Table 4.
Effectiveness of teleconsultations in patients with mental health conditions
| Outcome measures | N patients | TM, mean (SD or 95% CI) | F2F, mean (SD or 95% CI) | Treatment difference; TM vs. F2F, mean (95% CI) | Follow upa | Study ID |
|---|---|---|---|---|---|---|
| Videoconsultation vs. F2F | ||||||
| HAMD, mean (SD) | TM = 43, F2F = 42 | 13.92 (1.18) | 14.44 (1.19) | t = −0.31, P = 0.755 | 12 weeks (~3 months) | Choi 2014 (41) |
| 13.37 (1.18) | 14.80 (1.12) | t = −0.90, P = 0.369 | 24 weeks (~6 months) | |||
| TM = 56, F2F = 63 | 13.68 (1.00) | 14.08 (0.94) | t = –0.06, P = 0.772 | 12 weeks (3 months) | Choi 2014b (42) | |
| 12.38 (0.85) | 14.12 (0.80) | t = –1.49, P = 0.809 | 24 weeks (6 months) | |||
| 11.08 (1.07) | 14.16 (0.99) | t = –2.11, P = 0.035 | 36 weeks (9 months) | |||
| BDI response, n (%), [95% CI] | TM = 120, F2F = 121 | 27 (22·54%), [15.40, 29.69] | 26 (21·49%), [14.72, 28.25] | 1·05% (–8·30, 10·41) | 12 months | Egede 2015 (28) |
| GDS response, n (%), [95% CI] | 25 (20·96%), [14.45, 27.47] | 23 (19·30%), [13.29, 25.31] | 1·66% (–7·20, 10·52) | 12 months | ||
| BHS, mean (SD) | TM = 45, F2F = 42 | 4.89 (4.64) | 4.43 (4.94) | 0.40 (0.12, 0.68)b,d | 8 weeks (~2 months) | Luxton 2016 (30) |
| TM = 42, F2F = 36 | 5.21 (5.10) | 5.53 (5.97) | 0.28 (–0.01, 0.58) b,d | 3 months | ||
| BDI-II, mean (SD) | TM = 45, F2F = 42 | 13.82 (12.02) | 11.74 (12.08) | 0.36 (0.06, 0.66) b,d | 8 weeks (~2 months) | |
| TM = 42, F2F = 36 | 14.76 (12.89) | 15.00 (12.61) | 0.16 (–0.16, 0.48) b,d | 3 months | ||
| BDI-II | TM = 131, F2F = 134 | NR | NR | 0.89 (NI)c,d | Post-treatment (~8–9 weeks) | Acierno 2016 (31) |
| 1.18 (NI) c,d | 3 months | |||||
| –0.29 (NI) c,d | 6 months | |||||
| BDI-II | TM = 64, F2F = 68 | NR | NR | –2.4 (–6.3, 1.5) | Post-treatment (~12 weeks) | Acierno 2017 (32) |
| –2.0 (–5.7, 1.6) | 3 months | |||||
| –0.3 (–4.1, 3.6) | 6 months | |||||
| BDI-II, mean (SE) | TM = 45, F2F = 45 | 19.26 (2.6) | 20.99 (2.7) | NRe | Post-treatment (~10 weeks) | Maieritsch 2016 (33) |
| 17.08 (2.2) | 17.29 (2.3) | NRe | 12 weeks | |||
| DASS depression, mean (SD) | TM = 39, F2F = 42 | 14.28 (3.9) | 7.5 (2.3) | < 0.001 | Post-treatment (16 weeks) | Chavooshi 2017 (34) |
| 13.31 (4.5) | 6.5 (3.5) | < 0.001 | 12 months | |||
| WHODAS, mean (SD)’ | TM = 56, F2F = 63 | 29.72 (1.25) | 30.13 (1.19) | t = 0.24, P = 0.809 | 12 weeks (3 months) | Choi 2014b (42) |
| 29.38 (1.12) | 30.60 (1.05) | t = –0.80, P = 0.426 | 24 weeks (6 months) | |||
| 29.04 (1.32) | 31.07 (1.24) | t = –1.12, P = 0.261 | 36 weeks (9 months) | |||
| PCL-M | TM = 131, F2F = 134 | NR | NR | –0.11 (NI) c,d | Post-treatment (~8–9 weeks) | Acierno 2016 (31) |
| –1.84 (NI) c,d | 3 months | |||||
| –0.66 (NI) c,d | 6 months | |||||
| PCL-M | TM = 64, F2F = 68 | NR | NR | −3.2 (−8.6, 2.1) | Post-treatment (~12 weeks) | Acierno 2017 (32) |
| −2.8 (−7.6 to 2.0) | 3 months | |||||
| 0.03 (−4.9 to 5.0) | 6 months | |||||
