Review of key telepsychiatry outcomes
Top Cited Papers
Open Access
- 1 January 2016
- journal article
- review article
- Published by Baishideng Publishing Group Inc. in World Journal of Psychiatry
- Vol. 6 (2), 269-282
- https://doi.org/10.5498/wjp.v6.i2.269
Abstract
AIM: To conduct a review of the telepsychiatry literature. METHODS: We conducted a systematic search of the literature on telepsychiatry using the search terms, “telepsychiatry”, “telemental health”, “telecare”, “telemedicine”, “e-health”, and “videoconferencing”. To meet criteria for inclusion, studies had to: (1) be published in a peer-reviewed journal after the year 2000; (2) be written in English; (3) use videoconferencing technology for the provision of mental health assessment or treatment services; and (4) use an adequately-powered randomized controlled trial design in the case of treatment outcome studies. Out of 1976 studies identified by searches in PubMed (Medline database), Ovid medline, PsychInfo, Embase, and EBSCO PSYCH, 452 met inclusion criteria. Studies that met all inclusion criteria were organized into one of six categories: (1) satisfaction; (2) reliability; (3) treatment outcomes; (4) implementation outcomes; (5) cost effectiveness; and (6) and legal issues. All disagreements were resolved by reassessing study characteristics and discussion. RESULTS: Overall, patients and providers are generally satisfied with telepsychiatry services. Providers, however, tend to express more concerns about the potentially adverse of effects of telepsychiatry on therapeutic rapport. Patients are less likely to endorse such concerns about impaired rapport with their provider. Although few studies appropriately employ non-inferiority designs, the evidence taken together suggests that telepsychiatry is comparable to face-to-face services in terms of reliability of clinical assessments and treatment outcomes. When non-inferiority designs were appropriately used, telepsychiatry performed as well as, if not better than face-to-face delivery of mental health services. Studies using both rudimentary and more sophisticated methods for evaluating cost-effectiveness indicate that telepsychiatry is not more expensive than face-to-face delivery of mental health services and that telepsychiatry is actually more cost-effective in the majority of studies reviewed. Notwithstanding legal concerns about loss of confidentiality and limited capacity to respond to psychiatric emergencies, we uncovered no published reports of these adverse events in the use of telepsychiatry. CONCLUSION: A large evidence base supports telepsychiatry as a delivery method for mental health services. Future studies will inform optimal approaches to implementing and sustaining telepsychiatry services.Keywords
This publication has 119 references indexed in Scilit:
- Online Mental Health Resources in Rural Australia: Clinician Perceptions of AcceptabilityJournal of Medical Internet Research, 2013
- Telepsychiatry: Licensing and Professional Boundary ConcernsThe AMA Journal of Ethic, 2012
- How Do Low-Income Urban African Americans and Latinos Feel about Telemedicine? A Diffusion of Innovation AnalysisInternational Journal of Telemedicine and Applications, 2012
- The cost effectiveness of cognitive behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-faceBehaviour Research and Therapy, 2009
- Acceptability of Telepsychiatry in American IndiansTelemedicine and e-Health, 2008
- A randomized trial comparing the efficacy of cognitive–behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-faceBehaviour Research and Therapy, 2008
- Accuracy of telepsychiatric assessment of new routine outpatient referralsBMC Psychiatry, 2007
- Assessment of an enhanced program for depression management in primary care: a cluster randomized controlled trial. The INDI project (Interventions for Depression Improvement)BMC Public Health, 2007
- A Randomized Trial of Telemedicine-based Collaborative Care for DepressionJournal of General Internal Medicine, 2007
- The costs and potential savings of a novel telepaediatric service in QueenslandBMC Health Services Research, 2007