Evidence for Telemedicine in Psychiatry

Peter M. Yellowlees, MBBS, MD


May 06, 2016

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This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees. The first videoconference telepsychiatry consultation took place in 1956 at the University of Nebraska, and since then, thousands of papers have been written about the clinical use of information technologies (eg, videoconferencing, telephony, email, and messaging) in mental health.

A team of investigators from the University of Michigan, including myself, has published a major review assessing the state of scientific knowledge of tele-mental health (TMH) in terms of feasibility and acceptance, effects on medication compliance, health outcomes, and cost.[1] From 1362 papers published between 2005 and 2015, 59 randomized controlled trials (RCTs) were identified that included at least 150 patients each. These comprised 22 studies on feasibility and acceptance, seven on medication compliance, 25 on health outcomes, and five on cost.

The authors concluded that research in this area has relied heavily on RCTs, far exceeding comparable research in other telemedicine disciplines, and that TMH is feasible and leads to high satisfaction rates in patients of all ages. They noted a strong evidence base supporting the use of TMH to improve access and efficiency of care, and that TMH is associated with improved treatment adherence and outcomes especially for depression and anxiety, in primary care, and in patients who have comorbid medical conditions.

It is clear that 60 years after the first telepsychiatry consultation, the evidence is now in. We should no longer be thinking of telepsychiatry as being "new." Instead, we should be integrating a range of information technologies for clinical care routinely into our practices. Patients greatly appreciate the convenience and improved accessibility, and physicians can rest assured that what they are doing has a strong evidence base. Thank you for listening to this Medscape Psychiatry Minute. I look forward to seeing you online.


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