A multidisciplinary perspective on digital health interventions in schizophrenia care: Expanding the 2026 Grading of Recommendations, Assessment, Development and Evaluations guidelines.

In this paper, we aim to provide a multidisciplinary and lived-experience-informed perspective on existing evidence for the utilisation of digital health interventions in schizophrenia care. We have integrated the findings from the most recent meta-analysis of digital health interventions for people with schizophrenia, and latest available evidence on the feasibility and efficacy of digital health interventions as a potential adjunct treatment. We found that there is growing evidence from randomised controlled trials on the efficacy of digital health interventions in improving specific aspects of psychotic symptoms, cognition and reducing the risk of relapse. To date, however, there have been no randomised controlled trials evaluating digital health interventions that target physical health comorbidity, although promising co-designed interventions are emerging. Overall, the quantity and quality of evidence regarding the efficacy of digital health interventions for schizophrenia care is rapidly increasing. Given the established acceptability and feasibility of such treatment approaches, along with potential benefits and low adverse risk profile, digital health interventions with established evidence of efficacy should be considered as an adjunctive part of core treatment and overall clinical care, with dedicated attention to ensuring their safety, accessibility and sustainable implementation. Further high-quality randomised controlled trials establishing the efficacy of digital health interventions targeting physical health aspects, and rigorous implementation studies informing optimal and sustainable integration within routine care in mental health services, are required. Integration of lived experience, clinician and lived experience (peer) support input across all stages of the research process, including subsequent implementation in real-life services, is needed to ensure high acceptability of these innovative, adjunctive treatment approaches for people with schizophrenia.