Telemedical care improves quality of life in patients with schizophrenia and bipolar disorder. Results of a randomized controlled trial

Abstract Background: Schizophrenia and bipolar disorder are serious psychiatric disorders with a high disease burden, many years lived with disability and a high level of risk of relapses and re-hospitalisations. Besides, both diseases are often accompanied with a reduced quality of life. A low quality of life is one predictor for relapses. This study examines whether a telemedical care programme can improve quality of life. Methods: “Post stationary telemedical care of patients with severe psychiatric disorders” (Tecla) is a prospective controlled randomised intervention trial to implement and evaluate a telemedical care concept for patients with schizophrenia and bipolar disorder. Participants were randomised in an intervention or a control group. The intervention group received telemedical care including regular, individualised telephone calls and SMS messages. The quality of life was measured with the German version of WHOQOL-BREF. Effects of telemedicine on quality of life after 6 months were analysed using t-tests to compare the intervention with the control group. Participants also evaluated the telemedical care program based on a short standardised interview.Results: 118 participants were recruited, thereof 57.6% men (n = 68). Participants were 43 years old on average (SD) 13)). The IG showed higher QoL scores than the control group (CG) 6 months after the baseline for the WHOQOL total sum score (t-test (CI) 93.1 (92.4-93.8) vs 89.7 (88.8-90.6), p < 0.0001) and for 4 of 5 domains: global 62.0 (60.9-63.0) vs. 56.8 (55.6-58.1), p < 0.0001; physical health 63.8 (63.0-64.7) vs. 59.6 (58.5-60.6), p < 0.0001; psychological 60.9 (60.0-61.9) vs. 56.4 (55.1-57.6), p < 0.0001; environment 70.8 (70.1-71.6) vs. 67.5 (66.7-68.3), p < 0.0001).Conclusion: The Tecla telemedical care concept has led to improvements in quality of life for patients with severe psychiatric disorders. It provides a low-threshold and suitable component of psychiatric treatment. Trial registration: German Clinical Trials Register, DRKS00008548, registered 21 May 2015 – retrospectively registered, https://www.drks.de/drks_web/setLocale_EN.do