The effectiveness of telehealth versus face-to-face interventions for anxiety disorders: A systematic review and meta-analysis

Natalia Krzyżaniak*, Hannah Greenwood, Anna Scott, Ruwani Peiris, Magnolia Cardona, Justin Clark, Paul P Glasziou

*Corresponding author for this work

Research output: Contribution to journalReview articleResearchpeer-review

38 Citations (Scopus)
2292 Downloads (Pure)


Introduction: Worldwide, it is estimated that 264 million people meet the diagnostic criteria for anxiety conditions.Effective treatment regimens consist of cognitive and behavioural therapies. During the COVID-19 pandemic, treatment delivery relied heavily on telemedicine technologies which enabled remote consultation with patients via phone or video platforms. We aim to identify, appraise and synthesise randomised controlled trials comparing telehealth to face-to-face delivery of care to individuals of any age or gender, diagnosed with anxiety disorders, and disorders with anxiety features.
Methods: To conduct this systematic review and meta-analysis, we searched three electronic databases, clinical trial registries and citing-cited references of included studies.
Results: A total of five small randomised controlled trials were includable; telehealth was conducted by video in three studies, and by telephone in two. The risk of bias for the 5 studies was low to moderate for most domains. Outcomesrelated to anxiety, depression symptom severity, obsessive-compulsive disorder, function, working alliance, and satisfaction were comparable between the two modes of delivery at each follow-up time point (immediately post-intervention, 3 months, 6 months and 12 months), with no significant differences reported (p > 0.05). None of the trials reported on the costs of telehealth compared to face-to-face care.
Discussion: For effectively treating anxiety and related conditions, interventions delivered by telehealth appear to be as effective as the same therapy delivered in-person. However, further high-quality trials are warranted to determine theeffectiveness, acceptability, feasibility, and cost-effectiveness of telehealth interventions for the management of a wider range of anxiety disorders and treatments.
Original languageEnglish
Pages (from-to)250-261
Number of pages12
JournalJournal of Telemedicine and Telecare
Issue number2
Early online date3 Dec 2021
Publication statusPublished - 3 Dec 2021


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