BackgroundTelemental health platforms may increase access to care for older adults. Historically, older adults have tended to adopt new technologies at a slower rate which creates a perception that they may not be able to benefit from them. The purpose of this study was to determine whether or not older adult patients receiving psychiatric care for depression via a telemental health platform achieve the same outcomes as younger adults.MethodParticipant data utilized in the current investigation were obtained from a national mental health telehealth company (i.e., Brightside) and consisted of 12,908 U.S.-based adult patients receiving psychiatric care for depression between October, 2018 and January, 2022. Propensity matching was used to create an older and younger sample (n = 141 in each) using 23 covariates. These samples were then compared using repeated measures ANOVA on Patient Health Questionnaire-9 (PHQ-9) scores at start of treatment, 6 weeks, 8 weeks, 10 weeks, 12 weeks, 14 weeks, and 16 weeks.ResultsDespite matching, the groups still significantly differed on prior mental health treatment, such that more older adults reported having had prior mental health treatment. There were no other differences between the groups on assessed variables. Both younger and older adults had decreasing scores over time with no significant differences between them.ConclusionOlder adults have similar improvement in depression symptom severity over time following initiation of psychiatric treatment via a telehealth platform. These findings suggest that age is not a barrier to benefitting from telepsychiatric care.
Background Major Depressive Disorder and Generalized Anxiety Disorder are pervasive and debilitating conditions, though treatment is often inaccessible and based on trial-and-error prescribing methods. The present observational study seeks to describe the use of a proprietary precision prescribing algorithm piloted during routine clinical practice as part of Brightside’s telepsychiatry services. The primary aim is to determine the feasibility and acceptability of implementing this intervention. Secondary aims include exploring remission and symptom improvement rates. Methods Participants were adult patients enrolled in Brightside who completed at least 12 weeks of treatment for depression and/or anxiety and received a prescription for at least one psychiatric medication. A prescription recommendation was made by Brightside’s algorithm at treatment onset and was utilized for clinical decision support. Participants received baseline screening surveys of the PHQ-9 and GAD-7, and at weeks 2,4,6,8,10 and 12. Intent-to-treat (ITT) sensitivity analyses were conducted. Feasibility of the implementation was measured by the platform’s ability to enroll and engage participants in timely psychiatric care, as well as offer high touch-point treatment options. Acceptability was measured by patient responses to a 5-star satisfaction rating. Results Brightside accessed and treated 6248 patients from October 2018 to April 2021, treating a majority of patients within 4-days of enrollment. The average plan cost was $115/month. 89% of participants utilized Brightside’s core medication plan at a cost of $95/month. 13.4% of patients in the study rated Brightside’s services as highly satisfactory, averaging a 4.6-star rating. Furthermore, 90% of 6248 patients experienced a MCID in PHQ-9 or GAD-7 score. Remission rates were 75% (final PHQ-9 or GAD-7 score < 10) for the study sample and 59% for the ITT sample. 69.3% of Brightside patients were treated with the medication initially prescribed at intake. Conclusions Results suggest that the present intervention may be feasible and acceptable within the assessed population. Exploratory analyses suggest that Brightside’s course of treatment, guided by precision recommendations, improved patients’ symptoms of anxiety and depression.
Background Research and dissemination of smartphone apps to deliver coaching and psychological driven intervention had seen a great surge in recent years. Notably, Acceptance Commitment Therapy (ACT) protocols were shown to be uniquely effective in treating symptoms for both depression and anxiety when delivered through smartphone apps. The aim of this study is to expand on that work and test the suitability of artificial intelligence–driven interventions delivered directly through popular texting apps. Objective This study evaluated our hypothesis that using Kai.ai will result in improved well-being. Methods We performed a pragmatic retrospective analysis of 2909 users who used Kai.ai on one of the top messaging apps (iMessage, WhatsApp, Discord, Telegram, etc). Users’ well-being levels were tracked using the World Health Organization-Five Well-Being Index throughout the engagement with service. A 1-tailed paired samples t test was used to assess well-being levels before and after usage, and hierarchical linear modeling was used to examine the change in symptoms over time. Results The median well-being score at the last measurement was higher (median 52) than that at the start of the intervention (median 40), indicating a significant improvement (W=2682927; P<.001). Furthermore, HLM results showed that the improvement in well-being was linearly related to the number of daily messages a user sent (β=.029; t81.36=4; P<.001), as well as the interaction between the number of messages and unique number of days (β=–.0003; t81.36=–2.2; P=.03). Conclusions Mobile-based ACT interventions are effective means to improve individuals’ well-being. Our findings further demonstrate Kai.ai’s great promise in helping individuals improve and maintain high levels of well-being and thus improve their daily lives.
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