title: Home-Based Outpatient Telepsychiatry to Improve Adherence With Treatment Appointments: A Pilot Study.
abstract: OBJECTIVE
  This study examined whether patients who had been nonadherent with outpatient appointments and who were randomly assigned to receive treatment through a telepsychiatry intervention (home-based video teleconferencing) would show improvement in adherence to appointments, compared with a treatment-as-usual group.
  
  
  METHODS
  Participants (N=22) were randomly assigned to home-based video teleconferencing or to outpatient treatment as usual during a six-month study. The primary outcome measure was improvement in visit adherence, which was analyzed using a two-sample t test.
  
  
  RESULTS
  Percentage improvement in visit adherence did not differ significantly between the telepsychiatry and treatment-as-usual groups (14%, compared with 15%). A greater number of participants in the telepsychiatry group reported less subjective difficulty in keeping appointments.
  
  
  CONCLUSIONS
  A small number of participants, short study period, selection bias, and the Hawthorne effect may have limited measured impact in this study. The findings implied that visit nonadherence among frequently nonadherent individuals is largely unrelated to inconvenience.
authors.affiliation: The authors are with the Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York (e-mail: shulmamy@gmail.com ). Dr. Shulman is also with the Division of Substance Use Disorders, Columbia University Medical Center, New York.
authors.forename: Matisyahu
authors.initials: M
authors.lastname: Shulman
authors.affiliation: The authors are with the Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York (e-mail: shulmamy@gmail.com ). Dr. Shulman is also with the Division of Substance Use Disorders, Columbia University Medical Center, New York.
authors.forename: Majnu
authors.initials: M
authors.lastname: John
authors.affiliation: The authors are with the Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York (e-mail: shulmamy@gmail.com ). Dr. Shulman is also with the Division of Substance Use Disorders, Columbia University Medical Center, New York.
authors.forename: John M
authors.initials: JM
authors.lastname: Kane
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services; D008875:Middle Aged; D010349:Patient Compliance; D010865:Pilot Projects; D015983:Selection Bias; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome; D049269:Videoconferencing; D055815:Young Adult
keywords: Computer technology; Outpatient clinics; Patient compliance; Service delivery systems; Telemedicine; Telepsychiatry