Review of key telepsychiatry outcomes  

作　　者：Sam Hubley Sarah B Lynch Christopher Schneck Marshall Thomas Jay Shore 

机构地区：[1]Helen and Arthur E Johnson Depression Center,Department of Family Medicine [2]Department of Clinical Health Psychology,University of Colorado Denver

出　　处：《World Journal of Psychiatry》2016年第2期269-282,共14页世界精神病学杂志

摘　　要：AIM: To conduct a review of the telepsychiatry literature.METHODS: We conducted a systematic search of the literature on telepsychiatry using the search terms, "telepsychiatry", "telemental health", "telecare", "telemedicine", "e-health", and "videoconferencing". To meet criteria for inclusion, studies had to:(1) be published in a peer-reviewed journal after the year 2000;(2) be written in English;(3) use videoconferencing technology for the provision of mental health assessment or treatment services; and(4) use an adequately-powered randomized controlled trial design in the case of treatment outcome studies. Out of 1976 studies identified by searches in Pub Med(Medline database), Ovid medline, Psych Info, Embase, and EBSCO PSYCH, 452 met inclusion criteria. Studies that met all inclusion criteria were organized into one of six categories:(1) satisfaction;(2) reliability;(3) treatment outcomes;(4) implementation outcomes;(5) cost effectiveness; and(6) and legal issues. All disagreements were resolved by reassessing study characteristics and discussion.RESULTS: Overall, patients and providers are generally satisfied with telepsychiatry services. Providers, however, tend to express more concerns about the potentially adverse of effects of telepsychiatry on therapeutic rapport. Patients are less likely to endorse such concerns about impaired rapport with their provider. Although few studies appropriately employ non-inferiority designs, the evidence taken together suggests that telepsychiatry is comparable to face-to-face services in terms of reliability of clinical assessments and treatment outcomes. When non-inferiority designs were appropriately used, telepsychiatry performed as well as, if not better than face-to-face delivery of mental health services. Studies using both rudimentary and more sophisticated methods for evaluating cost-effectiveness indicate that telepsychiatry is not more expensive than face-to-face delivery of mental health services and that telepsychiatry is actually more cost-effective in the mAIM: To conduct a review of the telepsychiatry literature.METHODS: We conducted a systematic search of the literature on telepsychiatry using the search terms, "telepsychiatry", "telemental health", "telecare", "telemedicine", "e-health", and "videoconferencing". To meet criteria for inclusion, studies had to:(1) be published in a peer-reviewed journal after the year 2000;(2) be written in English;(3) use videoconferencing technology for the provision of mental health assessment or treatment services; and(4) use an adequately-powered randomized controlled trial design in the case of treatment outcome studies. Out of 1976 studies identified by searches in Pub Med(Medline database), Ovid medline, Psych Info, Embase, and EBSCO PSYCH, 452 met inclusion criteria. Studies that met all inclusion criteria were organized into one of six categories:(1) satisfaction;(2) reliability;(3) treatment outcomes;(4) implementation outcomes;(5) cost effectiveness; and(6) and legal issues. All disagreements were resolved by reassessing study characteristics and discussion.RESULTS: Overall, patients and providers are generally satisfied with telepsychiatry services. Providers, however, tend to express more concerns about the potentially adverse of effects of telepsychiatry on therapeutic rapport. Patients are less likely to endorse such concerns about impaired rapport with their provider. Although few studies appropriately employ non-inferiority designs, the evidence taken together suggests that telepsychiatry is comparable to face-to-face services in terms of reliability of clinical assessments and treatment outcomes. When non-inferiority designs were appropriately used, telepsychiatry performed as well as, if not better than face-to-face delivery of mental health services. Studies using both rudimentary and more sophisticated methods for evaluating cost-effectiveness indicate that telepsychiatry is not more expensive than face-to-face delivery of mental health services and that telepsychiatry is actually more cost-effective in the m

关 键 词：TELEPSYCHIATRY Telemental HEALTH VIDEOCONFERENCING Treatment ACCESS Implementation 

分 类 号：B849[哲学宗教—应用心理学] R-05[哲学宗教—心理学]