Patient Perspectives on Videoconferencing-Based Treatment for Alcohol Use Disorders

Tarp, Kristine; Nielsen, Anette Søgaard

doi:10.1080/07347324.2017.1348785

Cited by 11 publications

(37 citation statements)

References 20 publications

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“…This finding is consistent with other studies that demonstrate high levels of patient acceptance and satisfaction with virtual mental health care [29,30], even when they experience frustration because of technical difficulties [16]. Participants’ satisfaction may be associated with their ability to choose the format to receive psychotherapy week to week, increasing their perception of autonomy [31]. Participants subjectively felt that access to optional VC allowed them to attend therapy sessions more frequently.…”

Section: Discussionsupporting

confidence: 86%

Optional Web-Based Videoconferencing Added to Office-Based Care for Women Receiving Psychotherapy During the Postpartum Period: Pilot Randomized Controlled Trial

Yang¹,

Vigod²,

Hensel³

2019

J Med Internet Res

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Background Depression and anxiety during the postpartum period are common, with psychotherapy often being the preferred method of treatment. However, psychological, physical, and social barriers prevent women from receiving appropriate and timely psychotherapy. The option of receiving psychotherapy through videoconferencing (VC) during the postpartum period presents an opportunity for more accessible and flexible care. Objective The aim of this study was to assess the feasibility, acceptability, and preliminary effectiveness of optional VC added to usual office-based psychotherapy, with a psychotherapist during the postpartum period. Methods We conducted a pilot randomized controlled trial with 1:1 randomization to office-based care (treatment as usual; TAU) or office-based care with the option of VC (treatment as usual plus videoconferencing; TAU-VC) for psychotherapy during the postpartum period. We assessed the ability to recruit and retain postpartum women into the study from an urban perinatal mental health program offering postpartum psychotherapy, and we evaluated the uptake, acceptability, and satisfaction with VC as an addition to in-person psychotherapy. We also compared therapy attendance using therapist logs and symptoms between treatment groups. Symptoms were assessed at baseline and 3 months postrandomization with the Edinburgh Postnatal Depression Scale, Generalized Anxiety Disorder 7-item, and Parental Stress Scale. Furthermore, 3-month scores were compared between groups with intention-to-treat linear mixed-effects models controlling for baseline score. Results We enrolled 38 participants into the study, with 19 participants in each treatment group. Attendance data were available for all participants, with follow-up symptom measures available for 25 out of 38 participants (66%). Among the 19 TAU-VC participants, 14 participants (74%) utilized VC at least once. Most participants were highly satisfied with the VC option, and they reported average savings of Can $26 and 2.5 hours in travel and childcare expenses and time per appointment. There were no significant differences between the 2 groups for psychotherapy attendance or symptoms. Conclusions The option of VC appears to be an acceptable method of receiving psychotherapy for postpartum women, with benefits described in costs and time savings. On the basis of this small pilot sample, there were no significant differences in outcomes between office-based care with or without the option of VC. This study has demonstrated the feasibility of such a program in an urban center, which suggests that a larger study would be beneficial to provide evidence that is more conclusive.

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Section: Discussionsupporting

confidence: 86%

Optional Web-Based Videoconferencing Added to Office-Based Care for Women Receiving Psychotherapy During the Postpartum Period: Pilot Randomized Controlled Trial

Yang¹,

Vigod²,

Hensel³

2019

J Med Internet Res

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“…This study found that the primary barrier to participating was reluctance to receive treatment sessions via videoconferencing, as nonparticipants reported preferring personal contact. This finding is supported by a qualitative study also nested within the RCT [18]. Similar studies have also found participants to favor face-to-face meetings.…”

Section: Discussionsupporting

confidence: 57%

Videoconferencing-Based Treatment of Alcohol Use Disorders: Analyses of Nonparticipation

Tarp¹,

Mejldal²,

Nielsen³

2017

JMIR Formativ Res

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BackgroundWe recently conducted a small randomized controlled trial (RCT) aiming to examine the effectiveness of videoconferencing-based treatment of alcohol use disorders in a real-life setting. The patient and participation rates were lower than anticipated.ObjectiveThe objectives of our study were (1) to examine differences between participants and nonparticipants, and (2) to examine the characteristics of nonparticipants and their reported reasons for not participating.MethodsFirst, we analyzed nonparticipation through a comparative analysis of participants and nonparticipants using data from a clinical database, covering all patients starting treatment at the clinic. Second, on the basis of data from an anonymous questionnaire filled out by nonparticipants, we analyzed barriers to participating and the descriptive sociodemographics of nonparticipants who reported technical barriers versus those who did not.ResultsOf 128 consecutive patients starting treatment during the study period, we found no significant differences between participants (n=71) and nonparticipants (n=51) according to sociodemographics, alcohol measures, and composite scores. Of 51 nonparticipants, 43 filled out the questionnaire with reasons for not participating. We derived 2 categories of barriers from the questionnaire: scientific barriers, which were barriers to the scientific study in general (n=6), and technical barriers, which were barriers to using a laptop or videoconferencing specifically (n=27). We found no significant differences in sociodemographics between nonparticipants who reported technical barriers to participating in the study and those who did not note technical barriers. A total of 13 patients elaborated on technical barriers, and 9 patients found videoconferencing impersonal, preferred personal contact, and would rather attend face-to-face treatment at the clinic.ConclusionsPatient barriers to participating in the RCT were mainly concerned with the technology. There were no significant differences between participants and nonparticipants, nor between nonparticipants who noted technical barriers to participating and those who did not. If a similar study is to be conducted or the solution is to be upscaled and implemented, attention should be given to the user friendliness of the technical equipment and the recruitment process, preparing the patients by emphasizing the information given to them about the technical equipment and its advantages.

