Literature Collection

9461

Telemedicine's Role in Addressing the Opioid Epidemic

Type: Journal Article

Authors: Y. T. Yang, E. Weintraub, R. L. Haffajee

Year: 2018

Publication Place: England

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9462

Telemental health: responding to mandates for reform in primary healthcare

Type: Journal Article

Authors: K. M. Myers, D. Lieberman

Year: 2013

Publication Place: United States

Abstract: Telemental health (TMH) has established a niche as a feasible, acceptable, and effective service model to improve the mental healthcare and outcomes for individuals who cannot access traditional mental health services. The Accountability Care Act has mandated reforms in the structure, functioning, and financing of primary care that provide an opportunity for TMH to move into the mainstream healthcare system. By partnering with the Integrated Behavioral Healthcare Model, TMH offers a spectrum of tools to unite primary care physicians and mental health specialist in a mind-body view of patients' healthcare needs and to activate patients in their own care. TMH tools include video-teleconferencing to telecommute mental health specialists to the primary care setting to collaborate with a team in caring for patients' mental healthcare needs and to provide direct services to patients who are not progressing optimally with this collaborative model. Asynchronous tools include online therapies that offer an efficient first step to treatment for selected disorders such as depression and anxiety. Patients activate themselves in their care through portals that provide access to their healthcare information and Web sites that offer on-demand information and communication with a healthcare team. These synchronous and asynchronous TMH tools may move the site of mental healthcare from the clinic to the home. The evolving role of social media in facilitating communication among patients or with their healthcare team deserves further consideration as a tool to activate patients and provide more personalized care.

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9463

Telephone assessment, support, and counseling for depression in primary care medical clinics.

Type: Journal Article

Authors: Christopher Sheldon, Jeanette A. Waxmonsky, Rachael Meir, Courtney Morris, Laura Finkelstein, Melissa Sosa, David Brody

Year: 2014

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9464

Telephone counseling as an adjunct to antidepressant treatment in the primary care system. A pilot study

Type: Journal Article

Authors: S. Tutty, G. Simon, E. Ludman

Year: 2000

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9465

Telephone counseling for physical activity and diet in primary care patients

Type: Journal Article

Authors: E. Eakin, M. Reeves, S. Lawler, N. Graves, B. Oldenburg, C. Del Mar, K. Wilke, E. Winkler, A. Barnett

Year: 2009

Publication Place: Netherlands

Abstract: BACKGROUND: The delivery of effective interventions to assist patients to improve their physical activity and dietary behaviors is a challenge in the busy primary care setting. DESIGN: Cluster RCT with practices randomized to telephone counseling intervention or usual care. Data collection took place from February 2005 to November 2007, with analysis from December 2007 to April 2008. SETTING/PARTICIPANTS: Four-hundred thirty-four adult patients with type 2 diabetes or hypertension (mean age=58.2 [SD=11.8]; 61% female; mean BMI=31.1 [SD=6.8]) from a disadvantaged community were recruited from ten primary care practices. INTERVENTION: Twelve-month telephone counseling intervention. MAIN OUTCOME MEASURES: Physical activity and dietary intake were assessed by self-report at baseline, 4, and 12 months. RESULTS: At 12 months, patients in both groups increased moderate-to-vigorous physical activity by a mean of 78 minutes per week (SE=10). Significant intervention effects (telephone counseling minus usual care) were observed for: calories from total fat (decrease of 1.17%; p<0.007), energy from saturated fat (decrease of 0.97%; p<0.007), vegetable intake (increase of 0.71 servings; p<0.039), fruit intake (increase of 0.30 servings; p<0.001), and grams of fiber (increase of 2.23 g; p<0.001). CONCLUSIONS: The study targeted a challenging primary care patient sample and, using a telephone-delivered intervention, demonstrated modest improvements in diet and in physical activity. Results suggest that telephone counseling is a feasible means of delivering lifestyle intervention to primary care patients with chronic conditions-patients whose need for ongoing support for lifestyle change is often beyond the capacity of primary healthcare practitioners.

