Tele-Medicine Centre, Forensic Psychiatry, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru 560029, Karnataka, India.
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru 560029, Karnataka, India.
Natl Med J India. 2021 Sep-Oct;34(5):261-265. doi: 10.25259/NMJI_189_20.
Background Continuity of care for psychiatric disorders by conventional in-person consultation by psychiatrists is associated with several challenges. There is a need to develop alternative models of specialist care. We studied our 3 years' experience of live video consultations (VCs) from the tele after-care clinic to patients with psychiatric disorders at an Indian academic hospital. Methods We did a file review of 669 VCs provided to 213 patients in the first 3 years (2017-2019) from the telemedicine centre of a tertiary care academic hospital. We analysed details of sociodemography, clinical profile, tele after-care consultations and outcome. Results Two hundred and thirteen patients (55% men) were enrolled for the tele after-care clinic. The mean (SD) age of the patients was 42.2 (17.29) years and a majority were educated till high school and beyond. Patients with severe and common mental disorders constituted 60.1% and 40%, respectively. Among the total 669 appointments, 542 (81%) VCs were successfully provided; of the remaining, 125 were cancelled and 2 were aborted due to a medical emergency. Medication prescriptions were unchanged in 499 and modified/totally changed in 47 VCs. Conclusion Our large study shows that telepsychiatric after-care is a useful alternative method which can supplement in-person follow-up. Barriers such as distance, cost and medical illness can be overcome using tele after-care clinics for regular follow-ups in stabilized psychiatric patients. There is a need for prospective studies, preferably, randomized controlled trials comparing effectiveness of tele after-care with in-person consultations to assess treatment outcomes.
精神科医生传统的面对面咨询为精神障碍患者提供的连续性护理存在诸多挑战。因此，需要开发替代的专家护理模式。我们研究了我们在印度一家学术医院的远程后续诊所中，对精神障碍患者进行实时视频咨询（VC）的 3 年经验。
我们对远程医疗中心在 3 年内（2017-2019 年）为 213 名患者提供的 669 次 VC 进行了文件审查。我们分析了社会人口统计学、临床特征、远程后续咨询和结果的详细信息。
213 名患者（55%为男性）被纳入远程后续诊所。患者的平均（SD）年龄为 42.2（17.29）岁，大多数人接受过高中及以上教育。严重和常见精神障碍患者分别占 60.1%和 40%。在总共 669 次预约中，有 542 次（81%）成功提供了 VC；其余的 125 次被取消，2 次因医疗紧急情况而中止。499 次的药物处方未改变，47 次进行了修改/完全改变。
我们的大型研究表明，远程精神病学后续护理是一种有用的替代方法，可以补充面对面随访。通过远程后续诊所，为稳定的精神科患者进行常规随访，可以克服距离、成本和医疗疾病等障碍。需要前瞻性研究，最好是随机对照试验，比较远程后续与面对面咨询的有效性，以评估治疗结果。