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“…One reason why patients in the TAU+I group had significantly fewer premature dropouts may have been that they were more satisfied with their treatment course, having been given the opportunity to choose (before each session) whether to receive treatment via videoconferencing [ 24 ]. This may have led to increased experiences of flexibility and autonomy, making the patients feel more empowered [ 23 ], which, in turn, may have prevented dropouts. Similar notions were reported in a study on Web-based blended care therapy, where patients had positive perceptions of the Web-based sessions, especially regarding enhancing their self-management [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, studies regarding Web-based blended therapy for psychiatric disorders have, for example, examined designs with optional modules [ 20 ], with the opportunity to step up treatment if the patient felt it was necessary [ 21 ], and using a personal blend [ 22 ], enhancing patients’ self-management [ 12 ]. Similarly, a qualitative study nested within the RCT found that patients being offered videoconferencing may have experienced it as a means to enhance their autonomy and empowerment, with the ability to choose freely between the two formats having a positive impact on the treatment course [ 23 ]. Also, a mixed methods study linked to the RCT found that patients felt more satisfied with the treatment and prolonged their treatment courses when they had the opportunity to receive sessions via videoconferencing [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Optional Videoconferencing-Based Treatment of Alcohol Use Disorders: Randomized Controlled Trial

Tarp¹,

Bojesen²,

Mejldal³

et al. 2017

JMIR Ment Health

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BackgroundTreatment of alcohol use disorders (AUDs) is characterized by an adherence rate below 50%. Clinical research has found that patient adherence enhances treatment effect; hence, health authorities, clinicians, and researchers strive to explore initiatives contributing to patients receiving treatment. Concurrently, videoconferencing-based treatment is gaining ground within other addiction and psychiatric areas.ObjectiveThe aim of this study was to test whether optional videoconferencing increases adherence to and effectiveness of AUD treatment in a randomized controlled trial (RCT). We hypothesized that the intervention would decrease premature dropout (the primary outcome), as well as increase successful treatment termination, treatment duration, and treatment outcome (secondary outcomes).MethodsWe conducted this study in the public outpatient alcohol clinic in Odense, Denmark, between September 2012 and April 2013. It was an RCT with 2 groups: treatment as usual (TAU) and treatment as usual with add-on intervention (TAU+I). The TAU+I group had the option, from session to session, to choose to receive treatment as usual via videoconferencing. Data consisted of self-reported responses to the European version of the Addiction Severity Index (EuropASI). We collected data at baseline, at follow-up at 3, 6, and 12 months, and at discharge.ResultsAmong consecutive patients attending the clinic, 128 met the inclusion criteria, and 71 of them were included at baseline. For the primary outcome, after 180 days, 2 of 32 patients (6%) in the TAU+I group and 12 of 39 patients (31%) in the TAU group had dropped out prematurely. The difference is significant (P=.008). After 365 days, 8 patients (25%) in the TAU+I group and 17 patients (44%) in the TAU group had dropped out prematurely. The difference is significant (P=.02). For the secondary outcomes, significantly more patients in the TAU+I group were still attending treatment after 1 year (P=.03). We found no significant differences between the 2 groups with regard to successful treatment termination and treatment outcome.ConclusionsThe results indicate that offering patients optional videoconferencing may prevent premature dropouts from treatment and prolong treatment courses. However, the small sample size precludes conclusions regarding the effect of the intervention, which was not detectable in the patients’ use of alcohol and severity of problems.Trial RegistrationThe Regional Health Research Ethics Committee System in Denmark: S-20110052; https://komite.regionsyddanmark.dk/wm258128 (Archived by WebCite at http://www.webcitation.org/6tTL3CO6u)

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Patient Perspectives on Videoconferencing-Based Treatment for Alcohol Use Disorders

Cited by 11 publications

References 20 publications

Optional Web-Based Videoconferencing Added to Office-Based Care for Women Receiving Psychotherapy During the Postpartum Period: Pilot Randomized Controlled Trial

Optional Web-Based Videoconferencing Added to Office-Based Care for Women Receiving Psychotherapy During the Postpartum Period: Pilot Randomized Controlled Trial

Videoconferencing-Based Treatment of Alcohol Use Disorders: Analyses of Nonparticipation

Effectiveness of Optional Videoconferencing-Based Treatment of Alcohol Use Disorders: Randomized Controlled Trial

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