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9466

Telephone delivered incentives for encouraging adherence to supervised methadone consumption (TIES): Study protocol for a feasibility study for an RCT of clinical and cost effectiveness

Type: Journal Article

Authors: N. Metrebian, T. Weaver, S. Pilling, K. Goldsmith, E. Carr, J. Shearer, K. Woolston-Thomas, B. Tas, C. A. Getty, C. Cooper, R. van der Waal, M. Kelleher, E. Finch, P. Bijral, D. Taylor, J. Scott, J. Strang

Year: 2019

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9467

Telephone enhancement of long-term engagement (TELE) in continuing care for substance abuse treatment: a NIDA clinical trials network (CTN) study

Type: Journal Article

Authors: R. L. Hubbard, J. D. Leimberger, L. Haynes, A. A. Patkar, J. Holter, M. R. Liepman, K. Lucas, B. Tyson, T. Day, E. A. Thorpe, B. Faulkner, A. Hasson, National Institute on Drug Abuse

Year: 2007

Publication Place: United States

Abstract: The TELE study examined the feasibility and potential efficacy of phone calls to patients after discharge from short- term inpatient and residential substance abuse treatment programs to encourage compliance with continuing care plans. After review of their continuing care plans, 339 patients from four programs were randomized either to receive calls or to have no planned contact. Ninety-two percent of patients randomized to receive calls received at least one call. No difference was found between groups in self-reported attendance at one or more outpatient counseling sessions after discharge (p = .89). When program records of all participants were examined, those receiving calls had a greater likelihood of documented attendance (48%) than those not called (37%). Results were not statistically significant (p < .003) because of the Hochberg correction for multiple tests. While the phone calls were feasible, the lack of clear evidence of efficacy of the calls suggests the need for further investigation of the role of telephone intervention to encourage compliance and improve outcomes.

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9468

Telephone interpersonal counseling treatment for frequent attenders to primary care: Development and piloting

Type: Journal Article

Authors: D. Sinai, D. Lassri, C. Spira, J. D. Lipsitz

Year: 2024

Abstract:

BACKGROUND: Frequent attenders in primary care (FAs) consume a disproportionate amount of healthcare resources and often have depression, anxiety, chronic health issues, and interpersonal problems. Despite extensive medical care, they remain dissatisfied with the care and report no improvement in quality of life. OBJECTIVE: To pilot a Telephone-based Interpersonal Counseling intervention for Frequent Attenders (TIPC-FA) and assess its feasibility and efficacy in reducing symptoms and healthcare utilization. METHOD: Top 10% of primary care visitors were randomly assigned to TIPC-FA, Telephone Supportive Contact (Support), or Treatment as Usual (TAU). TIPC-FA and Support groups received six telephone sessions over twelve weeks, while the TAU group was interviewed twice. Multilevel regression tested for changes over time, considering patient and counselor variance. RESULTS: TIPC-FA and Support groups demonstrated reduced depressive symptoms, and the TIPC-FA group showed decreased somatization and anxiety. The TIPC-FA group demonstrated a trend towards less healthcare utilization than the TAU group. CONCLUSION: This pilot study suggests that IPC via telephone outreach is a feasible approach to treating FAs, achieving a reduction in symptoms not seen in other groups. Promising reduction in healthcare utilization in the TIPC-FA group warrants further exploration in larger-scale trials.

