Digitally enabled asynchronous remote medical management of anxiety and depression: A cohort study.
| Autor: | Perlman A; K Health Inc, New York, NY, USA.; Faculty of Medicine, Institute for Drug Research, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel., Pickman Y; K Health Inc, New York, NY, USA., Dreyfuss M; K Health Inc, New York, NY, USA., Manes I; K Health Inc, New York, NY, USA., Bak P; K Health Inc, New York, NY, USA., Souroujon D; K Health Inc, New York, NY, USA., Paz E; K Health Inc, New York, NY, USA., Ebbert JO; Mayo Clinic, Rochester, MN, USA., Zeltzer D; Berglas School of Economics, Tel Aviv University, Tel Aviv, Israel. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of telemedicine and telecare [J Telemed Telecare] 2024 Mar 14, pp. 1357633X241233788. Date of Electronic Publication: 2024 Mar 14. |
| DOI: | 10.1177/1357633X241233788 |
| Abstrakt: | Objective: To evaluate the clinical outcomes of a remote mental health program for managing anxiety and depression, primarily using asynchronous digital communication. Methods: This retrospective cohort study examined U.S. adults seeking remote care for anxiety and depression from January 2021 to May 2022. The program involves clinician-led assessment, patient education, medication management, and ongoing monitoring, primarily via text. Anxiety and depression were measured using Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scores. Outcomes examined were changes in scores, 50% score improvement rate, and remission rate (score <5) at 1, 3, and 6 months. Results: During the period evaluated, 11,844 program participants met the inclusion criteria. Most were female (n = 8328, 70.3%); their age ranged from 18-82 years (median 31 years). At baseline, median PHQ-9 and GAD-7 scores were 13 (IQR 9-17); 67% and 69% met score criteria for depression and anxiety, respectively. Most participants (80%) were prescribed a selective serotonin reuptake inhibitor (SSRI). By one month, average PHQ-9 and GAD-7 scores decreased significantly by 9.2 and 9.1 points (both p < .01). At 1-month follow-up, the 50% score improvement rate was 66% for PHQ-9 and 69% GAD-7 ( p < .01). Scores continued to decrease with follow-up. At 3 months, over half achieved remission (percent [95% CI]: 52% [51-54] for anxiety, 53% [52-55] for depression). Similar improvement was observed at 6 months and in sensitivity analyses accounting for loss to follow-up. Conclusions: Use of a remote mental health program with digital tools was associated with significant clinical improvement in anxiety and depression. Challenges remain in maintaining patient engagement and ensuring appropriate care quality monitoring in digital mental health programs. Additional research comparing remote digital care to traditional in-person models is warranted. Studies should examine long-term outcomes, optimal care protocols, and the challenges to integrating these programs into existing healthcare systems and ensuring equitable access. Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors were employees or paid consultants of K Health Inc. during the development and conduct of this study. |
| Databáze: | MEDLINE |
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