Mobile Phone Ownership and Endorsement of "mHealth" Among People With Psychosis: A Meta-analysis of Cross-sectional Studies

Abstract

There is currently growing interest in using mobile phones to support the treatment of psychotic disorders, such as schizophrenia. However, the widespread implementation of these interventions will ultimately depend upon patients' access to mobile devices and their willingness to engage with mobile health ("mHealth"). Thus, we conducted a systematic review and meta-analysis to assess mobile phone ownership and interest in mHealth among patients with psychosis. An electronic search of Ovid MEDLINE, Embase, PsycINFO, CENTRAL, AMED, Health Technology Assessment Database, and Health Management Information Consortium Database was conducted, using search terms synonymous with mobile phones and psychotic disorders. The initial literature search yielded 2572 results. Fifteen studies matched eligibility criteria, reporting data from 12 independent samples of psychiatric patients (n = 3227). Data pertaining to mobile phone ownership, usage, and opinions on mHealth among patients with psychotic disorders were extracted from these studies, and meta-analytic techniques were applied. The overall mobile phone ownership rate was 66.4% (95% CI = 54.1%-77.6%). However, we found strong statistical evidence that mobile phone ownership has been significantly increasing since 2007, and the rate among patients surveyed in the last 2 years was 81.4% (n = 454). Furthermore, in surveys of mHealth acceptability, the majority of patients responded in favor of using mobile phones to enhance contact with services and support self-management. Considering the increasing availability of mobile phones and the broad acceptability of mHealth among patients, there is now a need to develop and evaluate mHealth interventions to enhance healthcare services for people with psychosis.

Keywords: cell phone; e-health; psychotic disorder; schizophrenia; smartphone; technology.

Fig. 1.

PRISMA Flow diagram of systematic search and study selection.

Fig. 2.

Proportional meta-analysis of mobile phone ownership among patients with psychosis. The forest plot shows the mobile phone ownership rates among eligible samples (see “Methods” section) in each study, including each study’s proportion estimate (Box points) and the 95% CI (horizontal lines). The diamond shows the overall ownership rate estimated from a random-effects model.

Fig. 3.

The increase in mobile phone ownership over time. Blue points show individual studies, and point size represents sample size (square-rooted for scale). Blue line shows the fit of the GLM (see “Methods” section) and blue shading shows the SE. Grey line shows ownership among the general population in the United States.