Effectiveness, feasibility, and acceptability of interactive digital interventions for the treatment of sexual difficulties: a systematic review

Abstract

Sexual difficulties are common in the UK, but availability of treatment services is scarce. Interactive digital interventions (IDIs) have the potential to deliver tailored psychotherapies for the treatment of sexual difficulties. However, more evidence is needed to determine their effectiveness, feasibility, and acceptability, before widespread implementation. Systematic review across 5 databases, following Cochrane review methods. Meta-analysis of functional, cognitive, emotional, and behavioural outcomes associated with sexual experiences, taken from randomised-controlled trials (RCTs) only, were used to measure effectiveness of IDIs for sexual difficulties. Subgroup analysis was carried out, by gender and IDI level of guidance. A thematic analysis of qualitative and quantitative studies was performed to evaluate feasibility and acceptability. 9 RCTs were included in the meta-analysis and 10 studies in the thematic analysis. Guided IDIs improve functional (SMD 0.68; 95%CI 0.21-1.15), cognitive (SMD 0.62; 95%CI 0.17-1.07), and behavioural (SMD 0.35; 95%CI 0.11-0.59) outcomes for women with sexual difficulties. Little data on men meant no significant conclusions could be drawn. Although study attrition and intervention adherence need addressing, IDIs were found to be feasible and acceptable provided content is personalised and relevant to a diverse range of participants. Users appreciated interventions involving partners and valued therapist support. This review strengthens evidence that IDIs can be effective, feasible, and acceptable for people with sexual difficulties. Incorporation of partner involvement, therapist support, and personalisation when developing IDIs is recommended. IDIs offer an alternative to face-to-face treatments, which could help to reduce waiting-lists and increase availability of services for sexual difficulties. None