Fernando Irosh, Gupta Rahul, Simpson Kate, Szwec Stuart, Carey Mariko, Conrad Agatha, Heard Todd, Lampe Lisa
Hunter New England Local Health District, Newcastle, NSW, Australia.
School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.
BMC Psychiatry. 2025 Jul 1;25(1):635. doi: 10.1186/s12888-025-07023-8.
The need for time-efficient and accessible mental health assessment is a priority in the face of high demand, limited resources and a progressive increase in the percentage of adults experiencing high or very high levels of psychological distress. Although there is broader supportive evidence for using online assessment as a potential solution, there is relatively little evidence from randomised controlled trials.
To investigate whether patient online self-reported clinical information can save clinician time in subsequent mental health assessment via phone.
Patients referred to a public mental health service by general practitioners via fax during business hours between February 2020 and June 2022 were randomly allocated to either the intervention (self-reporting of clinical information followed by clinician assessment by phone) or control (clinician phone assessment as usual) arm. The time to complete the assessment (call duration) was the primary outcome measure.
Out of 758 referrals assessed for eligibility, 377 (49.34%) entered the study and were randomised. Out of 184 referrals allocated to the intervention arm, the assessment was completed in 125, but only 81 were included in the analysis, mostly due to failure of clinicians to follow the protocol (completing the assessment without using self-reported data, likely due to inexperience with the novel process). Of 193 referrals allocated to the control arm, 135 completed the assessment and were included in the analysis. Average assessment completion time in the control arm was 25.19 min (standard deviation (SD) of 11.5 min) and 20.76 min (SD 7.49 min) in the intervention arm respectively, with a mean difference of 4.43 min (17.59% time reduction). When a mixed effects linear model was used to adjust for potential seasonal effect and correlation of outcome within clinicians, a statistically significant reduction of 3.29 min (P = 0.016, 95% CI (5.85, 0.73)) was still demonstrated by using online assessment.
The use of online self-report clinical assessment by patients can save time to complete subsequent clinician assessment. Greater time-saving can be expected with better integration of this tool in workflow and increased clinician familiarity with using online self-reported data.
(registered retrospectively) Registry: Australian and New Zealand Clinical Trial Registry (ACTRN).
anzctr.org.au ACTRN12624001293550. Date of registration: 24/10/2024.
面对高需求、资源有限以及心理困扰程度高或非常高的成年人比例不断上升的情况，高效且可及的心理健康评估需求成为当务之急。尽管有更广泛的支持性证据表明使用在线评估是一种潜在解决方案，但随机对照试验的证据相对较少。
调查患者在线自我报告的临床信息是否能在后续通过电话进行的心理健康评估中节省临床医生的时间。
2020年2月至2022年6月工作时间内，由全科医生通过传真转介至公共心理健康服务机构的患者被随机分配至干预组（先自我报告临床信息，随后临床医生通过电话进行评估）或对照组（临床医生按常规通过电话进行评估）。完成评估的时间（通话时长）是主要结局指标。
在758例接受资格评估的转介患者中，377例（49.34%）进入研究并被随机分组。在分配至干预组的184例转介患者中，125例完成了评估，但仅81例纳入分析，主要原因是临床医生未遵循方案（未使用自我报告数据完成评估，可能是由于对新流程缺乏经验）。在分配至对照组的193例转介患者中，135例完成评估并纳入分析。对照组的平均评估完成时间为25.19分钟（标准差（SD）为11.5分钟），干预组为20.76分钟（SD为7.49分钟），平均差异为4.43分钟（时间减少17.59%）。当使用混合效应线性模型调整潜在的季节效应和临床医生内部结局的相关性时，使用在线评估仍显示出统计学上显著减少3.29分钟（P = 0.016，95%CI（5.85，0.73））。
患者使用在线自我报告临床评估可节省完成后续临床医生评估的时间。随着该工具在工作流程中更好地整合以及临床医生对使用在线自我报告数据的熟悉程度提高，预计可节省更多时间。
（追溯注册）注册机构：澳大利亚和新西兰临床试验注册中心（ACTRN）。
anzctr.org.au ACTRN12624001293550。注册日期：2024年10月24日。
