A review of evaluation approaches for telemental health programs

Abstract

Purpose Although studies have examined the effectiveness of telemental health programs, optimal approaches for their evaluation remain unclear. We sought to review the outcomes used to evaluate telemental health programs. Methods We conducted a literature search in PubMed and Google Scholar for peer-reviewed studies published between January 2010 until October 2019, and we excluded review articles, opinion papers, presentations, abstracts, and program report without data. Results 1310 articles were identified, 34 of which were reviewed. Studies used a combination of non-clinical and clinical outcomes, most commonly engagement and impact rates, and standardised clinical measures. Very few studies examined technological feasibility, cost-effectiveness, and qualitative satisfaction reports. Conclusions This review is the first to summarise approaches to evaluate telemental health programs. Strengths and weaknesses of the evaluation outcomes are discussed in this review, highlighting essential factors that should be taken into consideration when developing a standardised framework for the evaluation of future telemental health programs. KEY POINTS The methods used to evaluate telemental health programs are varied and no gold-standard for measurement of success exists. Clinical and non-clinical outcomes are being used to evaluate telemental health programs. More emphasis should be placed on feasibility measures such as cost-effectiveness. Therapeutic alliance should be a crucial part of evaluation of any telemental health program. Longer follow up times and larger sample sizes, as well as more diverse populations, are needed to generalise outcomes. Utilisation of clinical tools to assess success should be limited to standardised measures commonly used in clinical practice.