A Systematic Review of the Use of Telepsychiatry in Depression
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ORIGINAL PAPER
A Systematic Review of the Use of Telepsychiatry in Depression Giuseppe Guaiana1 · Julia Mastrangelo2 · Shawn Hendrikx3 · Corrado Barbui4 Received: 28 April 2020 / Accepted: 3 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Telepsychiatry, the use of televideo in psychiatric assessment and treatment, is utilized throughout Canada. Major depressive disorder (MDD) is common, with significant burdens of suffering and cost. This systematic review explores the literature on the use of televideo to diagnose and treat MDD, particularly acceptability and patient satisfaction, efficacy, and costeffectiveness. A literature search was conducted for years 1946 to 2019. Study eligibility criteria included: MDD as the condition of interest, use of televideo technology, randomized controlled trials (RCTs), Adult (18 years or older) population, any clinical setting, and any healthcare professional providing care. The study must have included at least one of the following measures, satisfaction, efficacy, and cost-effectiveness. Fourteen studies were included. Satisfaction is equivalent to or significantly higher than face-to-face intervention. Both televideo and control groups found relief from depressive symptoms, with differences either statistically insignificant or in favour of televideo. Despite increased cost upfront for televideo due to the technology required, televideo would eventually be more cost-effective due to reducing travel expenses. Limitations include that there is little RCT data, and what exists often uses a collaborative treatment model. Many studies consisted solely of U.S. Veterans, and have limited generalizability. Further research needed to directly compare psychiatrist assessment over televideo versus in-person, and determine if particular patient subgroups benefit more from televideo or in-person intervention. Systematic review registration number: CRD42016048224. Keywords Telemedicine · Telepsychiatry · Major depressive disorder
Introduction Telemedicine, the ability to provide healthcare remotely via technology, has the potential to reinvent the practice of medicine. This technology typically consists of a live video and audio connection between a physician and a patient (who may be located in a hospital, clinic, or their own home), provided by a service, which can be private or * Giuseppe Guaiana [email protected] 1
Department of Psychiatry and Department of Epidemiology and Biostatistics, Western University, London, Canada
2
Department of Psychiatry, Western University, London, Canada
3
Collections & Content Strategies, Western Libraries, Western University, London, Canada
4
Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
government-based. Patients in rural areas, those unable to leave their homes, or who must navigate other barriers, can access care via telemedicine they otherwise could not (Chaet et al. 2017). In their annual report for the
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