EFFECTIVENESS OF NON-PHARMACOLOGICAL INTERVENTIONS IN MANAGING ANXIETY AND DEPRESSION SYMPTOMS OF PATIENTS WITH CHRONIC KIDNEY DISEASE : A SYSTEMATIC REVIE AND META-ANALYSIS

Abstract

Aim: This review aims to explore the effectiveness of non-pharmacological interventions for chronic kidney disease patients with anxiety and depression symptoms. Method: Cochrane Library, EmBase, PubMed, PsycINFO, CINAHL, ProQuest, ProQuest Thesis, Scopus and Web of Science were systematically searched for randomised controlled trials (RCT) from inception until October 30, 2018). The risk of bias was assessed using the Cochrane Collaboration Risk of Bias Tool. Meta-analysis was performed on the RevMan software using the random effects model. The overall effect was assessed using effect size (Cohen’s d). Heterogeneity were examined using X2 test and I2 test statistics. Result: A total of 29 studies were included with 1,944 participants across 12 countries. The results of the meta-analysis showed a statistically significant change in measurement of anxiety outcomes favouring the intervention group over control group (MD = 0.96, 95%CIs [-1.36 to -0.56], p < 0.001) and depression measurement outcomes favours the experimental (interventions) group over the control group (MD = 0.79, 95%CIs [-1.11 to -0.46], p < 0.001). There was high heterogeneity among the outcomes and subgroup analyses were conducted. The overall quality of evidence was high. Conclusion: Non-pharmacological interventions are effective in managing anxiety and depression symptoms in patients with CKD