精神科临床试验中的初级保健患者：一项使用视频会议的试点研究。
Primary care patients in psychiatric clinical trials: a pilot study using videoconferencing.
作者信息
Williams Janet B W, Ellis Amy, Middleton Arthur, Kobak Kenneth A
机构信息
MedAvante, Inc,, MedAvante Research Institute, Hamilton, NJ, USA.
出版信息
Ann Gen Psychiatry. 2007 Oct 4;6:24. doi: 10.1186/1744-859X-6-24.
BACKGROUND
While primary care physicians play a pivotal role in the treatment of depression, collaboration between primary care and psychiatry in clinical research has been limited. Primary care settings provide unique opportunities to improve the methodology of psychiatric clinical trials, by providing more generalizable and less treatment-resistant patients. We examined the feasibility of identifying, recruiting, screening and assessing primary care patients for psychiatric clinical trials using high-quality videoconferencing in a mock clinical trial.
METHODS
1329 patients at two primary care clinics completed a self-report questionnaire. Those screening positive for major depression, panic, or generalized anxiety were given a diagnostic interview via videoconference. Those eligible were provided treatment as usual by their primary care physician, and had 6 weekly assessments by the off-site clinician via videoconferencing.
RESULTS
45 patients were enrolled over 22 weeks, with 36 (80%) completing the six-week study with no more than two missed appointments. All diagnostic groups improved significantly; 94% reported they would participate again, 87% would recommend participation to others, 96% felt comfortable communicating via videoconference, and 94% were able to satisfactorily communicate their feelings via video.
CONCLUSION
Results showed that primary care patients will enroll, participate in and complete psychiatric research protocols using remote interviews conducted via videoconference.
背景
虽然初级保健医生在抑郁症治疗中发挥着关键作用，但初级保健与精神病学在临床研究中的合作一直有限。初级保健机构提供了独特的机会来改进精神科临床试验的方法，因为其能提供更具普遍性且治疗抵抗性较低的患者。我们在一项模拟临床试验中，研究了使用高质量视频会议识别、招募、筛选和评估初级保健患者参与精神科临床试验的可行性。
方法
两家初级保健诊所的1329名患者完成了一份自我报告问卷。对筛查出重度抑郁、惊恐或广泛性焦虑呈阳性的患者通过视频会议进行诊断访谈。符合条件的患者由其初级保健医生照常提供治疗，且由场外临床医生通过视频会议进行6次每周一次的评估。
结果
在22周内招募了45名患者，其中36名（80%）完成了为期六周的研究，错过预约不超过两次。所有诊断组均有显著改善；94%的患者表示愿意再次参与，87%的患者会向他人推荐参与，96%的患者对通过视频会议交流感到舒适，94%的患者能够通过视频令人满意地表达自己的感受。
结论
结果表明，初级保健患者愿意参加、参与并完成通过视频会议进行的远程访谈的精神科研究方案。
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