School of Medicine and Public Health, University of Newcastle,Newcastle,Australia.
Division of Psychology and Mental Health,School of Health Sciences, Faculty of Biology, Medicine and Health,University of Manchester, Manchester Academic Health Science Centre; Greater Manchester Mental Health NHS Foundation Trust,Manchester,UK.
Psychol Med. 2018 Dec;48(16):2637-2657. doi: 10.1017/S0033291718001125. Epub 2018 May 25.
The mental and physical health of individuals with a psychotic illness are typically poor. Access to psychosocial interventions is important but currently limited. Telephone-delivered interventions may assist. In the current systematic review, we aim to summarise and critically analyse evidence for telephone-delivered psychosocial interventions targeting key health priorities in adults with a psychotic disorder, including (i) relapse, (ii) adherence to psychiatric medication and/or (iii) modifiable cardiovascular disease risk behaviours.
Ten peer-reviewed and four grey literature databases were searched for English-language studies examining psychosocial telephone-delivered interventions targeting relapse, medication adherence and/or health behaviours in adults with a psychotic disorder. Study heterogeneity precluded meta-analyses.
Twenty trials [13 randomised controlled trials (RCTs)] were included, involving 2473 participants (relapse prevention = 867; medication adherence = 1273; and health behaviour = 333). Five of eight RCTs targeting relapse prevention and one of three targeting medication adherence reported at least 50% of outcomes in favour of the telephone-delivered intervention. The two health-behaviour RCTs found comparable levels of improvement across treatment conditions.
Although most interventions combined telephone and face-to-face delivery, there was evidence to support the benefit of entirely telephone-delivered interventions. Telephone interventions represent a potentially feasible and effective option for improving key health priorities among people with psychotic disorders. Further methodologically rigorous evaluations are warranted.
患有精神病的个体的身心健康状况通常较差。获得心理社会干预措施很重要，但目前受到限制。电话干预可能会有所帮助。在本次系统评价中，我们旨在总结和批判性分析针对精神障碍成年患者的关键健康重点（包括 i）复发、ii）精神药物依从性和/或 iii）可改变的心血管疾病风险行为）的电话心理社会干预措施的证据。
在十篇同行评议和四篇灰色文献数据库中，检索了针对精神障碍成年患者的复发、药物依从性和/或健康行为的电话心理社会干预措施的英语研究。研究的异质性排除了荟萃分析。
共纳入 20 项试验[13 项随机对照试验（RCTs）]，涉及 2473 名参与者（预防复发=867；药物依从性=1273；健康行为=333）。针对预防复发的 8 项 RCT 中的 5 项和针对药物依从性的 3 项 RCT 中的 1 项报告了至少 50%的结果有利于电话干预。两项健康行为 RCT 发现治疗条件下的改善水平相当。
尽管大多数干预措施结合了电话和面对面的交付方式，但有证据支持完全通过电话交付的干预措施的益处。电话干预代表了改善精神障碍患者关键健康重点的一种潜在可行和有效的选择。需要进一步进行方法严格的评估。