| PCL, mean (SE) | TM = 45, F2F = 45 | 48.07 (2.3) | 45.13 (2.5) | NRe | Post-treatment (~10 weeks) | Maieritsch 2016 (33) |
| 46.17 (2.2) | 45.94 (2.3) | NRe | 12 weeks | |||
| NPRS, mean (SD) | TM = 39, F2F = 42 | 6.15 (2.25) | 4.22 (1.65) | P < 0.001 | Post-treatment (16 weeks) | Chavooshi 2017 (34) |
| 6.36 (1.78) | 4.17 (1.14) | P < 0.001 | 12 m | |||
| DASS anxiety, mean (SD) | TM = 39, F2F = 42 | 15.9 (3.8) | 6.8 (3.4) | < 0.001 | Post-treatment (16 weeks) | |
| 15.3 (5.1) | 6.5 (5.3) | < 0.001 | 12 months | |||
| HbA1C, mean | TM = 43, F2F = 47 | 6.875 | 7.698 | –0.82 (–1.41, –0.24) | 12 months | Egede 2018 (45) |
| Telephone consultation vs. F2F | ||||||
| HAMD, mean (SD) | TM = 40, F2F = 18 | 13.3 (5.6) | 12.7 (7.2) | 0.60 (–3.15, 4.35) | 8 weeks (2 months) | Fann 2015 (43) |
| 11.5 (6.2) | 11.9 (6.1) | –0.40 (–3.81, 3.01) | 16 weeks (4 months) | |||
| 10.4 (6.4) | 12.1 (7.8) | –1.70 (–5.81, 2.41) | 24 weeks (6 months) | |||
| TM = 45 F2F = 47 | 12.8 (9.2) | 11.8 (7.2) | P = 0.93 | Post-treatment (18 weeks) | Kalapatapu 2014 (39) | |
| TM = 44 F2F = 47 | 13.4 (8.3) | 10.4 (6.0) | P = 0.12 | 3 months follow-up | ||
| TM = 42 F2F = 46 | 13.5 (8.7) | 10.4 (6.0) | P = 0.15 | 6 months | ||
| TM = 152 F2F = 141 | 13.58 (12.42 to 14.74)b | 12.51 (11.22 to 13.81) b | 1.07 (−0.63, 2.76), P = 0.22 | Post-treatment (18 weeks) | Mohr 2012 (38) | |
| TM = 146 F2F = 136 | 14.58 (13.45 to 15.71) b | 12.33 (11.01 to 13.64) b | 2.25 (0.52, 3.99), P = 0.01 | 3 months | ||
| TM = 134 F2F = 136 | 15.06 (13.84 to 16.27) b | 12.14 (10.84 to 13.45) b | 2.91 (1.20, 4.63) P < 0.001 | 6 months | ||
| HADS-depression, change from baseline (SD) | TM = 43 F2F = 35 | 1.86 (3.29) | 2.31 (4.40) | –0.45 (–2.19, 1.28) | 8 weeks (2 months) | Watson 2016 (36) |
| HADS-anxiety, change from baseline (SD) | TM = 43 F2F = 35 | 2.02 (3.54) | 2.11 (4.54) | –0.09 (–1.91, 1.73) | 8 weeks (2 months) | |
| PSWQ, mean change from baseline | TM = 87, F2F = 84 | –7.83 (11.45) | –6.73 (12.23) | P = 0.046 | 4 months | Alcantara 2016 (37) |
BDI, Beck depression inventory, BHS, Beck Hopelessness scale, DASS, Depression anxiety stress scale, GDS, Geriatric depression scale, HADS, Hospital anxiety and depression scale, HAMD, Hamilton rating scale for depression, NI, non-inferior, NPRS, Numeric pain rating scale, NR, not reported, PCL-M, Post-traumatic stress disorder checklist-military, PSWQ, Penn State Worry Questionnaire, WHODAS, World health organisation disability assessment schedule
aMean values with were measured at the specified follow-up times reported in the table
bStandardised difference using the baseline standard deviation; 90% Confidence interval used to evaluate non-inferiority
cCI not reported in the text, assessed as non-inferior (lower bound of CI < –8.8 for PCL-M and < –5.0 for BDI)
d90% Confidence interval used to evaluate non-inferiority
eTreatment difference not calculated in the study due to high levels of attrition