Digital Therapeutics for People with Schizophrenia Spectrum Disorders: A Systematic Literature Review
Introduction: Pharmacological treatments for negative and cognitive symptoms in schizophrenia spectrum disorders (SSD) are lacking, and evidence-based psychosocial interventions are inaccessible for most patients. Digital therapeutics (DTs; health software aimed at treating/alleviating elements of a disease/condition) may provide an accessible means of delivering evidence-based treatment for negative and cognitive symptoms in SSD.
Aims and Objectives: To conduct a systematic literature review to investigate whether people with SSD find DTs acceptable and can use them effectively, whether DTs are effective and generally safe, and if DT use can impact real-world functioning and/or quality of life (QoL).
Methods: The PROSPERO-registered systematic review (CRD42023476545) was conducted per PRISMA guidelines. Databases (MEDLINE/Embase/PsycINFO/Cochrane-SR/ClinicalTrials.gov/WHO International Clinical Trials Registry) and key congresses were searched up to Jan-28-2024 for articles on DTs in adults with SSD. Screening was completed by 2 reviewers, each blinded to the other's decisions, and article summaries extracted (Excel).
Results: 116 citations provided 97 primary research articles containing 58 unique studies, 39 of which were primary studies with results. DT usage/acceptance was generally very good. 20/24 studies assessing effectiveness had ≥1 outcome showing significant change versus comparator DT/baseline; 23 had ≥1 outcome showing no difference. DTs were generally safe. Of 20 studies reporting real-world functioning/QoL, 5 reported ≥1 significant outcome; 17 reported ≥1 outcome showing no difference.
Conclusions: People with SSD are able to use DTs. Although effectiveness outcomes varied across/within studies, DTs may provide an acceptable strategy for delivering accessible, generally safe, evidence-based care to people with SSD.
Funding: Boehringer Ingelheim Pharmaceuticals, Inc.
