Telemedicine in Depression Care by Physicians: Scoping Review

par Jean-François Echelard

Background: Depression is a common disorder and is burdensome regarding mental and physical health as well as societal costs. Although traditional in-person consultations are the usual way of caring for depressed patients, telemedicine may be well-suited to psychiatric assessment and management. Telepsychiatry can be defined as the use of information and communication technologies such as videoconferencing and telephoning for the care of psychopathologies. 

Objective: This review aims to evaluate the extent and nature of the existing literature on telemedicine for the care of depression by physicians. This review also aims to examine the effects and perceptions regarding this virtual care, and how it compares to traditional in-person care. 

Methods: Identification of relevant articles was done through a search on three databases. Eligibility criteria were applied to select studies about the use of telemedicine for the care of depressed patients by physicians specifically. A data extraction grid was used to chart data from all included articles. 

Results: The search resulted in 28 articles and all 13 non-review studies were analyzed in detail. Most non-review studies were conducted in the USA, during the last decade, mostly with telemedicine programs lead by psychiatrists instead of general practioners, and mostly included a randomization process. The average study population size was 135. Only a small majority of included articles had a clear and explicit declared absence of conflicts of interest. Non-review papers articles contained measured outcomes related to depression variables, perceptions and other variables. All applicable studies resulted in improvement in depression with the use of telepsychiatry, and it was at least equivalent to in-person care. Telepsychiatry again performed at least as well as in-person care according to almost every metric studied for patient satisfaction and other perceptions. Quality of life, functioning and similar variables were significantly improved with virtual care. In regard to cost-effectiveness, telepsychiatry performed better than in-person care. Furthermore, some studied telemedicine programs were designed with cultural sensitivity or based on collaborative care. 

Conclusions: More research is recommended regarding various outcomes from the use of telemedicine in relation to the wide-ranging burden of this disease, including depression variables, perceptions, health care outcomes and other outcomes. Studies should be conducted in various clinical contexts including primary care and developing countries. Although in-person consultations are the traditional approach to depression care, telepsychiatry is a promising modality of care for patients suffering from this burdensome disease.

*Puisque cette recherche a été faite en anglais, ce résumé est en anglais . Les textes du Pouls sont habituellement en français.