Frank Hannah E, Grumbach Nicholas M, Conrad Selby M, Wheeler Julia, Wolff Jennifer
Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University.
Bradley Hospital, Lifespan Health System.
J Affect Disord Rep. 2021 Jul;5:100146. doi: 10.1016/j.jadr.2021.100146. Epub 2021 Apr 14.
This study examined the transition to telehealth services during the COVID-19 pandemic in terms of attendance rates, the provision of evidence-based interventions, and clinical outcomes.
The feasibility of in-person versus telehealth visits for integrated primary care sessions was compared using chart review data. Data on patient characteristics, attendance, symptom severity and improvement, and evidence-based intervention use were collected for patients ( = 173) from an integrated primary clinic that primarily serves a low-income, diverse sample of adults and children whose primary presenting problems are depression and anxiety.
Attendance significantly improved after the transition to telehealth, as indicated by fewer cancellations and more appointments attended. Patients showed significant improvement and decreases in symptoms. The quality of care was maintained, as indicated by consistent evidence-based intervention use over time.
This study was limited by the fact that it took place in an academically-affiliated primary care clinic, which may not be representative of all community settings. In addition, analyses related to clinical symptoms were only conducted with a small subset of participants and there was no comparison group.
Telehealth through integrated primary care might be a viable option to improve accessibility of mental health services for low-income, racial/ethnic minority adults and children.
本研究从就诊率、循证干预措施的提供以及临床结果等方面,考察了在2019冠状病毒病大流行期间向远程医疗服务的转变情况。
利用病历审查数据,比较了综合初级保健会诊中面对面就诊与远程医疗就诊的可行性。收集了来自一家综合初级诊所的173名患者的患者特征、就诊情况、症状严重程度及改善情况,以及循证干预措施使用情况的数据。该诊所主要服务于低收入、多样化的成人和儿童样本,他们的主要就诊问题是抑郁和焦虑。
向远程医疗转变后,就诊情况显著改善,表现为取消预约减少,就诊预约增多。患者症状有显著改善且减轻。随着时间推移,循证干预措施的持续使用表明护理质量得以维持。
本研究受限于其在一家学术附属初级保健诊所开展,可能无法代表所有社区环境。此外,仅对一小部分参与者进行了与临床症状相关的分析,且没有对照组。
通过综合初级保健提供的远程医疗可能是提高低收入种族/族裔少数群体成人及儿童心理健康服务可及性的一个可行选择。