Improving treatment adherence and longitudinal outcomes in patients with a serious mental illness by using telemedicine.

A psycho-educational programme was developed using the health belief model and the individual s cognitive model of the disorder and treatment. The participants were 51 rural inpatients admitted to a tertiary psychiatric centre. Twenty-four inpatients (13 men, 11 women) were discharged using discharge planning by videoconference involving the general practitioner, case manager and a family member. Patients then received six sessions of the psycho-educational programme. A control group of 27 inpatients (16 men, 11 women) were discharged with conventional discharge summaries to general practitioners and case managers and did not receive the psycho-educational programme. More patients in the control group than in the telemedicine group were readmitted to hospital over a 12-month period. Significantly more patients in the control group reported medication side-effects than those in the telemedicine group. Patients in the telemedicine group reported greater treatment adherence and compliance than those in the control group. When compared with the control group, the telemedicine group reported significantly more satisfaction with their treatment and discharge planning.