Telemedicine interventions for medication adherence in mental illness: A systematic review.

OBJECTIVE: To conduct a systematic review to assess the evidence for telemedicine interventions for pharmacologic adherence in persons with depression, bipolar disorder, or schizophrenia.

METHOD: We searched PubMed and PsycINFO in August 2018 without restrictions on years or language. We also searched tables of contents in 2 journals, meeting abstracts, reference lists from identified studies and review articles. The selection criteria required that articles be randomized controlled trials involving outpatient adults diagnosed with depression, bipolar disorder, or schizophrenia; that they involve telemedicine interventions; and that they include an outcome of medication adherence. Initially, 1 author identified relevant titles. Two authors independently reviewed the abstracts and titles.

RESULTS: Of 512 articles identified through database searching, we identified 17 articles that we categorized by intensity of intervention and rated by quality of evidence. There were 3 low-, 3 medium- and 11 high-intensity interventions. The most common type of technology used was the phone. Efficacy for adherence was demonstrated by 9 studies.

CONCLUSIONS: Telemedicine may improve medication adherence in patients with depression, bipolar disorder, or schizophrenia. Future studies are needed to better understand how technology can be tailored to different types of nonadherence.