Primary Care Physician Adherence to Telepsychiatry Recommendations: Intermediate Outcomes from a Randomized Clinical Trial
| Autor: | Lorin M Scher, Peter Mackinlay Yellowlees, Alvaro Gonzalez, Robert M McCarron, Joseph M. Kim, Jamie L. Mouzoon, Young Soo Kang, Daniel J. Tancredi, Monica K. Lieng, Magi S. Aurora, Steven Chan, James P. Marcin, Glen Xiong, Michelle Burke Parish |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Telemedicine Biomedical Engineering telepsychiatry Collaborative Care Health Informatics Primary care Physicians Primary Care law.invention Adenosine Triphosphate Library and Information Studies Health Information Management Randomized controlled trial Clinical Research law Physicians collaborative care Humans Medicine remote consultation Referral and Consultation Primary Care Original Research Psychiatry Remote Consultation business.industry Telepsychiatry Primary care physician mental health services General Medicine Good Health and Well Being community psychiatry Family medicine Public Health and Health Services business Medical Informatics |
| Zdroj: | Telemed J E Health Telemedicine journal and e-health : the official journal of the American Telemedicine Association, vol 28, iss 6 |
| ISSN: | 1556-3669 1530-5627 |
| DOI: | 10.1089/tmj.2021.0389 |
| Popis: | OBJECTIVE: To compare clinical recommendations given by psychiatrists and the adherence to these recommendations by primary care physicians (PCP) following consultations conducted by asynchronous telepsychiatry (ATP) and synchronous telepsychiatry (STP). MATERIALS AND METHODS: ATP and STP consultations were compared using intermediate data from a randomized clinical trial with adult participant enrollment between April 2014 and December 2017. In both study arms, PCPs received written recommendations from the psychiatrist after each encounter. Independent clinicians reviewed PCP documentation to measure adherence to those recommendations in the 6 months following the baseline consultation. RESULTS: Medical records were reviewed for 645 psychiatrists’ consult recommendations; 344 from 61 ATP consultations and 301 from 62 STP consultations. Of those recommendations, 191 (56%) and 173 (58%) were rated fully adherent by two independent raters for ATP and STP, respectively. In a multilevel ordinal logistic regression model adjusted for recommendation type and recommended implementation timing, there was no statistically significant difference in adherence to recommendations for ATP compared with STP (adjusted odds ratio = 0.91, 95% confidence interval = 0.51–1.62). The profiles of recommendation type were comparable between ATP and STP. CONCLUSIONS: This is the first PCP adherence study comparing two forms of telemedicine. Although we did not find evidence of a difference between ATP and STP; this study supports the feasibility and acceptability of ATP and STP for the provision of collaborative psychiatric care. Clinical Trial Identifier NCT02084979. |
| Databáze: | OpenAIRE |
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