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Published Online: 1 March 2017

Home-Based Outpatient Telepsychiatry to Improve Adherence With Treatment Appointments: A Pilot Study

Matisyahu Shulman, M.D., Majnu John, Ph.D., M.S., and John M. Kane, M.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 68, Number 7
https://doi.org/10.1176/appi.ps.201600244
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Abstract

Objective:

This study examined whether patients who had been nonadherent with outpatient appointments and who were randomly assigned to receive treatment through a telepsychiatry intervention (home-based video teleconferencing) would show improvement in adherence to appointments, compared with a treatment-as-usual group.

Methods:

Participants (N=22) were randomly assigned to home-based video teleconferencing or to outpatient treatment as usual during a six-month study. The primary outcome measure was improvement in visit adherence, which was analyzed using a two-sample t test.

Results:

Percentage improvement in visit adherence did not differ significantly between the telepsychiatry and treatment-as-usual groups (14%, compared with 15%). A greater number of participants in the telepsychiatry group reported less subjective difficulty in keeping appointments.

Conclusions:

A small number of participants, short study period, selection bias, and the Hawthorne effect may have limited measured impact in this study. The findings implied that visit nonadherence among frequently nonadherent individuals is largely unrelated to inconvenience.

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Information & Authors

Information

Published In

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Cover: Roosting Birds, by Milton Avery, 1945. Watercolor. Victoria and Albert Museum, London. © The Milton Avery Trust/Artists Rights Society, New York City.

Psychiatric Services
Volume 68 • Number 7 • July 01, 2017
Pages: 743 - 746
PubMed: 28245700

History

Received: 30 May 2016
Revision received: 16 September 2016
Accepted: 21 October 2016
Published online: 1 March 2017
Published in print: July 01, 2017

Keywords

  1. Service delivery systems
  2. Patient compliance
  3. Computer technology
  4. Telemedicine
  5. Telepsychiatry
  6. Outpatient clinics

Authors

Details

Matisyahu Shulman, M.D.
The authors are with the Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York (e-mail: [email protected]). Dr. Shulman is also with the Division of Substance Use Disorders, Columbia University Medical Center, New York.
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Majnu John, Ph.D., M.S.
The authors are with the Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York (e-mail: [email protected]). Dr. Shulman is also with the Division of Substance Use Disorders, Columbia University Medical Center, New York.
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John M. Kane, M.D.
The authors are with the Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York (e-mail: [email protected]). Dr. Shulman is also with the Division of Substance Use Disorders, Columbia University Medical Center, New York.
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Competing Interests

Dr. Kane has been a consultant for or received honoraria from Alkermes, Eli Lilly, EnVivo Pharmaceuticals (Forum), Forest (Allergan), Genentech, H. Lundbeck, Intra-Cellular Therapies, Janssen Pharmaceutica, Johnson and Johnson, Otsuka, Reviva, Roche, Sunovion, and Teva and is a shareholder in MedAvante, Inc., Vanguard Research Group, and LB Pharmaceuticals, Inc. The other authors report no financial relationships with commercial interests.

Funding Information

National Institute on Drug Abuse10.13039/100000026: T32 DA007294 24
This study was partly supported by National Institute on Drug Abuse grant T32 DA007294.

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