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9469

Telephone psychotherapy and telephone care management for primary care patients starting antidepressant treatment: a randomized controlled trial

Type: Journal Article

Authors: G. E. Simon, E. J. Ludman, S. Tutty, B. Operskalski, M. Von Korff

Year: 2004

Publication Place: United States

Abstract: CONTEXT: Both antidepressant medication and structured psychotherapy have been proven efficacious, but less than one third of people with depressive disorders receive effective levels of either treatment. OBJECTIVE: To compare usual primary care for depression with 2 intervention programs: telephone care management and telephone care management plus telephone psychotherapy. DESIGN: Three-group randomized controlled trial with allocation concealment and blinded outcome assessment conducted between November 2000 and May 2002. SETTING AND PARTICIPANTS: A total of 600 patients beginning antidepressant treatment for depression were systematically sampled from 7 group-model primary care clinics; patients already receiving psychotherapy were excluded. INTERVENTIONS: Usual primary care; usual care plus a telephone care management program including at least 3 outreach calls, feedback to the treating physician, and care coordination; usual care plus care management integrated with a structured 8-session cognitive-behavioral psychotherapy program delivered by telephone. MAIN OUTCOME MEASURES: Blinded telephone interviews at 6 weeks, 3 months, and 6 months assessed depression severity (Hopkins Symptom Checklist Depression Scale and the Patient Health Questionnaire), patient-rated improvement, and satisfaction with treatment. Computerized administrative data examined use of antidepressant medication and outpatient visits. RESULTS: Treatment participation rates were 97% for telephone care management and 93% for telephone care management plus psychotherapy. Compared with usual care, the telephone psychotherapy intervention led to lower mean Hopkins Symptom Checklist Depression Scale depression scores (P =.02), a higher proportion of patients reporting that depression was "much improved" (80% vs 55%, P<.001), and a higher proportion of patients "very satisfied" with depression treatment (59% vs 29%, P<.001). The telephone care management program had smaller effects on patient-rated improvement (66% vs 55%, P =.04) and satisfaction (47% vs 29%, P =.001); effects on mean depression scores were not statistically significant. CONCLUSIONS: For primary care patients beginning antidepressant treatment, a telephone program integrating care management and structured cognitive-behavioral psychotherapy can significantly improve satisfaction and clinical outcomes. These findings suggest a new public health model of psychotherapy for depression including active outreach and vigorous efforts to improve access to and motivation for treatment.

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9470

Telephone-based psychiatric referral-care management intervention health outcomes.

Type: Journal Article

Authors: Faika Zanjani, Heather Bush, David Oslin

Year: 2010

Publication Place: US

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9471

Telephone-based psychiatry advice service for general practitioners

Type: Journal Article

Authors: S. E. Bradstock, A. J. Wilson, M. J. Cullen, K. L. Barwell

Year: 2005

Publication Place: Australia

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9472

Telephone-delivered cognitive-behavioral therapy for older, rural Veterans with depression and anxiety in home-based primary care

Type: Journal Article

Authors: Terri L. Barrera, Jeremy P. Cummings, Maria Armento, Jeffrey A. Cully, Amber Bush Amspoker, Nancy L. Wilson, Michael J. Mallen, Srijana Shrestha, Mark E. Kunik, Melinda A. Stanley

Year: 2017

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9473

Telephone-delivered collaborative care for treating post-CABG depression: a randomized controlled trial

Type: Journal Article

Authors: B. L. Rollman, B. H. Belnap, M. S. LeMenager, S. Mazumdar, P. R. Houck, P. J. Counihan, W. N. Kapoor, H. C. Schulberg, C. F. Reynolds

