%0 Journal Article
%@ 2368-7959
%I JMIR Publications
%V 10
%N 
%P e44790
%T Psychiatric Treatment Conducted via Telemedicine Versus In-Person Modality in Posttraumatic Stress Disorder, Mood Disorders, and Anxiety Disorders: Systematic Review and Meta-Analysis
%A Shaker,Ali Abbas
%A Austin,Stephen F
%A Storebø,Ole Jakob
%A Schaug,Julie Perrine
%A Ayad,Alaa
%A Sørensen,John Aasted
%A Tarp,Kristine
%A Bechmann,Henrik
%A Simonsen,Erik
%+ Psychiatric Department, Region Zealand Psychiatry, Psychiatric Research Unit, Fælledvej 6, Slagelse, 4200, Denmark, 45 58536070, ashak@regionsjaelland.dk
%K telemedicine
%K telepsychiatry
%K video consultation
%K mobile health
%K mHealth
%K eHealth
%K COVID-19
%K synchronous technology
%K anxiety
%K psychiatry
%K patient satisfaction
%K depression
%K posttraumatic stress disorder
%K PTSD
%D 2023
%7 5.7.2023
%9 Review
%J JMIR Ment Health
%G English
%X Background: Telemedicine has played a vital role in providing psychiatric treatment to patients during the rapid transition of services during the COVID-19 pandemic. Furthermore, the use of telemedicine is expected to expand within the psychiatric field. The efficacy of telemedicine is well described in scientific literature. However, there is a need for a comprehensive quantitative review that analyzes and considers the different clinical outcomes and psychiatric diagnoses. Objective: This paper aimed to assess whether individual psychiatric outpatient treatment for posttraumatic stress disorder, mood disorders, and anxiety disorders in adults using telemedicine is equivalent to in-person treatment. Methods: A systematic search of randomized controlled trials was conducted using recognized databases for this review. Overall, 4 outcomes were assessed: treatment efficacy, levels of patient satisfaction, working alliance, and attrition rate. The inverse-variance method was used to summarize the effect size for each outcome. Results: A total of 7414 records were identified, and 20 trials were included in the systematic review and meta-analysis. The trials included posttraumatic stress disorder (9 trials), depressive disorder (6 trials), a mix of different disorders (4 trials), and general anxiety disorder (1 trial). Overall, the analyses yielded evidence that telemedicine is comparable with in-person treatment regarding treatment efficacy (standardized mean difference −0.01, 95% CI −0.12 to 0.09; P=.84; I2=19%, 17 trials, n=1814), patient satisfaction mean difference (−0.66, 95% CI −1.60 to 0.28; P=.17; I2=44%, 6 trials, n=591), and attrition rates (risk ratio 1.07, 95% CI 0.94-1.21; P=.32; I2=0%, 20 trials, n=2804). The results also indicated that the working alliance between telemedicine and in-person modalities was comparable, but the heterogeneity was substantial to considerable (mean difference 0.95, 95% CI −0.47 to 2.38; P=.19; I2=75%, 6 trials, n=539). Conclusions: This meta-analysis provided new knowledge on individual telemedicine interventions that were considered equivalent to in-person treatment regarding efficacy, patient satisfaction, working alliance, and attrition rates across diagnoses. The certainty of the evidence regarding efficacy was rated as moderate. Furthermore, high-quality randomized controlled trials are needed to strengthen the evidence base for treatment provided via telemedicine in psychiatry, particularly for personality disorders and a range of anxiety disorders where there is a lack of studies. Individual patient data meta-analysis is suggested for future studies to personalize telemedicine. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42021256357; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=256357 
%M 37277113
%R 10.2196/44790
%U https://mental.jmir.org/2023/1/e44790
%U https://doi.org/10.2196/44790
%U http://www.ncbi.nlm.nih.gov/pubmed/37277113