考察远程医疗温暖交接在综合初级保健中提高患者心理健康治疗参与度的效用：随机视频短片研究

Examining the Utility of a Telehealth Warm Handoff in Integrated Primary Care for Improving Patient Engagement in Mental Health Treatment: Randomized Video Vignette Study.

作者信息

Fountaine Alex R, Iyar Megumi M, Lutes Lesley D

机构信息

The Center for Obesity and Well-Being Research Excellence, Department of Psychology, University of British Columbia - Okanagan Campus, Kelowna, BC, Canada.

出版信息

JMIR Form Res. 2023 Jun 20;7:e40274. doi: 10.2196/40274.

DOI:10.2196/40274

PMID:37338963

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10337291/

Abstract

BACKGROUND

A warm handoff from a physician to a mental health provider is often patients' first contact with psychological services and provides a unique opportunity for improving treatment engagement in integrated primary care (IPC) settings.

OBJECTIVE

In light of the COVID-19 pandemic, this study sought to examine the impact of different types of telehealth mental health referrals on both the anticipated likelihood of accepting treatment services and anticipated likelihood of continued treatment engagement.

METHODS

A convenience sample of young adults (N=560) was randomized to view 1 of 3 video vignettes: warm handoff in IPC, referral as usual (RAU) in IPC, or RAU in standard primary care.

RESULTS

Logistic associations between referral type and the likelihood of referral acceptance (χ=10.9, P=.004) and the likelihood of continued engagement (χ=32.6, P<.001) were significant. Participants who received a warm handoff were significantly more likely to anticipate both accepting the referral (b=0.35; P=.002; odds ratio 1.42, 95% CI 1.15-1.77) and engaging in continued treatment (b=0.62; P<.001; odds ratio 1.87, 95% CI 1.49-2.34) compared with those who received RAU in the standard primary care condition. Furthermore, 77.9% (436/560) of the sample indicated that they would be at least somewhat likely to access IPC mental health services for their own mental health concerns if they were readily available in their own primary care physician's office.

CONCLUSIONS

A telehealth warm handoff resulted in the increased anticipated likelihood of both initial and continued engagement in mental health treatment. A telehealth warm handoff may have utility in fostering the uptake of mental health treatment. Nonetheless, a longitudinal assessment in a primary care clinic of the utility of a warm handoff for fostering referral acceptance and continued treatment engagement is needed to hone the adoptability of a warm handoff process and demonstrate practical evidence of effectiveness. The optimization of a warm handoff would also benefit from additional studies examining patient and provider perspectives about the factors affecting treatment engagement in IPC settings.

摘要

背景

医生向心理健康服务提供者进行热情交接通常是患者首次接触心理服务，为改善综合初级保健（IPC）环境中的治疗参与度提供了独特机会。

目的

鉴于2019冠状病毒病大流行，本研究旨在探讨不同类型的远程医疗心理健康转诊对接受治疗服务的预期可能性和持续治疗参与的预期可能性的影响。

方法

对年轻成年人（N = 560）的便利样本进行随机分组，观看3个视频短片中的1个：IPC中的热情交接、IPC中的常规转诊（RAU）或标准初级保健中的RAU。

结果

转诊类型与转诊接受可能性（χ = 10.9，P = .004）和持续参与可能性（χ = 32.6，P < .001）之间的逻辑关联具有显著性。与在标准初级保健条件下接受常规转诊的参与者相比，接受热情交接的参与者更有可能预期接受转诊（b = 0.35；P = .002；优势比1.42，95%可信区间1.15 - 1.77）和参与持续治疗（b = 0.62；P < .001；优势比1.87，95%可信区间1.49 - 2.34）。此外，77.9%（436/560）的样本表示，如果他们自己的初级保健医生办公室能够随时提供，他们至少有一定可能性会因自身心理健康问题而寻求IPC心理健康服务。

结论

远程医疗热情交接导致首次和持续参与心理健康治疗的预期可能性增加。远程医疗热情交接可能有助于促进心理健康治疗的采用。尽管如此，需要在初级保健诊所进行纵向评估，以确定热情交接在促进转诊接受和持续治疗参与方面的效用，从而优化热情交接过程并证明其有效性的实际证据。优化热情交接还将受益于更多研究，这些研究考察患者和提供者对影响IPC环境中治疗参与因素的看法。