Mental health specialist video consultations for patients with depression or anxiety disorders in primary care: protocol for a randomised controlled feasibility trial.
feasibility
mental health
primary care
telemedicine
video consultations
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
04 09 2019
04 09 2019
Historique:
entrez:
7
9
2019
pubmed:
7
9
2019
medline:
2
10
2020
Statut:
epublish
Résumé
Most people suffering from depression and anxiety disorders are entirely treated in primary care. Due to growing challenges in ageing societies, for example, patients' immobility and multimorbidity, the transition to specialised care becomes increasingly difficult. Although the co-location of general practitioners and mental health specialists improves the access to psychosocial care, integrated in-person approaches are not practical for rural and single-doctor practices with limited personnel and financial resources. Treating primary care patients via internet-based video consultations by remotely located mental health specialists bears the potential to overcome structural barriers and provide low-threshold care. The aim of this randomised controlled feasibility trial is to investigate the feasibility of implementing of mental health specialist video consultations in primary care practices. Fifty primary care patients with significant depression and/or anxiety symptomatology will be randomised in two groups receiving either the treatment as usual as provided by their general practitioner or up to five video consultations conducted by a mental health specialist. The video consultations focus on (1) systematic diagnosis plus proactive monitoring using validated clinical rating scales, (2) the establishment of an effective working alliance and (3) a stepped-care algorithm within integrated care adjusting treatments based on clinical outcomes. We will investigate the following outcomes: effectiveness of the recruitment strategies, patient acceptance of randomisation, practicability of the technical and logistical processes related to implementing video consultations in the practices' workflows, feasibility of the data collection and clinical parameters. This trial has undergone ethical scrutiny and has been approved by the Medical Faculty of the University of Heidelberg Ethics Committee (S-634/2018). The findings will be disseminated to the research community through presentations at conferences and publications in scientific journals. This feasibility trial will prepare the ground for a large-scale, fully powered randomised controlled trial. DRKS00015812.
Identifiants
pubmed: 31488484
pii: bmjopen-2019-030003
doi: 10.1136/bmjopen-2019-030003
pmc: PMC6731787
doi:
Banques de données
DRKS
['DRKS00015812']
Types de publication
Clinical Trial Protocol
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e030003Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
J Psychosom Res. 2002 Oct;53(4):849-57
pubmed: 12377293
Behav Healthc Tomorrow. 2004 Apr;13(2):10-2, 15-6
pubmed: 15119120
Diabetes Care. 2005 Nov;28(11):2655-61
pubmed: 16249535
J Gen Intern Med. 2007 Aug;22(8):1086-93
pubmed: 17492326
Lancet. 2007 Sep 8;370(9590):851-8
pubmed: 17826170
BMJ. 2008 Sep 29;337:a1655
pubmed: 18824488
Health Aff (Millwood). 2009 May-Jun;28(3):w490-501
pubmed: 19366722
Eur J Health Econ. 2005 Jun;6(2):124-30
pubmed: 19787848
Health Aff (Millwood). 2009 Nov-Dec;28(6):w1171-83
pubmed: 19884491
Gen Hosp Psychiatry. 2010 Jul-Aug;32(4):345-59
pubmed: 20633738
Clin Rehabil. 2011 Mar;25(3):264-74
pubmed: 20971749
J Clin Epidemiol. 2012 Mar;65(3):301-8
pubmed: 22169081
Depress Anxiety. 2012 Sep;29(9):749-53
pubmed: 22949272
BMJ. 2013 Jan 08;346:e7586
pubmed: 23303884
Am J Psychiatry. 2013 Apr;170(4):414-25
pubmed: 23429924
Am J Psychiatry. 2013 Mar;170(3):256-62
pubmed: 23450286
Telemed J E Health. 2013 Sep;19(9):722-30
pubmed: 23909884
Lancet. 2013 Nov 9;382(9904):1575-86
pubmed: 23993280
Am Psychol. 2013 Dec;68(9):791-800
pubmed: 24341643
BMJ. 2014 Mar 07;348:g1687
pubmed: 24609605
PLoS One. 2014 Sep 29;9(9):e108114
pubmed: 25264616
Ann Fam Med. 2015 Jan-Feb;13(1):56-68
pubmed: 25583894
PLoS One. 2015 Feb 06;10(2):e0116820
pubmed: 25658103
Clin Psychol Rev. 2015 Aug;40:91-110
pubmed: 26094079
Ann Intern Med. 2015 Aug 18;163(4):298-9
pubmed: 26121401
Int Rev Psychiatry. 2015;27(6):469-75
pubmed: 26397182
Psychosom Med. 2016 Jan;78(1):5-12
pubmed: 26461855
Int Rev Psychiatry. 2015;27(6):476-89
pubmed: 26493089
Telemed J E Health. 2016 Feb;22(2):87-113
pubmed: 26624248
Int Rev Psychiatry. 2015;27(6):525-39
pubmed: 26634618
Eur Psychiatry. 2017 Mar;41:60-67
pubmed: 28049083
Psychiatr Prax. 2018 Mar;45(2):87-94
pubmed: 28125848
Dtsch Arztebl Int. 2017 Oct 27;114(43):721-728
pubmed: 29143731
J Clin Psychol Med Settings. 2018 Jun;25(2):187-196
pubmed: 29234927
J Clin Psychol Med Settings. 2018 Jun;25(2):109-126
pubmed: 29480434
Psychosomatics. 2018 May - Jun;59(3):227-250
pubmed: 29544663
Telemed J E Health. 2018 Nov;24(11):827-832
pubmed: 30358514
BMC Med Res Methodol. 2018 Nov 15;18(1):135
pubmed: 30442094
J Clin Psychol. 2019 Feb;75(2):260-270
pubmed: 30589440
J Affect Disord. 2019 Feb 15;245:1168-1186
pubmed: 30699860
Int Rev Psychiatry. 2018 Dec;30(6):292-309
pubmed: 30821540
Psychother Psychosom Med Psychol. 2019 Jul 17;:null
pubmed: 31315140
J Med Internet Res. 2019 Aug 19;21(8):e13382
pubmed: 31429419