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

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