Patel Sheila V, Saavedra Lissette M, Rodriguez Borja Ivette, Philbrick Sarah, Schwimmer Manny, Ruwala Richa, Viswanathan Meera
RTI International, Research Triangle Park, NC.
The Ohio State University, Columbus, OH.
Med Care. 2025 Feb 1;63(2):134-151. doi: 10.1097/MLR.0000000000002098. Epub 2025 Jan 9.
Telehealth services can increase access to care by reducing barriers. Telephone-administered care, in particular, requires few resources and may be preferred by communities in areas that are systemically underserved. Understanding the effectiveness of audio-based care is important to combat the current mental health crisis and inform discussions related to reimbursement privileges.
We compared the effectiveness of audio-based care to usual care for managing mental health and substance use disorders (MHSUD).
We used systematic review methods to synthesize available evidence.
We searched for English-language articles reporting randomized controlled trials (RCTs) of adults diagnosed with MHSUD published since 2012.
We abstracted data on clinical outcomes, patient-reported health and quality of life, health care access and utilization, care quality and experience, and patient safety.
We included 31 RCTs of participants diagnosed with depression, post-traumatic stress disorder (PTSD), other serious mental illness (SMI), anxiety, insomnia, or substance use disorder (SUD). Most of the evidence was for interventions targeting depression, PTSD, and SUD. The evidence demonstrates promise for: (1) replacing in-person care with audio care for depression, other SMI, and SUD (very low to moderate certainty of comparable effectiveness); and (2) adding audio care to monitor or treat depression, PTSD, anxiety, insomnia, and SUD (low to moderate certainty of evidence favoring audio care for clinical outcomes).
MHSUD can be managed with audio care in certain situations. However, more evidence is needed across conditions, and specifically for anxiety and other conditions for which no research was identified.
远程医疗服务可以通过减少障碍来增加医疗服务的可及性。特别是电话管理的护理所需资源较少，可能受到系统性服务不足地区社区的青睐。了解基于音频的护理的有效性对于应对当前的心理健康危机以及为有关报销特权的讨论提供信息非常重要。
我们比较了基于音频的护理与常规护理在管理心理健康和物质使用障碍（MHSUD）方面的有效性。
我们使用系统评价方法来综合现有证据。
我们搜索了自2012年以来发表的报告诊断为MHSUD的成年人随机对照试验（RCT）的英文文章。
我们提取了关于临床结果、患者报告的健康和生活质量、医疗服务可及性和利用情况、护理质量和体验以及患者安全的数据。
我们纳入了31项针对诊断为抑郁症、创伤后应激障碍（PTSD）、其他严重精神疾病（SMI）、焦虑症、失眠症或物质使用障碍（SUD）的参与者的RCT。大多数证据针对的是针对抑郁症、PTSD和SUD的干预措施。证据表明在以下方面有前景：（1）用音频护理替代抑郁症、其他SMI和SUD的面对面护理（可比有效性的确定性非常低至中等）；以及（2）添加音频护理以监测或治疗抑郁症、PTSD、焦虑症、失眠症和SUD（支持音频护理用于临床结果的证据确定性低至中等）。
在某些情况下，MHSUD可以通过音频护理进行管理。然而，需要针对更多情况提供更多证据，特别是针对焦虑症以及未发现相关研究的其他情况。
