gms | German Medical Science

Background and state of research: In response to the extensive implementation of telemental health services during the COVID-19 pandemic, several recent studies examined patient use and satisfaction with the services – including determinants for those outcomes. However, a systematic review of the recent literature is lacking. This may be helpful to identify practical implications and guide future research in this field.

Research question and objectives, hypothesis: The objective of our systematic review was to give an extensive overview of the literature on and highlight influential determinants of patient use and satisfaction with synchronous telemental health services during the pandemic.

Method: The systematic review was registered in PROSPERO and written according to PRISMA guidelines. Peer-reviewed quantitative studies that observed determinants of patient use and satisfaction with synchronous telemental health services during the pandemic were included. PubMed, PsycINFO and Web of Science database searches were made in August 2022 for English- and German-language studies published from 2020 onwards. Key steps were performed by two reviewers. Determinants were synthesized into major categories informed by dimension of the widely used and established Unified Theory of Acceptance and Use of Technology (UTAUT).

Results: Of the 20 included studies, n=10 examined determinants of patient use, n=7 determinants of patient satisfaction and n=3 studies observed both outcomes. The study quality was mainly good or fair. Most of the studies were from North America (n=14). Great heterogeneity concerning study designs, methods and findings existed. Various determinants for patient use and satisfaction were included. While most findings were mixed or non-significant, some indications for potential relationships were found. For instance, female sex, younger age and lower psychological symptom severity showed positive associations with the outcomes.

Discussion: Our systematic review was the first to synthesize studies that observed determinants of patient use and satisfaction with telemental health services during the pandemic. In the recent studies, sociodemographic characteristics were most frequently considered. Nevertheless, health-related determinants (e.g., psychological symptom severity or diagnosis) also received some attention. The UTAUT dimensions were partly neglected in the included studies. Research gaps were highlighted, which call for future quantitative and qualitative studies to secure and expand the recent findings, which could help to eventually improve respective services in the future.

Implication for care: Findings revealed potential target groups (e.g., female and young patients with mild symptoms) for future post-pandemic telemental health interventions. Services should be developed and implemented informed by these groups and their preferences. However, the findings also showed that patients that were especially burdened during pandemic times (such as older patients with severe symptoms) were harder to reach through the services. Efforts are needed to better reach those groups in the future.