Are self-administered psychosocial interventions as efficacious as guided interventions in the management if chronic health conditions?

Background: While it is acknowledged that psychosocial interventions can improve the quality of life (QOL) of individuals with a physical illness; they are often not routinely part of supportive care, potentially due to costs and issues relating to long-term sustainability.
Aim: To assess the efficacy of self-administered, psychosocial interventions to improve outcomes among individuals with a physical illness (including individuals with cancer).
Methods: Eligible studies comparing a self-administered intervention to a control group were identified through search of the CINAHL, MEDLINE, PsychINFO and Web of Knowledge databases and secondary searches of reference lists. Random effects meta-analyses were performed separately for the primary (anxiety, depression) and secondary (distress, QOL, self-efficacy, (coping) outcomes.
Results: The search yielded 24 manuscripts that met the eligibility criteria for inclusion. The standard mean difference (SMD) was significant for anxiety (SMD = −0.13, 95%CI = −0.25 to −0.01), depression (SMD = −0.27, 95%CI = −0.38 to −0.16), distress (SMD = −0.20, 95%CI = −0.37 to −0.04), global (SMD = 0.25, 95%CI = 0.06 to 0.44) and disease-specific (SMD = −0.18, 95%CI = −0.31 to −0.05) QOL, and self-efficacy (SMD = 0.54, 95%CI = 0.34 to 0.73). Non-significant results were found for mental, physical, and social functioning and coping.
Conclusions: Self-administered interventions are a potentially efficacious and cost-effective approach to address some of the most common supportive care needs of patients with cancer, especially anxiety, depression and distress. Future studies need to compare the efficacy and cost-effectiveness of different
levels of guidance directly, and the potential impact of tailoring these interventions to individuals’ needs.