Efficacy of Digital Technology-Based Interventions for Reducing Caregiver Burden and Stress: A Systematic Review and Meta-analysis

Maria José Lumini^1*Daniela França²Maria Rui Sousa¹Fátima Araújo¹Carla Cardoso³Marta Sá⁴Mafalda Lopes¹Maria José Peixoto¹Teresa Martins¹

• ¹Escola Superior de Enfermagem do Porto, Porto, Portugal
• ²Escola Superior de Saude de Santa Maria, Porto, Portugal
• ³Instituto Portugues de Oncologia do Porto Francisco Gentil EPE, Porto, Portugal
• ⁴Unidade Local de Saúde Povoa do Varzim, Portugal, Póvoa do Varzim, Portugal

Background: Demographic aging and increasing dependency associated with chronic diseases have intensified the caregiving responsibilities of family members, often leading to significant burden and stress. Digital technology-based interventions have emerged as promising strategies to support family caregivers, yet their effectiveness remains inconsistent across studies. Method: A systematic review and meta-analysis was conducted following JBI methodology and PRISMA guidelines. Literature searches were performed in CINAHL Complete, MEDLINE Complete, Scopus, and Web of Science (August 2024, updated September 2025). Studies were included if they involved family caregivers aged ≥18 years supporting individuals with functional dependency, implemented technology-based interventions, and employed experimental designs. Two independent reviewers conducted screening, data extraction, and quality assessment. Meta-analyses were performed to calculate standardized effect sizes (Cohen's d) for caregiver burden, stress, and quality of life outcomes. Results: Sixteen studies comprising 2,716 caregivers were included, predominantly randomized controlled trials. Interventions utilized diverse digital modalities including mobile applications, websites, telemonitoring, and tele-coaching, with most delivered by nurses. Meta-analysis revealed significant short-term reductions in caregiver burden (d=-0.65, 95% CI: -1.00 to -0.30, p<0.01) and stress (d=-0.62, 95% CI: -0.81 to -0.43, p<0.01). However, heterogeneity was substantial for burden (I²=75%) and effects on quality of life were non-significant with very high variability (I²=92%). Long-term effectiveness could not be determined due to limited follow-up data. Conclusion: Digital technology-based interventions demonstrate moderate effectiveness in reducing caregiver burden and stress in the short term. However, considerable variability in outcomes suggests that effectiveness is influenced by intervention characteristics, delivery modalities, and contextual factors. Future research should focus to strengthen the consistency of the findings, including subgroup analyses by type of intervention and evaluation of their long-term effects. Systematic Review Registration: PROSPERO (CRD42024574765)