Background: Medication adherence is critical to the effectiveness of psychopharmacologic therapy. Psychiatric disorders present special adherence considerations, notably an altered capacity for decision making and the increased street value of controlled substances. A wide range of interventions designed to improve adherence in mental health and substance use disorders have been studied; recently, many have incorporated information technology (eg, mobile phone apps, electronic pill dispensers, and telehealth). Many intervention components have been studied across different disorders. Furthermore, many interventions incorporate multiple components, making it difficult to evaluate the effect of individual components in isolation. Objective: The aim of this study was to conduct a systematic scoping review to develop a literature-driven, transdiagnostic taxonomic framework of technology-based medication adherence intervention and measurement components used in mental health and substance use disorders. Methods: This review was conducted based on a published protocol (PROSPERO: CRD42018067902) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review guidelines. We searched 7 electronic databases: MEDLINE, EMBASE, PsycINFO, the Cochrane Central Register of Controlled Trials, Web of Science, Engineering Village, and ClinicalTrials.gov from January 2000 to September 2018. Overall, 2 reviewers independently conducted title and abstract screens, full-text screens, and data extraction. We included all studies that evaluate populations or individuals with a mental health or substance use disorder and contain at least 1 technology-delivered component (eg, website, mobile phone app, biosensor, or algorithm) designed to improve medication adherence or the measurement thereof. Given the wide variety of studied interventions, populations, and outcomes, we did not conduct a risk of bias assessment or quantitative meta-analysis. We developed a taxonomic framework for intervention classification and applied it to multicomponent interventions across mental health disorders. Results: The initial search identified 21,749 results; after screening, 127 included studies remained (Cohen kappa: 0.8, 95% CI 0.72-0.87). Major intervention component categories include reminders, support messages, social support engagement, care team contact capabilities, data feedback, psychoeducation, adherence-based psychotherapy, remote care delivery, secure medication storage, and contingency management. Adherence measurement components include self-reports, remote direct visualization, fully automated computer vision algorithms, biosensors, smart pill bottles, ingestible sensors, pill counts, and utilization measures. Intervention modalities include short messaging service, mobile phone apps, websites, and interactive voice response. We provide graphical representations of intervention component categories and an element-wise breakdown of multicomponent interventions. Conclusions: Many technology-based medication adherence and monitoring interventions have been studied across psychiatric disease contexts. Interventions that are useful in one psychiatric disorder may be useful in other disorders, and further research is necessary to elucidate the specific effects of individual intervention components. Our framework is directly developed from the substance use disorder and mental health treatment literature and allows for transdiagnostic comparisons and an organized conceptual mapping of interventions.

Objective: This proof-of-concept study aimed to evaluate if a library-initiated program of bibliotherapy could be effective in reducing overall levels of stress and anxiety in first-year medical students. Methods: This mixed-methods study consisted of an Interrupted Time Series (ITS) where participants established baseline levels of stress and anxiety by completing the 10-item Perceived Stress Scale (PSS-10) three times prior to intervention and three times following, with a bibliotherapy intervention delivered at the halfway point. Four focus groups were held following completion of the ITS with questions designed to solicit feedback related to how enjoyable and valuable participants found the study, as well as priorities for wellness. Results: An independent samples t-test was conducted to compare mean PSS-10 scores in the pre-intervention group to those in the post-intervention group. The results indicate no significant difference between scores pre-intervention (M= 17.85, SD=6.76) and post-intervention (M=17.21, SD=6.87, t(162)=.604, two-sided p=.547, 95% CI [-1.46, 2.75]). Focus group analysis revealed that participants found involvement in the study to be a useful component of a personal wellness or mental health maintenance program. Conclusions: Quantitative results did not achieve statistical significance, but analysis of focus groups indicates that participants derived benefit from involvement in the study, particularly related to the regular self-reflection required by completing the monthly PSS-10. The study is a successful proof-of-concept, indicating that medical students derive benefit from a librarian-led bibliotherapy program as part of student wellness.

In 2007, 7.5% of all persons becoming Lawful Permanent Residents (LPRs) of the United States were born in India or Pakistan. Immigrants from South Asia represent a diversity of cultural, ethnic, religious, and linguistic groups. Roughly one-third of individuals who speak a South Asian language at home also reported speaking English less than “very well.” Individuals seeking South Asian language health information created and/or translated in the United States will find that online resources are limited. Historically and currently, India and Pakistan have been among the top countries of origin of immigrants to Britain and the rest of the United Kingdom. This article is a review of select U.K. Web sites that provide health information in South Asian languages. It includes Web sites created by U.K. governmental agencies as well as registered charities.