Year: 2009

Abstract: Abstract. CONTEXT: Depressive symptoms commonly follow coronary artery bypass graft (CABG) surgery and are associated with less positive clinical outcomes.OBJECTIVE: To test the effectiveness of telephone-delivered collaborative care for post-CABG depression vs usual physician care. DESIGN, SETTING, AND PARTICIPANTS: Single-blind effectiveness trial at 7 university-based and community hospitals in or near Pittsburgh, Pennsylvania. Participants were 302 post-CABG patients with depression (150, intervention; 152, usual care) and a comparison group of 151 randomly sampled post-CABG patients without depression recruited between March 2004 and September 2007 and observed as outpatients until June 2008. INTERVENTION: Eight months of telephone-delivered collaborative care provided by nurses working with patients' primary care physicians and supervised by a psychiatrist and primary care physician from this study. MAIN OUTCOME MEASURES: Mental health-related quality of life (HRQL) measured by the Short Form-36 Mental Component Summary (SF-36 MCS) at 8-month follow-up; secondary outcome measures included assessment of mood symptoms (Hamilton Rating Scale for Depression [HRS-D]), physical HRQL (SF-36 PCS), and functional status (Duke Activity Status Index [DASI]); and hospital readmissions. RESULTS: The intervention patients reported greater improvements in mental HRQL (all P < or = .02) (SF-36 MCS: Delta, 3.2 points; 95% confidence interval [CI], 0.5-6.0), physical functioning (DASI: Delta, 4.6 points; 95% CI, 1.9-7.3), and mood symptoms (HRS-D: Delta, 3.1 points; 95% CI, 1.3-4.9); and were more likely to report a 50% or greater decline in HRS-D score from baseline (50.0% vs 29.6%; number needed to treat, 4.9 [95% CI, 3.2-10.4]) than usual care patients (P < .001). Men with depression were particularly likely to benefit from the intervention (SF-36 MCS: Delta, 5.7 points; 95% CI, 2.2-9.2; P = .001). However, the mean HRQL and physical functioning of intervention patients did not reach that of the nondepressed comparison group. CONCLUSION: Compared with usual care, telephone-delivered collaborative care for treatment of post-CABG depression resulted in improved HRQL, physical functioning, and mood symptoms at 8-month follow-up.

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9474

Telephone-Delivered Stepped Collaborative Care for Treating Anxiety in Primary Care: A Randomized Controlled Trial

Type: Journal Article

Authors: B. L. Rollman, B. H. Belnap, S. Mazumdar, K. Z. Abebe, J. F. Karp, E. J. Lenze, H. C. Schulberg

Year: 2017

Publication Place: United States

Abstract: BACKGROUND: Collaborative care for depression is more effective in improving treatment outcomes than primary care physicians' (PCPs) usual care (UC). However, few trials of collaborative care have targeted anxiety. OBJECTIVE: To examine the impact and 12-month durability of a centralized, telephone-delivered, stepped collaborative care intervention (CC) for treating anxiety disorders across a network of primary care practices. DESIGN: Randomized controlled trial with blinded outcome assessments. PARTICIPANTS: A total of 329 patients aged 18-64 referred by their PCPs in response to an electronic medical record (EMR) prompt. They include 250 highly anxious patients randomized to either CC or to UC, and 79 moderately anxious patients who were triaged to a watchful waiting (WW) cohort and later randomized if their conditions clinically deteriorated. INTERVENTION: Twelve months of telephone-delivered CC involving non-mental health professionals who provided patients with basic psycho-education, assessed preferences for guideline-based pharmacotherapy, monitored treatment responses, and informed PCPs of their patients' care preferences and progress via the EMR. MAIN MEASURES: Mental health-related quality of life ([HRQoL]; SF-36 MCS); secondary outcomes: anxiety (Hamilton Anxiety Rating Scale [SIGH-A], Panic Disorder Severity Scale) and mood (PHQ-9). KEY RESULTS: At 12-month follow-up, highly anxious patients randomized to CC reported improved mental HRQoL (effect size [ES]: 0.38 [95 % CI: 0.13-0.63]; P = 0.003), anxiety (SIGH-A ES: 0.30 [0.05-0.55]; P = 0.02), and mood (ES: 0.45 [0.19-0.71] P = 0.001) versus UC. These improvements were sustained for 12 months among African-Americans (ES: 0.70-1.14) and men (ES: 0.43-0.93). Of the 79 WW patients, 29 % met severity criteria for randomization, and regardless of treatment assignment, WW patients reported fewer anxiety and mood symptoms and better mental HRQoL over the full 24-month follow-up period than highly anxious patients who were randomized at baseline. CONCLUSIONS: Telephone-delivered, centralized, stepped CC improves mental HRQoL, anxiety and mood symptoms. These improvements were durable and particularly evident among those most anxious at baseline, and among African-Americans and men.

