Ten Years of Bipolar Telehealth: Program Evaluation of a Team-Based Telemental Health Clinic.

IF 2.8 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Telemedicine and e-Health Pub Date : 2024-10-18 DOI:10.1089/tmj.2024.0411
Nathan R Stein, Kelly L Stolzmann, Erica A Abel, Claire M Burgess, Aleda Franz, Samantha L Connolly, Nathaniel Meshberg, Hannah M Bailey, David N Osser, Eric G Smith, Mark S Bauer, Linda Godleski, Christopher J Miller
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Abstract

Objectives: Telemental health via videoconferencing (TMH-V) can overcome many of the barriers to accessing quality mental health care. Toward this end, in 2011, the U.S. Department of Veterans Affairs (VA) established the National Bipolar Disorders TeleHealth (BDTH) Program to provide expert mental health consultation and treatment to Veterans with bipolar spectrum disorders. Methods: Initial analyses of BDTH services suggested that participants had positive changes in quality-of-care indices and clinical outcomes; however, that evaluation was based on a limited sample of both participants and VA medical centers. We were able to confirm and expand upon those early results by using nearly eight times the number of participants and more than twice as many medical centers. Results: For the 2,456 Veterans who completed the intake to our program, there were significant improvements in some of the quality metrics (e.g., lithium use) and a 54% reduction in positive suicide screens (p < 0.05). The Veterans who completed the initial and postprogram assessments (n = 815) reported a 16.6% reduction in manic symptoms (p < 0.001), a 29.3% reduction in depressive symptoms (p < 0.001), and a 21.2% reduction in mood episodes (p < 0.001). Additionally, these Veterans demonstrated significant improvements (p < 0.001) in mental health-related quality of life between the two assessments. Conclusions: These analyses provide further support for the general effectiveness and safety of telemental health via videoconferencing. Future research should examine the generalizability of these findings across various subgroups (e.g., minority patients, patients in rural areas), populations, and health care systems.

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躁郁症远程医疗十年:基于团队的远程医疗诊所项目评估。
目标:通过视频会议进行远程心理健康(TMH-V)可以克服许多获得优质心理健康护理的障碍。为此,美国退伍军人事务部(VA)于 2011 年设立了国家双相情感障碍远程保健(BDTH)项目,为患有双相情感谱系障碍的退伍军人提供专业的心理健康咨询和治疗。方法:对 BDTH 服务的初步分析表明,参与者在护理质量指标和临床结果方面都发生了积极的变化;然而,该评估是基于参与者和退伍军人医疗中心的有限样本进行的。通过使用近八倍的参与者和两倍多的医疗中心,我们证实并扩大了这些早期结果。结果:对于 2456 名完成了我们项目入门的退伍军人来说,一些质量指标(如锂的使用)有了显著改善,自杀筛查阳性率降低了 54%(P < 0.05)。完成项目初期和后期评估的退伍军人(n = 815)报告称,躁狂症状减少了 16.6%(p < 0.001),抑郁症状减少了 29.3%(p < 0.001),情绪发作减少了 21.2%(p < 0.001)。此外,在两次评估之间,这些退伍军人的心理健康相关生活质量也有显著改善(p < 0.001)。结论:这些分析进一步证明了通过视频会议进行远程医疗的普遍有效性和安全性。未来的研究应考察这些发现在不同亚群(如少数民族患者、农村地区患者)、人群和医疗保健系统中的普遍性。
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来源期刊
Telemedicine and e-Health
Telemedicine and e-Health 医学-卫生保健
CiteScore
8.80
自引率
6.40%
发文量
270
审稿时长
2.3 months
期刊介绍: Telemedicine and e-Health is the leading peer-reviewed journal for cutting-edge telemedicine applications for achieving optimal patient care and outcomes. It places special emphasis on the impact of telemedicine on the quality, cost effectiveness, and access to healthcare. Telemedicine applications play an increasingly important role in health care. They offer indispensable tools for home healthcare, remote patient monitoring, and disease management, not only for rural health and battlefield care, but also for nursing home, assisted living facilities, and maritime and aviation settings. Telemedicine and e-Health offers timely coverage of the advances in technology that offer practitioners, medical centers, and hospitals new and innovative options for managing patient care, electronic records, and medical billing.
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