Team-Based Telecare for Bipolar Disorder
| Autor: | Cynthia Brandt, Lois Krawczyk, Christopher J. Miller, Erica A. Abel, Meghan Rooney, Aleda Franz, Linda Godleski, David N. Osser, Jerry Fleming, Mark S. Bauer |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Program evaluation Telemedicine Bipolar Disorder Collaborative Care Health Informatics Telehealth 03 medical and health sciences Patient safety 0302 clinical medicine Health Information Management Nursing Humans Medicine 030212 general & internal medicine Cooperative Behavior Veterans Affairs Aged Quality Indicators Health Care Aged 80 and over Patient Care Team Chronic care business.industry Telecare General Medicine Middle Aged United States 030227 psychiatry United States Department of Veterans Affairs Videoconferencing Female business Program Evaluation |
| Zdroj: | Telemedicine and e-Health. 22:855-864 |
| ISSN: | 1556-3669 1530-5627 |
| DOI: | 10.1089/tmj.2015.0255 |
| Popis: | Numerous randomized controlled trials indicate that collaborative chronic care models improve outcome in a wide variety of mental health conditions, including bipolar disorder. However, their spread into clinical practice is limited by the need for a critical mass of patients and specialty providers in the same locale. Clinical videoconferencing has the potential to overcome these geographic limitations.A videoconference-based collaborative care program for bipolar disorder was implemented in the Department of Veterans Affairs. Program evaluation assessed experience with the first 400 participants, guided by five domains specified by the American Telemedicine Association: treatment engagement, including identification of subpopulations at risk for not being reached; participation in treatment; clinical impact; patient safety; and quality of care.Participation rates resembled those for facility-based collaborative care. No participant characteristics predicted nonengagement. Program completers demonstrated significant improvements in several clinical indices, without evidence of compromise in patient safety. Guideline-based quality of care assessment after 1 year indicated increased lithium use, decreased antidepressant use, and increased prazosin use in individuals with comorbid post-traumatic stress disorder, but no impact on already high rates of lithium serum level monitoring.Clinical videoconferencing can extend the reach of collaborative care models for bipolar disorder. The next step involves assessment of the videoconference-based collaborative care for other serious mental health conditions, investigation of barriers and facilitators of broad implementation of the model, and evaluation of the business case for deployment and sustainability in clinical practice. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|