What About Telepsychiatry?

García-Lizana, Francisca; Muñoz-Mayorga, Ingrid

doi:10.4088/pcc.09m00831whi

Cited by 120 publications

(149 citation statements)

References 22 publications

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“…[48][49]51 Ten systematic reviews were selected (QS ≥22) for detailed extraction of findings and evidence based recommendations (Table IV). 23,[26][27][28][38][39][54][55][56][57] One of these was a policy document which provided detailed grading of evidence-based recommendations. 38 Two of these systematic reviews were non-effectiveness reviews included to provide synthesised information on utilization and cost.…”

Section: Resultsmentioning

confidence: 99%

“…23,[26][27][28]38,54 Reviews were mainly on medication management 38 and short courses of cognitive behavioral therapy (CBT). 27,38 Though it was felt that telepsychiatry for therapy requires more study, the fact that patients quickly adapt and establish rapport with their therapists 38 , the adherence of therapists to practice guidelines and the equivalence in clinical outcomes from therapy 64 , (primarily CBT) 26 suggest that telepsychiatry can replace follow up therapy.…”

Section: Question 2: Are Telepsychiatry Treatments Equivalent To Facementioning

confidence: 99%

“…38,54 In addition, there are no data that telepsychiatry services are harmful, so it is believed to be safe. 26,28 Summary of reviews analyzed …”

Section: Question 2: Are Telepsychiatry Treatments Equivalent To Facementioning

confidence: 99%

“…Generally the literature of telepsychiatry is characterised by descriptive and poor evaluation studies, with few high quality evidence studies regarding the effectiveness of telepsychiatry to be found. [26][27][28] In addition, there are only a handful of reported telepsychiatry papers from the developing world [29][30][31][32] and only one reported out of Africa. 33 Before considering the implementation of telepsychiatry in South Africa, it is important to assess the existing evidence for telepsychiatry before making recommendations for the application of telepsychiatry to this environment 34 based on the level of evidence found.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence

Chipps¹,

Brysiewicz²,

Mars³

2012

Afr. J. Psych

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Objective: A review of systematic reviews of the effectiveness and feasibility of videoconference-based telepsychiatry services for resource constrained environments was conducted. Specifically with the aim of producing an evidence-based review of the effectiveness and feasibility of videoconference-based telepsychiatry services in resource constrained countries like South Africa. Methods: Eight key questions on telepsychiatry effectiveness and feasibility were identified and inclusion and exclusion criteria were developed. Review of citations from 2000-2011 from CINAHL, Medline, Pubmed, PsycInfo, EBSCOhost, SABINET, Cochrane Database of Systematic Reviews (CCTR), Cochrane Controlled Trial Registry (CCTR), Database of Abstracts of Reviews of Effectiveness (DARE), unpublished abstracts through NEXUS and internet search engines (Google/Google scholar) was conducted. Results: Ten systematic reviews were included for review. Despite the methodological limitations and heterogeneity of the systematic reviews, there appears to be good evidence of effectiveness (reliability and improved outcomes) and feasibility (use, satisfaction, acceptability and cost) for videoconference-based telepsychiatry internationally. The application of this evidence in lower middle income countries is dependent on the integration of telepsychiatry into local health system contexts. Conclusion: Based on the evidence, resource constrained countries such as South Africa should be encouraged to develop telepsychiatry programs along with rigorous evaluation methods.

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Section: Resultsmentioning

confidence: 99%

Section: Question 2: Are Telepsychiatry Treatments Equivalent To Facementioning

confidence: 99%

“…38,54 In addition, there are no data that telepsychiatry services are harmful, so it is believed to be safe. 26,28 Summary of reviews analyzed …”

Section: Question 2: Are Telepsychiatry Treatments Equivalent To Facementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence

Chipps¹,

Brysiewicz²,

Mars³

2012

Afr. J. Psych

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“…The psychiatrist links via videoconferencing from the consultant telepsychiatry service to a Mental Health Care Practitioner at a referring site, with or without the Mental Health Care User being present. 29,31 Depending on specific language needs, a translator may also be required at the referring site.…”

Section: Structural Componentsmentioning

confidence: 99%

A telepsychiatry model to support psychiatric outreach in the public sector in South Africa

