Telemedicine as a Tool to Improve Medicine Adherence in Patients with Affective Disorders – A Systematic Literature Review

Abstract

Affective disorders are a common psychological impairment. A major problem with respect to treatment is medication non-adherence. eHealth interventions are already widely used in the treatment of patients living with affective disorders. The aim of this systematic literature review is to obtain the current scientific evidence to eHealth as a tool to improve medication adherence in patients with affective disorders. A systematic search was performed across PubMed, Cochrane Library, Web of Science and PsycInfo. Studies in English and German published between 2007 and 2020 were included. The review followed the PRISMA guidelines and were performed with the CADIMA online tool. A total of 17 articles were included in this review. Eleven studies were randomized controlled trials, two were controlled clinical trials, and four had a pre-/post-design. Three different types of interventions could be identified: internet-based self-management programs (n=4), multi-faceted interventions addressing different dimensions of medication adherence (n=4), and single-faceted interventions (n=9) comprising four mobile interventions and five telehealth interventions. Eleven interventions addressed patients with (comorbid) depressions and six addressed patients with bipolar disorders. Six interventions showed a statistically significant positive effect on medication adherence. None of the studies showed a statistically significant negative effect. All interventions which had a statistically significant positive effect on medication adherence involved personal contacts between therapists and patients. All included eHealth interventions are at least as effective as control conditions and seems to be effective for patients with depression as well as with bipolar disorders. Personal contacts seem to improve the effectiveness of eHealth interventions. eHealth interventions are an effective way to improve medication adherence in patients with affective disorders. In rural or underserved regions, eHealth can supplement usual care interventions on medication adherence by expanding access. More analyses are needed in order to understand determinants for the effectiveness of eHealth interventions on medication adherence enhancement.

A systematic review of interventions to improve medication adherence in family medicine patients

“…Similarly, Hacihasanolu et al [14] performed a comprehensive intervention consisting of clinic and home visits, education, and follow-up interviews, which resulted in a substantial improvement in adherence among individuals with hypertension. In a previous systematic review, the authors found that 6 out of 17 studies that used telemedicine showed a significant improvement in the medication adherence and all interventions which had a statistically significant positive effect on medication adherence involved personal contacts between therapists and patients [33]. Moreover, multiple studies have demonstrated that provider-guided therapies are more successful than self-guided ones [34][35][36][37][38][39].…”

Medication “underuse” headache

“…Exploring innovative treatment strategies, such as telemedicine and digital health tracking interventions, might improve patient physiological data to go along with clinical states as well as outcomes. This could facilitate better patient engagement and improved adherence to medication regimens, resulting in better outcomes such as reduced pain hours per month, less disability, lightened burden of migraine over time and improved quality of life of our patients (138).…”