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9475

Telephone-facilitated treatment of depression in primary care using the PHQ-9

Type: Journal Article

Authors: Gary J. Kennedy

Year: 2004

Publication Place: Inc

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9476

Telepsychiatric Consultation as a Training and Workforce Development Strategy for Rural Primary Care

Type: Journal Article

Authors: Al Achkar, I. M. Bennett, L. Chwastiak, T. Hoeft, T. Normoyle, M. Vredevoogd, D. G. Patterson

Year: 2020

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9477

Telepsychiatry and integrated primary care: setting expectations and creating an effective process for success

Type: Journal Article

Authors: J. Calderone, A. Lopez, S. Schwenk, J. Yager, J. H. Shore

Year: 2020

Abstract:

Telepsychiatry, especially in the form of live interactive videoconferencing, has greatly advanced the availability and use of specialist psychiatric consultations in primary care settings. Nevertheless, reliance on telepsychiatry, with corresponding decreases in direct face-to-face interaction between primary care providers and psychiatrists, can create unique challenges such as reducing the availability of non-verbal cues, and preventing the informal interactions that are so necessary for clarifying clinical and process details and for building essential team-based trust and rapport. Written from the perspective of an integrated psychiatrist, this article offers recommendations for a formal process to optimize virtual care coordination by setting clear expectations and providing communication tools for an effective and efficient telepsychiatry enabled integrated service.

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9478

Telepsychiatry and other technologies for integrated care: evidence base, best practice models and competencies

Type: Journal Article

Authors: D. M. Hilty, N. Sunderji, S. Suo, S. Chan, R. M. McCarron

Year: 2018

Publication Place: England

Abstract: Telehealth facilitates integrated, patient-centred care. Synchronous video, telepsychiatry (TP), or telebehavioural health provide outcomes as good as in-person care. It also improves access to care, leverages expertise at a distance, and is effective for education and consultation to primary care. Other technologies on an e-behavioural health spectrum are also useful, like telephone, e-mail, text, and e-consults. This paper briefly organizes these technologies into low, mid and high intensity telehealth models and reviews the evidence base for interventions to primary care, and, specifically, for TP and integrated care (IC). Technology, mobile health, and IC competencies facilitate quality care. TP is a high intensity model and it is the best-studied option. Studies of IC are preliminary, but those with collaborative and consultative care show effectiveness. Low- and mid-intensity technology options like telephone, e-mail, text, and e-consults, may provide better access for patients and more timely provider communication and education. They are also probably more cost-effective and versatile for health system workflow. Research is needed upon all technology models related to IC for adult and paediatric primary care populations. Effective healthcare delivery matches the patients' needs with the model, emphasizes clinician competencies, standardizes interventions, and evaluates outcomes.

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9479

Telepsychiatry appointments in a continuing care setting: kept, cancelled and no-shows

Type: Journal Article

Authors: H. Leigh, H. Cruz, R. Mallios

Year: 2009

Publication Place: England

Abstract: We reviewed the appointment data for a psychiatry service in California that provided consultations and also therapy through telepsychiatry. Over an 18-month period, there were 7523 telepsychiatry appointments and 115,148 conventional (face-to-face) appointments. A higher proportion of the telepsychiatry appointments was kept (92% telepsychiatry vs. 87% non-telepsychiatry). Also, telepsychiatry appointments were significantly less likely to be cancelled by patients (3.5% vs. 4.8%) and significantly less likely to be no-shows (4.2% vs. 7.8%). These findings were similar in three of the four counties where the service was delivered. However, one county was different, and further examination suggested that the morale of the staff and patients may have contributed to the unenthusiastic acceptance of telepsychiatry. We conclude that telepsychiatry can be used effectively in continuing care settings as well as in evaluation settings, and that staff and patient morale are important factors in successful telepsychiatry.

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9480

Telepsychiatry for Children Improved Symptoms, Halved ED Visits

Type: Web Resource

Authors: H. Splete

Year: 2012

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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