The University of Sydney, Sydney, NSW, Australia.
Sydney Local Health District, Sydney, NSW, Australia.
Acad Psychiatry. 2023 Feb;47(1):25-34. doi: 10.1007/s40596-022-01701-5. Epub 2022 Sep 9.
The authors aimed to determine if Project Extension for Community Healthcare Outcomes (ECHO), a health-education model utilising teleconferencing technology, improves the capacity of clinicians in assessing and managing complex psychiatric patients.
Three pilot Project ECHO programs were evaluated as a prospective waitlist-controlled trial, focusing on Adult Eating Disorders, Adult Intellectual Disability Mental Health, and General Mental Health. Each program comprised 9-10 weekly teleconferencing group sessions. Participants and waitlist-controls completed pre- and post-program surveys. The primary outcomes were self-reported knowledge and confidence in assessing and managing complex patients relevant to each group. Linear mixed models were used to assess the group-by-time interaction, or change over time, as appropriate.
Between July 2020 and June 2021, three series of the Adult Intellectual Disability Mental Health program, two series of the Adult Eating Disorders program, and two series of the General Mental Health program were delivered. Compared to waitlist-controls (n = 21), there were statistically significant improvements in self-reported knowledge and confidence for all topics amongst participants of the Adult Eating Disorders program (n = 44). In the Adult Intellectual Disability Mental Health program, there were significant improvements in self-reported knowledge and confidence amongst participants (n = 67) for most topics compared to controls (n = 21). There were no waitlist-controls for the General Mental Health program, but within-group analysis (n = 28) showed significant improvements in participants' knowledge and confidence following program completion, compared to baseline.
Project ECHO is a feasible and effective model to develop workforce capacity in managing complex psychiatric conditions.
作者旨在确定社区医疗保健成果扩展项目（ECHO）是否可以提高临床医生评估和管理复杂精神疾病患者的能力。该项目利用远程会议技术进行健康教育。
采用前瞻性等待对照试验，对三个试点 ECHO 项目进行评估，分别为成人饮食障碍、成人智力残疾心理健康和一般心理健康。每个项目包括 9-10 周的每周远程会议小组会议。参与者和候补组在项目前后完成了调查。主要结果是自我报告的评估和管理与每个组相关的复杂患者的知识和信心。线性混合模型用于评估组间时间交互作用，或根据需要随时间的变化。
2020 年 7 月至 2021 年 6 月，完成了三期成人智力残疾心理健康项目、两期成人饮食障碍项目和两期一般心理健康项目。与候补组（n=21）相比，成人饮食障碍项目的参与者（n=44）在自我报告的评估和管理复杂患者的所有主题上的知识和信心均有统计学显著提高。在成人智力残疾心理健康项目中，与对照组（n=21）相比，参与者（n=67）在大多数主题上的自我报告知识和信心均有显著提高。一般心理健康项目没有候补组，但在完成项目后，与基线相比，参与者的知识和信心均有显著提高。
ECHO 项目是一种可行且有效的模型，可以提高管理复杂精神疾病的劳动力能力。
