Naik Shalini S, Manjunatha Narayana, Kumar Channaveerachari Naveen, Math Suresh Bada, Moirangthem Sydney
Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
Tele Medicine Centre, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
Indian J Psychol Med. 2020 Nov 1;42(5 Suppl):102S-107S. doi: 10.1177/0253717620963341. eCollection 2020 Oct.
Access to mental health care has significant disparities due to treatment gap, more so particularly for the remotely residing, physically vulnerable, aging populations. Adoption of technology will enable more people to receive specialty care addressing distance, transportation and cost-related barriers to treatment engagement from the comfort of home. Telemedicine has been regarded as "electronic personal protective equipment" by reducing the number of physical contacts and risk contamination for patients during COVID-19 crisis. This review aimed to give a broad view of patients' perception of the use of telepsychiatry in terms of clinical outcome, cost-effectiveness, and solutions to address patients' challenges with the adoption of technology. Over the years, telepsychiatry, both in synchronous and asynchronous modalities, had shown to improve patients' adherence to treatment, follow-up rates, and clinical symptoms, overcome stigma and discrimination, and save cost expenses accessing health care with better satisfaction and usability outcomes. Its utility is widespread such as in delivering care emergency evaluation, crisis intervention, conducting neuropsychological assessments, psychotherapy, promoting lifestyle modification, enhancing self-efficacy, and overcoming patients' linguistic and cultural barriers to care. However, patients' privacy and confidentiality and psychiatrists' legal liability remain as matter of major concern in digital platform. To keep up with the pace of technology and patients' expectations, a more agile approach is essential to develop, improve, and evaluate telepsychiatric interventions.
由于治疗差距,获得心理健康护理存在显著差异,对于居住在偏远地区、身体脆弱的老年人群体而言更是如此。采用技术将使更多人能够在家中舒适地接受专科护理,解决距离、交通和与治疗参与相关的成本障碍。在新冠疫情危机期间,远程医疗通过减少患者的身体接触次数和感染风险,被视为“电子个人防护设备”。本综述旨在从临床结果、成本效益以及解决患者在采用技术方面面临的挑战的解决方案等方面,全面了解患者对远程精神病学使用的看法。多年来,同步和异步模式的远程精神病学都显示出能提高患者的治疗依从性、随访率和临床症状,克服耻辱感和歧视,并节省获得医疗保健的成本费用,同时获得更好的满意度和可用性结果。其效用广泛,例如在提供护理紧急评估、危机干预、进行神经心理评估、心理治疗、促进生活方式改变、增强自我效能以及克服患者在护理方面的语言和文化障碍等方面。然而,患者的隐私和保密性以及精神科医生的法律责任仍然是数字平台上的主要关注点。为了跟上技术发展的步伐和患者的期望,采用更灵活的方法对于开发、改进和评估远程精神病学干预措施至关重要。