ORIGINAL ARTICLE
Comparative Efficacy of Different Cognitive Behavior Therapy Delivery Formats for Depression in Patients With Cancer: A Network Meta-Analysis of Randomized Controlled Trials
Liyang Duan,
Shu Zhang,
Qianwen Yan,
Xiaolin Hu,
Liyang Duan
West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Search for more papers by this authorShu Zhang
West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Search for more papers by this authorQianwen Yan
West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Search for more papers by this authorCorresponding Author
Xiaolin Hu
West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Sichuan, China
Correspondence: Xiaolin Hu
Search for more papers by this authorLiyang Duan,
Shu Zhang,
Qianwen Yan,
Xiaolin Hu,
Liyang Duan
West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Search for more papers by this authorShu Zhang
West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Search for more papers by this authorQianwen Yan
West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Search for more papers by this authorCorresponding Author
Xiaolin Hu
West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
Tianfu Jincheng Laboratory, City of Future Medicine, Chengdu, Sichuan, China
Correspondence: Xiaolin Hu
Search for more papers by this authorFunding: The study is supported by the National Natural Sciences Foundation of China (82473752 and 82172842), Sichuan Provincial Science and Technology Department Key Research and Development Program (2022YFSY0012 and 2024SYSX0066), the China Medical Board (Grant#22-482), the Ministry of Education University-Industry Collaborative Education Program (230720523707281), Sichuan University Graduate Students Education Teaching Reform Research Program (GSSCU2023090 and GSSCU2023095), Chengdu Eastern New Area Municipal Administration Committee, Bureau of Culture and Tourism Program (00402053A29YN), and Chengdu Eastern New Area Technology Innovation Research and Development Program (2024-DBXQ-KJYF009).
Liyang Duan and Shu Zhang contributed equally to this work.
ABSTRACT
Background
Cognitive behavior therapy (CBT) has been shown to be effective in improving depression in patients with cancer. However, diversity exists in the CBT delivery formats, and the optimal delivery format remains unconfirmed.
Objectives
To compare the efficacy of different delivery formats of CBT interventions on depression in patients with cancer.
Design
Network meta-analysis of randomized controlled trials.
Data Source
Six databases, including PubMed, Web of Science, Embase, CINAHL, the Cochrane Central Register of Controlled Trials and PsycINFO, were searched from inception to May 30, 2024.
Methods
Two reviewers independently conducted study inclusion, data extraction, and risk of bias assessment. A pairwise meta-analysis and a network meta-analysis were performed sequentially to determine the efficacy of CBT delivery formats for improving depression in patients with cancer.
Results
A total of 34 randomized controlled trials involving six delivery formats of CBT were included. Face-to-face group CBT (SMD = −0.88, 95% CI [−1.33, −0.44]), internet-based individual CBT (SMD = −0.49, 95% CI [−0.92, −0.06]), app-based individual CBT (SMD = −0.81, 95% CI [−1.45, −0.18]), and combined delivery formats of CBT for individual (SMD = −0.35, 95% CI [−0.62, −0.09]) were significantly more effective than the inactive control. The ranking probabilities revealed that face-to-face group CBT (P-score = 0.86), app-based individual CBT (P-score = 0.74) and internet-based individual CBT (P-score = 0.57) were the three most effective delivery formats of CBT.
Conclusions
This study revealed the efficacy ranking of different CBT delivery formats in improving depression in patients with cancer. These findings are expected to provide evidence-based support for future research and clinical decision making for improving depression in patients with cancer.
Trial Registration
PROSPERO (CRD42024553977)
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
The datasets generated or analyzed during this study are available from the corresponding author on reasonable request.
Supporting Information
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Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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