Determinants of Patient Use and Satisfaction With Synchronous Telemental Health Services During the COVID-19 Pandemic: Systematic Review

Abstract

Background Several recent studies examined patient use and satisfaction with synchronous telemental health services in response to the widespread implementation during the COVID-19 pandemic. However, a systematic review of recent literature on the determinants of these outcomes is missing. Objective The aim of this systematic review was to give an extensive overview of the literature on and highlight the influential determinants of patient use and satisfaction with synchronous telemental health services during the COVID-19 pandemic. Methods This review satisfied the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and was registered in PROSPERO. Peer-reviewed, quantitative studies that observed the determinants of patient use or satisfaction with synchronous telemental health services during the COVID-19 pandemic were included. PubMed, PsycInfo, and Web of Science database searches were conducted in August 2022 for English and German language studies published from 2020 onward. Key steps were performed by 2 reviewers. Determinants were synthesized into major categories informed by the dimensions of the widely used and established Unified Theory of Acceptance and Use of Technology. Results Of the 20 included studies, 10 studies examined determinants of patient use, 7 examined determinants of patient satisfaction, and 3 observed both outcomes. The quality of the studies was mainly good or fair. There was substantial heterogeneity in the study designs, methods, and findings. Sociodemographic characteristics and health-related determinants were mostly considered. Some of the major dimensions of the Unified Theory of Acceptance and Use of Technology were neglected in recent studies. Although most findings were mixed or nonsignificant, some indications for potential relationships were found (eg, for sex, age, and symptom severity). Conclusions The findings revealed potential target groups (eg, female and young patients with mild symptoms) for future postpandemic telemental health interventions. However, they also identified patient groups that were harder to reach (eg, older patients with severe symptoms); efforts may be beneficial to address such groups. Future quantitative and qualitative research is needed to secure and expand on recent findings, which could help improve services. Trial Registration PROSPERO CRD42022351576; https://tinyurl.com/yr6zrva5

Impacts of Telehealth Adoption on the Quality of Care for Individuals With Serious Mental Illness: Retrospective Observational Analysis of Veterans Affairs Administrative Data

“…Telehealth accelerated during the COVID-19 pandemic and is likely to persist. Although telehealth is accepted by most psychiatric patients, individuals with primary or co-occurring serious mental illness (SMI; ie, psychotic spectrum disorders and bipolar disorders) show lower engagement [ 1 2 ] and are less likely to use video-based services [ 3 , 4 ] than other diagnostic groups. A systematic review found that individuals with (vs without) SMI use telehealth at lower rates, despite much higher in-person mental health care (MH) use among individuals with SMI [ 2 ].…”

“…Although telehealth is accepted by most psychiatric patients, individuals with primary or co-occurring serious mental illness (SMI; ie, psychotic spectrum disorders and bipolar disorders) show lower engagement [ 1 2 ] and are less likely to use video-based services [ 3 , 4 ] than other diagnostic groups. A systematic review found that individuals with (vs without) SMI use telehealth at lower rates, despite much higher in-person mental health care (MH) use among individuals with SMI [ 2 ]. A study of patients with SMI who use telehealth during the pandemic found that, although many patients with SMI maintained engagement, individuals with schizophrenia were the least likely to engage in telehealth [ 3 ].…”