Efficacy of Online-Based Intervention for Anxiety during COVID-19: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

COVID-19 has caused widespread psychological suffering. Anxiety is one of the several psychological disorders that are escalating globally, yet social distance constraints restrict in-person mental health therapy. Anxiety and other psychological disorders whose treatments are limited due to social distancing continue to grow, so there is an increasing need to use mental healthcare that can be offered remotely, especially in the pandemic era. This study aimed to conduct a systematic review and meta-analysis of the efficacy of online-based interventions for anxiety during COVID-19. This study followed the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA). We collected data from three databases, namely PubMed, CINAHL, and Oxford Library Press, published in 2020–2022. Additionally, we collected data using the snowball technique. This meta-analysis analyzed the pooled mean difference (MD) and its p-value using random-effects models. Critical appraisal and risk of bias were assessed using Cochrane Risk of Bias (Rob) 2. We retrieved 34 RCTs for systematic review and 14 RCTs for meta-analysis, yielding 9159 participants for general anxiety disorder (GAD-7) measurement and 1303 participants for depression anxiety stress scale (DASS-21) measurement. This study shows that online-based interventions significantly reduce GAD-7 score (a pooled MD of 1.30; 95% CI: 2.83–4.65; p = 0.00001) and insignificantly reduce DASS-21 (0.05; 95% CI: −2.63–2.72; p = 0.97) according to pre- and post-test in intervention group. Additionally, there is a significant difference between the intervention and control groups, where the intervention group performed statistically progressively better than the controls (−7.26; 95% CI: −11.58–−2.95; p = 0.001) (−2.08; 95% CI: −6.71–2.55; p = 0.001). Online-based interventions have proved effective for reducing general anxiety during the COVID-19 pandemic. Consequently, this meta-analysis can be adapted as a model for mental health services in the new normal.