Abstract
BACKGROUND: Telemedicine has emerged as a promising tool to enhance adherence and monitoring in patients with eating disorders (EDs). Traditional face-to-face cognitive therapies remain the gold standard; however, integrating telemedicine may provide additional support and improve patient engagement and retention. Given the increasing use of digital health interventions, it is crucial to assess their safety and effectiveness in complementing conventional treatments. OBJECTIVE: We aimed to evaluate the safety and effectiveness of telemedicine as a complementary tool for cognitive face-to-face therapies to promote adherence and monitoring of patients with EDs. METHODS: We consulted the National Institute for Health and Care Excellence, the Canadian Agency for Drugs and Technologies in Health (now known as Canada's Drug Agency), MEDLINE (Ovid), Embase, Web of Science, Cochrane Library, international HTA database (International Network of Agencies for Health Technology Assessment), CINAHL (EBSCO), and PsycINFO (EBSCO) websites and databases in December 2024 to identify eligible systematic reviews, synthesis reports, or meta-analyses that address telemedicine as a complementary therapy to face-to-face care in patients with EDs. Two researchers performed an independent critical reading of the systematic reviews and assessed the risk of bias using AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews, version 2). RESULTS: We initially identified 1004 studies, but only 5 (0.5%) systematic reviews met the inclusion criteria. Email, vodcasts, smartphone apps, and SMS text messaging were the principal telemedicine channels. Telemedicine interventions were safe, helpful, and motivating; improved retention rates and patient-physician communication; and reduced ED symptoms. CONCLUSIONS: Telemedicine interventions showed promising, positive findings as a complementary tool for face-to-face ED treatment that must be interpreted cautiously. The limited number of systematic reviews selected and their moderate to critically low quality underscore the need for further research in this area.