Information and Communication Technology (ICT) includes the use of computers, telephones, television and radio, video and audio recordings. It consists of all technical means used to handle information and communication. During the last twenty years there has been a growing trend towards the use of ICT for the delivery of education, treatment and social support for people with mental illness.
Education about illness and treatment has been found to be a good way to increase a person's awareness of their health. ICT has the potential to improve many aspects of overall care, including: better education and social support; improved information and management of illness; increased access to health services; improved quality of care; better contact and continuity with services and cut costs. Recent studies show that ICT and the web may also support people in their working lives and social relationships plus help cope with depression and anxiety. However, there is a lack of knowledge about the specific effectiveness of ICT for helping people with severe mental health problems such as schizophrenia.
This review includes six studies with a total of 1063 people. Although education and support using ICT shows great promise, there was no clear benefit of using ICT (when compared with standard or usual care and/or other methods of education and support) for people with severe mental illness. However, the authors of the review suggest that this should not put off or postpone future high quality research on ICT, which is a promising and growing area of much importance.
This Plain Language Summary has been written by Benjamin Gray, Service User and Service User Expert, Rethink Mental Illness. Email: ben.gray@rethink.org
Using ICT to deliver psychoeducational interventions has no clear effects compared with standard care, other methods of delivering psychoeducation and support, or both. Researchers used a variety of methods of delivery and outcomes, and studies were few and underpowered. ICT remains a promising method of delivering psychoeducation; the equivocal findings of this review should not postpone high-quality research in this area.
Poor compliance with treatment often means that many people with schizophrenia or other severe mental illness relapse and may need frequent and repeated hospitalisation. Information and communication technology (ICT) is increasingly being used to deliver information, treatment or both for people with severe mental disorders.
To evaluate the effects of psychoeducational interventions using ICT as a means of educating and supporting people with schizophrenia or related psychosis.
We searched the Cochrane Schizophrenia Group Trials Register (2008, 2009 and September 2010), inspected references of identified studies for further trials and contacted authors of trials for additional information.
All clinical randomised controlled trials (RCTs) comparing ICT as a psychoeducational and supportive tool with any other type of psychoeducation and supportive intervention or standard care.
We selected trials and extracted data independently. For homogenous dichotomous data we calculated fixed-effect risk ratios (RR) with 95% confidence intervals (CI). For continuous data, we calculated mean differences (MD). We assessed risk of bias using the criteria described in the Cochrane Handbook for Systematic Reviews of Interventions.
We included six trials with a total of 1063 participants. We found no significant differences in the primary outcomes (patient compliance and global state) between psychoeducational interventions using ICT and standard care.
Technology-mediated psychoeducation improved mental state in the short term (n = 84, 1 RCT, RR 0.75, 95% CI 0.56 to 1.00; n = 30, 1 RCT, MD -0.51, 95% CI -0.90 to -0.12) but not global state (n = 84, 1 RCT, RR 1.07, 95% CI 0.82 to 1.42). Knowledge and insight were not effected (n = 84, 1 RCT, RR 0.89, 95% CI 0.68 to 1.15; n = 84, 1 RCT, RR 0.77, 95% CI 0.58 to 1.03). People allocated to technology-mediated psychoeducation perceived that they received more social support than people allocated to the standard care group (n = 30, 1 RCT, MD 0.42, 95% CI 0.04 to 0.80).
When technology-mediated psychoeducation was used as an adjunct to standard care it did not improve general compliance in the short term (n = 291, 3 RCTs, RR for leaving the study early 0.81, 95% CI 0.55 to 1.19) or in the long term (n = 434, 2 RCTs, RR for leaving the study early 0.70, 95% CI 0.39 to 1.25). However, it did improve compliance with medication in the long term (n = 71, 1 RCT, RR 0.45, 95% CI 0.27 to 0.77). Adding technology-mediated psychoeducation on top of standard care did not clearly improve either general mental state, negative or positive symptoms, global state, level of knowledge or quality of life. However, the results were not consistent regarding level of knowledge and satisfaction with treatment.
When technology-mediated psychoeducation plus standard care was compared with patient education not using technology the only outcome reported was satisfaction with treatment. There were no differences between groups.