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Barriers and difficulties in clinical communication, namely in the context of depression, have been largely documented (Schwenk et al., 2004; Thompson & McCabe, 2012). Several studies report that most physicians and patients don’t have habits of information sharing and that patients often report that they do not always remember what physicians say during consultations (Savard, 2004). This communication fails may affect different dimensions of the patient-physician relationship and may also compromise compliance and adherence to the treatment, reducing therapeutic outcomes. There are several communication barriers between depressed patients and their physicians, being these barriers frequently in the base of difficulties, such as poor adherence to the prescribed regimen and inadequate patient elucidation about the therapeutic plan (Schwenk et al, 2004).
In this context, specific communication strategies can be used to better engage patients, enabling them to monitor symptoms, change their behaviour and contribute to creating a “strong treatment alliance” (Savard, 2004). That can include, for instance, discussions about the duration of treatment, expected improvement, and adverse effects and, most importantly, can prevent the premature discontinuation of treatment. While assuming a more active role in their own care, patients can better learn about their condition and be more open to collect new information and build knowledge from other sources, as printed materials, digital resources, peers/family or health professionals. This openness to health literacy is of major importance when addressing conditions like depression which treatment relies on, most of the time, on the patient's ability to build an informed path to recovery.
Indeed, the use of digital media communication and digital-based health interventions on patient care is increasing, being deeply influenced by a growing number and diversity of eHealth applications and by the pervasive use of social media networks: patients with depression share their stories online, and search for information on the Internet, showing a predisposition to use digital solutions.
The suggestion to use digital resources to help patients with depression has been reported in several studies and more consistently during the last years (Chandrashekar, 2018; Karasouli & Adams, 2014; Mohr, Riper, & Schueller, 2018; Naslund et al., 2017). Personal e-health apps, mobile phones, and other digital resources should, therefore, be considered when observing clinical communication challenges. Mobile phones are powerful tools to enhance interactions between physicians and patients with symptoms of depression. These can benefit from using these devices, which can help them to comply with medication, cope with the disorder, monitor symptoms and side effects and prepare doctor’s visits, complementing traditional strategies (Savard, 2004). Internet-based interventions for depression are considered equally beneficial to regular face-to-face therapy (Wagner, Horn, & Maercker, 2014) and others have shown that digital-based stress-management interventions can be effective and can potentially reduce stress-related mental health problems (Heber et al., 2017). New media strategies and solutions are, most of the time, a path to support patients’ needs and can enhance patients-physicians-in-person communication, namely when used between consultations. They can support the promotion of a cooperative relationship between patients and physicians and of a patient-centered communication style, so important in the treatment of depression. Digital-based tools and applications can, therefore, promote the desired “personal bound” between patients and physicians and a “follow-up communication style” as they easily increase and facilitate the regularity of the contact. This regular contact represents a powerful tool to help patients with depression to see the doctor as a more active element of their alliance (Thompson & McCabe, 2012).