual ACT was less effective. In terms of acceptability (dropout for any reason), all delivery formats did not differ statistically significantly from each other. CONCLUSIONSFor depression symptoms, individual, group, and internet treatment formats appeared to be effective interventions. Applying effective and acceptable ACT in a range of different formats will make ACT easier to implement, disseminate, and deliver across different settings and diverse patient populations. More research is needed to verify the ACT in telephone and combined formats for the management of depression.</description><issn>0165-0327</issn><issn>1573-2517</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNotkctO5DAQRS00SPQAH8DOSzYJdqX9CLtWi5eENBtmbbmdiuQmiYNtQOGr-ETcwKqudI9OLS4hF5zVnHF5ta_3tquBAdRM1oyrI7LiQjUVCK7-kFVhRMUaUCfkb0p7xphsFVuRz20YZxtt9m9Ise_RHdKEKVE7ddQ6h3O2Oz_4vNDQ084XJuKU6Wb7RDscCh0X2oc42pxoDjRHtLk0cywSH6ZruqFpSRkL4B2N-Obx_Vs-YX4P8ZmOmG1lJzssyafDk1jaMPoP7KgLU45hGErM0dshnZHjvhw8_72n5P_tzdP2vnr8d_ew3TxWDpTOVatarWTXCw2ACqRt9VoDNjtsrAOpJYIUjmu5ZmIndC9Rl6ZhsG6BC8GbU3L5451jeHnFlM3ok8NhsBOG12SKA0Ao2UJB-Q_qYkgpYm_m6EcbF8OZOaxj9qasYw7rGCZNWaf5Aj3kh5A</recordid><startdate>20220915</startdate><enddate>20220915</enddate><creator>Sun, Yue</creator><creator>Ji, Mengmeng</creator><creator>Zhang, Xuer</creator><creator>Chen, Ji</creator><creator>Wang, Yang</creator><creator>Wang, Zhiwen</creator><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20220915</creationdate><title>Comparative effectiveness and acceptability of different ACT delivery formats to treat depression: A systematic review and network meta-analysis of randomized controlled trials</title><author>Sun, Yue ; Ji, Mengmeng ; Zhang, Xuer ; Chen, Ji ; Wang, Yang ; Wang, Zhiwen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c278t-979876df5822e726a98482e3be3ac2686e265c186405b58f6e8e3a30249215513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sun, Yue</creatorcontrib><creatorcontrib>Ji, Mengmeng</creatorcontrib><creatorcontrib>Zhang, Xuer</creatorcontrib><creatorcontrib>Chen, Ji</creatorcontrib><creatorcontrib>Wang, Yang</creatorcontrib><creatorcontrib>Wang, Zhiwen</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of affective disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sun, Yue</au><au>Ji, Mengmeng</au><au>Zhang, Xuer</au><au>Chen, Ji</au><au>Wang, Yang</au><au>Wang, Zhiwen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparative effectiveness and acceptability of different ACT delivery formats to treat depression: A systematic review and network meta-analysis of randomized controlled trials</atitle><jtitle>Journal of affective disorders</jtitle><date>2022-09-15</date><risdate>2022</risdate><volume>313</volume><spage>196</spage><epage>203</epage><pages>196-203</pages><issn>0165-0327</issn><eissn>1573-2517</eissn><abstract>BACKGROUNDAcceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of acute depression. However, whether ACT can be effectively delivered in individual, group, internet, and combined delivery format remain unclear. We aimed to examine the most effective delivery format for ACT via a network meta-analysis (NMA). METHODSAn electronic literature search was conducted by two reviewers in the Pubmed, Cochrane library, Embase, PsycINFO, CINAHL, CNKI, Wangfang databases to identify relevant studies that were published up to March 21th, 2021. We conducted pairwise and NMA to evaluate the relative effectiveness and rank the probability of different ACT delivery formats. A series of analyses and assessments, such as the risk of bias, and GRADE were performed concurrently. RESULTSA total of 23 studies were included in our analysis based on a series of rigorous screenings, which comprised 690 depressed patients. The effectiveness of individual, group, internet, and combine ACT did not differ statistically significantly from each other. Compared with control group, individual delivery format (standardized mean difference [SMD] = -1.44, confidence interval (CI) = -2.11 to -0.76 GRADE low), group delivery format (SMD = -1.34, 95 % CI = -1.91 to -0.78 GRADE moderate), and internet delivery format (SMD = -0.66, 95 % CI = -1.25 to -0.06 GRADE low) showed the largest improvement on depressive symptoms, whereas the combined group and individual ACT was less effective. In terms of acceptability (dropout for any reason), all delivery formats did not differ statistically significantly from each other. CONCLUSIONSFor depression symptoms, individual, group, and internet treatment formats appeared to be effective interventions. Applying effective and acceptable ACT in a range of different formats will make ACT easier to implement, disseminate, and deliver across different settings and diverse patient populations. More research is needed to verify the ACT in telephone and combined formats for the management of depression.</abstract><doi>10.1016/j.jad.2022.06.017</doi><tpages>8</tpages></addata></record>
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title Comparative effectiveness and acceptability of different ACT delivery formats to treat depression: A systematic review and network meta-analysis of randomized controlled trials
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