Zaheer Salaha, Garofalo Vanessa, Rodie David, Perivolaris Athina, Chum Jenny, Crawford Allison, Geist Rose, Levinson Andrea, Mitchell Brian, Oslin David, Sunderji Nadiya, Mulsant Benoit H
Geriatric Mental Health Services, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Centre for Addiction and Mental Health, Toronto, ON, Canada.
JMIR Ment Health. 2018 Dec 10;5(4):e10224. doi: 10.2196/10224.
Depression, anxiety, and at-risk drinking are highly prevalent in primary care settings. Many jurisdictions experience geographical barriers to accessing mental health services, necessitating the development and validation of alternative models of care delivery. Existing evidence supports the acceptability and effectiveness of providing mental health care by telephone.
This analysis assesses patient's acceptability of computer-aided telephone support delivered by lay providers to primary care patients with depression, anxiety, or at-risk drinking.
The Primary care Assessment and Research of a Telephone intervention for Neuropsychiatric conditions with Education and Resources study is a randomized controlled trial comparing a computer-aided telephone-based intervention to usual care enhanced by periodic assessments in adult primary care patients referred for the treatment of depression, anxiety, or at-risk drinking; no part of the study involves in-person contact. For this analysis, the following data were obtained: reasons provided for declining consent; reasons provided for withdrawing from the study; study retention rate; and a thematic analysis of a satisfaction survey upon study completion.
During the consent process, 17.1% (114/667) patients referred to the study declined to participate and 57.0% of them (65/114) attributed their refusal to research-related factors (ie, randomization and time commitment); a further 16.7% (19/114) declined owing to the telephone delivery of the intervention. Among the 377 participants who were randomized to the 1-year intervention, the overall retention rate was 82.8% (312/377). Almost no participants who withdrew from the study identified the telephone components of the study as their reason for withdrawal. Analysis of a qualitative satisfaction survey revealed that 97% (38/39) of comments related to the telephone components were positive with key reported positive attributes being accessibility, convenience, and privacy.
Our results suggest that a computer-aided telephone support is highly acceptable to primary care patients with depression, anxiety, or at-risk drinking. In particular, these patients appreciate its accessibility, flexibility, and privacy.
ClinicalTrials.gov NCT02345122; https://clinicaltrials.gov/ct2/show/NCT02345122 (Archived by WebCite at http://www.webcitation.org/73R9Q2cle).
抑郁症、焦虑症和危险饮酒在初级保健机构中极为普遍。许多司法管辖区在获得心理健康服务方面存在地理障碍，因此需要开发和验证替代的护理提供模式。现有证据支持通过电话提供心理健康护理的可接受性和有效性。
本分析评估由非专业提供者提供的计算机辅助电话支持对患有抑郁症、焦虑症或危险饮酒的初级保健患者的可接受性。
“初级保健神经精神疾病电话干预评估与研究及教育与资源”研究是一项随机对照试验，将基于计算机辅助电话的干预与通过定期评估加强的常规护理进行比较，研究对象为被转诊接受抑郁症、焦虑症或危险饮酒治疗的成年初级保健患者；研究不涉及面对面接触。对于本分析，获取了以下数据：拒绝同意的原因；退出研究的原因；研究保留率；以及研究完成后满意度调查的主题分析。
在同意过程中，被转诊参加研究的患者中有17.1%（114/667）拒绝参与，其中57.0%（65/114）将其拒绝归因于与研究相关的因素（即随机分组和时间投入）；另有16.7%（19/114）因干预通过电话提供而拒绝。在随机分配到为期1年干预组的377名参与者中，总体保留率为82.8%（312/377）。几乎没有退出研究的参与者将研究的电话部分作为其退出原因。对定性满意度调查的分析显示，与电话部分相关的评论中有97%（38/39）是积极的，报告的关键积极属性是可及性、便利性和隐私性。
我们的结果表明，计算机辅助电话支持对于患有抑郁症、焦虑症或危险饮酒的初级保健患者是高度可接受的。特别是，这些患者赞赏其可及性、灵活性和隐私性。
ClinicalTrials.gov NCT02345122；https://clinicaltrials.gov/ct2/show/NCT02345122（由WebCite存档于http://www.webcitation.org/73R9Q2cle）。
