SynthesisJournal of medical Internet research2011
A systematic review of the impact of adherence on the effectiveness of e-therapies.
Synthesis in Journal of medical Internet research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04948996 (Effectiveness of Group Versus Individual Self-management of Depression Using a Mobile App to Increase Treatment Adherence Among Users of a University-based Helpline in the Dominican Republic.), which is not on this map. Cited by 535 papers, 16 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effectiveness of Group Versus Individual Self-management of Depression Using a Mobile App to Increase Treatment Adherence Among Users of a University-based Helpline in the Dominican Republic.
Who cites it
535 citing papers in PubMed, 16 syntheses or guidelines pooled it.
- Attrition in Digital Self-Management Interventions for Patients With Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD): Mixed Methods Systematic Review.Journal of medical Internet research · 2026Pooled it
- The effect of internet-based acceptance and commitment therapy on sleep quality and insomnia in adults: a systematic review and meta-analysis.Scientific reports · 2026Pooled it
- Effectiveness of Digital Health Interventions on Body Weight and Dietary Intake Outcomes Among Culturally and Linguistically Diverse (CALD) and Indigenous Populations: A Systematic Review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026Pooled it
- Effectiveness of Self-Help Interventions to Reduce Work Disability: A Rapid Mixed Methods Systematic Review.Journal of occupational rehabilitation · 2026Pooled it
- Association between user engagement and clinical outcomes in smartphone apps for depression and anxiety: A systematic review and meta-analysis.Psychiatry research · 2026Pooled it
- Interactive Conversational Agents to Improve Dietary Behaviors for Health Promotion: Mixed Systematic Review.Journal of medical Internet research · 2025Pooled it
- The effectiveness of mindfulness-based cognitive therapy on rumination and related psychological indicators: a systematic review and meta-analysis.BMC psychology · 2025Pooled it
- Digital Mental Health Interventions for the Prevention and Treatment of Social Anxiety Disorder in Children, Adolescents, and Young Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of medical Internet research · 2025Pooled it
- Methodological quality in randomised clinical trials of mental health apps: systematic review and longitudinal analysis.BMJ mental health · 2025Pooled it
- Pooled it
- Factors Associated With Digital Intervention Engagement and Adherence in Patients With Cancer: Systematic Review.Journal of medical Internet research · 2024Pooled it
- The Effectiveness of Strategies to Improve User Engagement With Digital Health Interventions Targeting Nutrition, Physical Activity, and Overweight and Obesity: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2023Pooled it
- Are digital health interventions valuable to support patients with cancer and caregivers? An umbrella review of web-based and app-based supportive care interventions.Cancer medicine · 2023Pooled it
- Assessing Patient Adherence to and Engagement With Digital Interventions for Depression in Clinical Trials: Systematic Literature Review.Journal of medical Internet research · 2023Pooled it
- Skill Enactment and Knowledge Acquisition in Digital Cognitive Behavioral Therapy for Depression and Anxiety: Systematic Review of Randomized Controlled Trials.Journal of medical Internet research · 2023Pooled it
- Assessing the Acceptability and Effectiveness of Mobile-Based Physical Activity Interventions for Midlife Women During Menopause: Systematic Review of the Literature.JMIR mHealth and uHealth · 2022Pooled it
- Behavioral Modification as a Putative Mediator of Digital Therapeutic Response in Temporomandibular Disorders: Secondary Analysis of a Multicenter Sham-Controlled Randomized Trial.JMIR mHealth and uHealth · 2026Trial
- Efficacy of a self-guided online resilience intervention for improving mental health among university students: A randomized controlled trial.Scientific reports · 2026Trial
- Digital Mental Health Treatment and Symptoms of Depression and Anxiety in Breast Cancer Survivors: A Randomized Clinical Trial.JAMA network open · 2026Trial
- Effect of a Personalized Mobile App on Glucose Control in Adults With Prediabetes and Type 2 Diabetes: Exploratory Pilot Randomized Controlled Trial.JMIR human factors · 2026Trial
475 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAs the popularity of e-therapies grows, so too has the body of literature supporting their effectiveness. However, these interventions are often plagued by high attrition rates and varying levels of user adherence. Understanding the role of adherence may be crucial to understanding how program usage influences the effectiveness of e-therapy interventions.
objectiveThe aim of this study was to systematically review the e-therapy literature to (1) describe the methods used to assess adherence and (2) evaluate the association of adherence with outcome of these interventions.
methodsA systematic review of e-therapy interventions was conducted across disease states and behavioral targets. Data were collected on adherence measures, outcomes, and analyses exploring the relationship between adherence measures and outcomes.
resultsOf 69 studies that reported an adherence measure, only 33 (48%) examined the relationship between adherence and outcomes. The number of logins was the most commonly reported measure of adherence, followed by the number of modules completed. The heterogeneity of adherence and outcome measures limited analysis. However, logins appeared to be the measure of adherence most consistently related to outcomes in physical health interventions, while module completion was found to be most related to outcomes in psychological health interventions.
conclusionsThere is large variation in the reporting of adherence and the association of adherence with outcomes. A lack of agreement about how best to measure adherence is likely to contribute to the variation in findings. Physical and psychological outcomes seem influenced by different types of adherence. A composite measure encompassing time online, activity completion, and active engagements with the intervention may be the best measure of adherence. Further research is required to establish a consensus for measuring adherence and to understand the role of adherence in influencing outcomes.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.