The Effectiveness of Interactive Computer-Based Interventions for Sexual Problems in Adults: A Systematic Review

Background Sexual function problems are a recognised neglected area of research and service delivery, which gives cause for concern as there is a high prevalence of people with sexual problems (e.g., erectile problems, lack of sexual desire, hypersexuality etc.) within general practice and sexual health services. Many more people experience sexual problems but do not seek help for them. Barriers to help-seeking include discomfort and embarrassment discussing sexual problems with health professionals, geographic barriers, and time constraints due to work and/or childcare commitments. Computer-based interventions for sexual problems have the potential to overcome some of these barriers, and provide a convenient, wide-reaching, and cost-effective alternative to face-to-face interventions Objective This systematic review aimed to determine the effectiveness of interactive computer-based interventions for sexual problems in adults, with the primary outcomes of interest being symptom improvement, satisfaction, and level of distress. Methods Search strategy: 8 databases were searched for randomised controlled trials (RCTs) of interactive computer-based interventions for sexual problems, including CINAHL, CENTRAL, EMBASE, ERIC, IBSS, MEDLINE, PSYCINFO, and Web of Science. Grey literature databases, on-going trials registers, hand searching, reference and citation tracking, and consultation with experts were also used to identify further studies. Relevant authors were contacted for missing information. Searching took place Sep 2012 to Jan 2013, with no language or date restrictions. Selection criteria: RCTs of interactive computer-based interventions for sexual problems, involving adults aged 18 or over, irrespective of gender, sexuality, ethnicity, nationality and type of sexual problem. Data collection and analysis: Two review authors independently screened titles and abstracts, applied eligibility criteria, and extracted full text data. Study quality: Assessed using the Cochrane risk of bias assessment tool. Cochrane and PRISMA guidelines were used to guide the review. Results and conclusions The search generated 8692 citations. 8633 were excluded at the title level, 42 at the abstract level, and a further eight at the full text data extraction level. Reasons for exclusion at the full text level: Intervention did not meet the study definition of an interactive computer-based intervention (3); study not a RCT (2), duplicate: a thesis, the content of which was published elsewhere and already included in study (1); and outcomes not related to sexual function (2). Target populations: Four studies targeted men and their partners, two targeted women and their partners, and three targeted couples more generally. Eight out of the nine studies targeted heterosexual participants only. Interventions: All interventions were interactive computer-based interventions that were delivered via the internet or on individual computers. Three focused on erectile dysfunction (ED), two on female sexual dysfunction (FSD), one on both ED and FSD, and three were non-specific. All nine interventions drew on Cognitive behaviour therapy in their design. Data from included studies will be tabulated to provide a descriptive synthesis of the studies, and if appropriate, the data will be meta-analysed. Please note: A full set of results will be available well before the conference in September, 2013. []