Hybrid mHealth care: Patient perspectives of blended treatments for psychosis. A systematic review.

Background: mHealth interventions use mobile and wireless technologies to deliver aspects of healthcare, and have been extensively employed in mental health research, showcasing their potential to address the significant treatment gap. While numerous studies underscore the advantages and functionalities of mHealth, challenges persist regarding patient uptake and sustained engagement among individuals with psychosis spectrum disorder. This review aims to explore individual-level barriers and facilitators to engagement with hybrid digital systems, which involves the integration of digital tools alongside in-person care.

Method: Four electronic databases (Medline, Web of Science, CINAHL, and PsychINFO) were systematically searched to identify hybrid digital interventions for psychosis spectrum disorders. Studies that only reported the efficacy of the interventions were excluded. 16 studies were included in the final review.

Results: Six themes were identified in this review, including mHealth as a tool to aid communication, the central role of the therapist, an increased sense of support through the provision of digital support, allowing greater insight into auditory hallucinations, enabling technologies and barriers to engagement.

Conclusions: This review demonstrated the factors impacting engagement in hybrid interventions for psychosis spectrum disorder. By identifying barriers and facilitators, the findings could offer valuable guidance for the design of innovative digital interventions. These findings also underscore the importance of prioritising trustworthiness in digital systems. Future research should focus on establishing and implementing trustworthy digital systems to enhance engagement and effectively integrate mobile health into conventional healthcare practices.