Monica K Lieng1,2, Magi S Aurora3,4, Young Kang2,5, Joseph M Kim3,5, James P Marcin1, Steven R Chan3,6, Jamie L Mouzoon1, Daniel J Tancredi1, Michelle Parish3, Alvaro D Gonzalez3, Lorin Scher3, Glen Xiong3, Robert M McCarron7, Peter Yellowlees3. 1. Department of Pediatrics, Center for Health and Technology, University of California Davis Health, Sacramento, California, USA. 2. School of Medicine, University of California Davis Health, Sacramento, California, USA. 3. Department of Psychiatry, Center for Health and Technology, University of California Davis Health, Sacramento, California, USA. 4. Department of Family Medicine, Center for Health and Technology, University of California Davis Health, Sacramento, California, USA. 5. Department of Internal Medicine, Center for Health and Technology, University of California Davis Health, Sacramento, California, USA. 6. Veterans Health Administration, Palo Alto Health Care System, Palo Alto, California, USA. 7. School of Medicine, University of California Irvine, Irvine, California, USA.
Abstract
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.
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.
Entities:
Keywords:
collaborative care; community psychiatry; mental health services; remote consultation; telemedicine; telepsychiatry
Authors: Peter M Yellowlees; Alberto Odor; Ana-Maria Iosif; Michelle Burke Parish; Najia Nafiz; Kesha Patrice; Glen Xiong; Robert McCaron; Richard Sanchez; Enrique Ochoa; Donald Hilty Journal: Telemed J E Health Date: 2013-03-01 Impact factor: 3.536
Authors: Margaret Lowenstein; Olusinmi Bamgbose; Nathaniel Gleason; Mitchell D Feldman Journal: J Med Internet Res Date: 2017-08-04 Impact factor: 5.428
Authors: Peter M Yellowlees; Michelle Burke Parish; Alvaro D Gonzalez; Steven R Chan; Donald M Hilty; Byung-Kwang Yoo; Paul Leigh; Robert M McCarron; Lorin M Scher; Andres F Sciolla; Jay Shore; Glen Xiong; Katherine M Soltero; Alice Fisher; Jeffrey R Fine; Jennifer Bannister; Ana-Maria Iosif Journal: J Med Internet Res Date: 2021-05-16 Impact factor: 5.428