1 Research and Development, University College Capital, Denmark.
2 Physiotherapy Programme, University College Capital, Denmark.
J Telemed Telecare. 2018 Jan;24(1):31-36. doi: 10.1177/1357633X16670285. Epub 2016 Sep 22.
Introduction Telepsychiatric modalities are used widely in the treatment of many mental illnesses. It has also been proposed that telepsychiatric modalities could be a way to reduce readmissions. The purpose of the study was to conduct a systematic review of the literature on the effects of telepsychiatric modalities on readmissions in psychiatric settings. Methods We conducted a systematic literature search in MEDLINE, CINAHL, Embase, Cochrane, PsycINFO and Joanna Briggs databases in October 2015. Inclusion criteria were (a) patients with a psychiatric diagnosis, (b) telepsychiatric interventions and (c) an outcome related to readmission. Results The database search identified 218 potential studies, of which eight were eligible for the review. Studies were of varying quality and there was a tendency towards low-quality studies (five studies) which found positive outcomes regarding readmission, whereas the more methodological sound studies (three studies) found no effect of telepsychiatric modalities on readmission rates. Discussion Previous studies have proven the effectiveness of telepsychiatric modalities in the treatment of various mental illnesses. However, in the present systematic review we were unable to find an effect of telepsychiatric modalities on the rate of readmission. Some studies found a reduced rate of readmissions, but the poor methodological quality make the findings questionable. At the present time there is no evidence to support the use of telepsychiatry due to heterogeneous interventions, heterogeneous patient groups and lack of high-quality studies.
介绍 远程精神病学模式在许多精神疾病的治疗中得到了广泛应用。也有人提出,远程精神病学模式可能是减少再入院的一种方法。本研究的目的是对远程精神病学模式对精神科环境中再入院影响的文献进行系统评价。
方法 我们于 2015 年 10 月在 MEDLINE、CINAHL、Embase、Cochrane、PsycINFO 和 Joanna Briggs 数据库中进行了系统的文献检索。纳入标准为:(a)有精神科诊断的患者,(b)远程精神病学干预,(c)与再入院相关的结果。
结果 数据库搜索确定了 218 项潜在研究,其中 8 项符合审查标准。这些研究的质量参差不齐,有 5 项研究质量较低,发现远程精神病学模式对再入院率有积极影响,而 3 项研究质量较高,发现远程精神病学模式对再入院率没有影响。
讨论 先前的研究已经证明了远程精神病学模式在治疗各种精神疾病方面的有效性。然而,在本次系统评价中,我们未能发现远程精神病学模式对再入院率有影响。一些研究发现再入院率降低,但研究方法质量差,使得研究结果值得怀疑。目前,由于干预措施不同、患者群体不同以及缺乏高质量的研究,没有证据支持使用远程精神病学。