2012

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The access of rural Mental Health Care Users in South Africa to specialist psychiatrists and quality mental health care is currently sub-optimal. Health professionals and planners working in psychiatry lack a well-defined and feasible outreach model to facilitate the delivery of services to remote and rural areas. In response to this challenge, a three-year action research telepsychiatry study was undertaken by the Departments of Psychiatry and TeleHealth at the University of KwaZulu-Natal, to develop a telepsychiatry outreach model based on local research and international evidence. The Model draws on needs and infrastructure assessments of the designated psychiatric hospitals in the province, a review of the published international evidence on telepsychiatry and videoconference-based education, and an evaluation of local clinical and educational telepsychiatry implementations in KwaZuluNatal. The Model proposed is "virtual", i.e. not bound to provincial or district referral patterns, aims not to add to the burden on the current workforce and is intended to be integrated into psychiatry outreach services and policy. The Model should be subjected to in situ testing for validation and implementation. It is hoped that an implementation of this Model will improve the access of Mental Health Care Users to specialist psychiatry care.

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Use of Telemedicine and Quality of Care Among Medicare Enrollees With Serious Mental Illness

Wilcock,

Huskamp,

Busch

et al. 2023

JAMA Health Forum

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ImportanceDuring the COVID-19 pandemic, a large fraction of mental health care was provided via telemedicine. The implications of this shift in care for use of mental health service and quality of care have not been characterized.ObjectiveTo compare changes in care patterns and quality during the first year of the pandemic among Medicare beneficiaries with serious mental illness (schizophrenia or bipolar I disorder) cared for at practices with higher vs lower telemedicine use.Design, Setting, and ParticipantsIn this cohort study, Medicare fee-for-service beneficiaries with schizophrenia or bipolar I disorder were attributed to specialty mental health practices that delivered the majority of their mental health care in 2019. Practices were categorized into 3 groups based on the proportion of telemental health visits provided during the first year of the pandemic (March 2020-February 2021): lowest use (0%-49%), middle use (50%-89%), or highest use (90%-100%). Across the 3 groups of practices, differential changes in patient outcomes were calculated from the year before the pandemic started to the year after. These changes were also compared with differential changes from a 2-year prepandemic period. Analyses were conducted in November 2022.ExposurePractice-level use of telemedicine during the first year of the COVID-19 pandemic.Main Outcomes and MeasuresThe primary outcome was the total number of mental health visits (telemedicine plus in-person) per person. Secondary outcomes included the number of acute hospital and emergency department encounters, all-cause mortality, and quality outcomes, including adherence to antipsychotic and mood-stabilizing medications (as measured by the number of months of medication fills) and 7- and 30-day outpatient follow-up rates after discharge for a mental health hospitalization.ResultsThe pandemic cohort included 120 050 Medicare beneficiaries (mean [SD] age, 56.5 [14.5] years; 66 638 females [55.5%]) with serious mental illness. Compared with prepandemic changes and relative to patients receiving care at practices with the lowest telemedicine use: patients receiving care at practices in the middle and highest telemedicine use groups had 1.11 (95% CI, 0.45-1.76) and 1.94 (95% CI, 1.28-2.59) more mental health visits per patient per year (or 7.5% [95% CI, 3.0%-11.9%] and 13.0% [95% CI, 8.6%-17.4%] more mental health visits per year, respectively). Among patients of practices with middle and highest telemedicine use, changes in adherence to antipsychotic and mood-stabilizing medications were −0.4% (95% CI, −1.3% to 0.5%) and −0.1% (95% CI, −1.0% to 0.8%), and hospital and emergency department use for any reason changed by 2.4% (95% CI, −1.5% to 6.2%) and 2.8% (95% CI, −1.2% to 6.8%), respectively. There were no significant differential changes in postdischarge follow-up or mortality rates according to the level of telemedicine use.Conclusions and RelevanceIn this cohort study of Medicare beneficiaries with serious mental illness, patients receiving care from practices that had a higher level of telemedicine use during the COVID-19 pandemic had more mental health visits per year compared with prepandemic levels, with no differential changes in other observed quality metrics over the same period.

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What About Telepsychiatry?

Cited by 120 publications

References 22 publications

Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence

Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence

A telepsychiatry model to support psychiatric outreach in the public sector in South Africa

Use of Telemedicine and Quality of Care Among Medicare Enrollees With Serious Mental Illness

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