Mobile Phone Ownership and Endorsement of “mHealth” Among People With Psychosis: A Meta-analysis of Cross-sectional Studies

Abstract

There is currently growing interest in using mobile phones to support the treatment of psychotic disorders, such as schizophrenia. However, the widespread implementation of these interventions will ultimately depend upon patients' access to mobile devices and their willingness to engage with mobile health ("mHealth"). Thus, we conducted a systematic review and meta-analysis to assess mobile phone ownership and interest in mHealth among patients with psychosis. An electronic search of Ovid MEDLINE, Embase, PsycINFO, CENTRAL, AMED, Health Technology Assessment Database, and Health Management Information Consortium Database was conducted, using search terms synonymous with mobile phones and psychotic disorders. The initial literature search yielded 2572 results. Fifteen studies matched eligibility criteria, reporting data from 12 independent samples of psychiatric patients (n = 3227). Data pertaining to mobile phone ownership, usage, and opinions on mHealth among patients with psychotic disorders were extracted from these studies, and meta-analytic techniques were applied. The overall mobile phone ownership rate was 66.4% (95% CI = 54.1%-77.6%). However, we found strong statistical evidence that mobile phone ownership has been significantly increasing since 2007, and the rate among patients surveyed in the last 2 years was 81.4% (n = 454). Furthermore, in surveys of mHealth acceptability, the majority of patients responded in favor of using mobile phones to enhance contact with services and support self-management. Considering the increasing availability of mobile phones and the broad acceptability of mHealth among patients, there is now a need to develop and evaluate mHealth interventions to enhance healthcare services for people with psychosis.

Differences in the Use and Opinions About New eHealth Technologies Among Patients With Psychosis: Structured Questionnaire (Preprint)

“…These results contradict the lower rates obtained by the NAMI study in 2014 [7], and they are more similar to the results of recent studies [9,11,18], which found that the access and use of technology in patients diagnosed with psychotic disorders are equivalent to those in the general population. The differences between the two comparison groups in our study suggested that the access and use are not equivalent between FEP and CP patients.…”

“…Based on these studies, we elaborated the survey, which is divided into five parts: the items for the first part, which aims to assess clinical and demographic information and the items for the second part, which measures the access and use of the internet, mobile and social media, were taken from the Spanish National Statistic Institute (INE) survey and from Trefflich et al [10] and Robotham et al [16] studies. Items for the third part of the questionnaire, which assesses the use of the internet in relation to mental health, and the items for the fourth part, which measures experiences with technology and the effect of internet usage on patient's health, were based on a survey of the National Alliance on Mental Illness (NAMI) [7] and the studies of Firth et al [9] and Gay et al [11]. The last part of the survey, which rates the interest of the patients in using an e-Health app and their interest in different tracking and reminder services, was an originally developed section.…”

“…In 2014, the National Alliance on Mental Illness (NAMI) [7] showed that 54% of American patients with schizophrenia owned a smartphone compared to the 64% in the general American population [8]. However, recent studies have shown that these rates have changed and that the access of these patients to technology is similar to the general population at the moment [9].…”

“…Finally, there are several studies that have confirmed the interest of psychotic patients in using the emerging e-Health systems to help them to cope with their illness [4,9,11,12]. However, there is a lack of studies that have assessed this interest in relation to the evolution of the disease (FEP compared to CP).…”

“…There are a few studies that have found some controversial results when studying this interest between different age surveys. Some of these studies have suggested that younger patients would be more willing to endorse e-Health treatments [9,11], while others have suggested the opposite result [13,14]. Consequently, it is necessary to study the variations in the interest in these services in relation to the evolution of the illness.…”