Treatment outcomes in depression: Comparison of remote treatment through telepsychiatry to in-person treatment
Treatment outcomes in depression: Comparison of remote treatment through telepsychiatry to in-person treatment
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DOI：
10.1176/appi.ajp.161.8.1471
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发表时间：
2004-08-01
影响因子：
17.7
通讯作者：
Hauser, P
中科院分区：
文献类型：
--
作者：
Ruskin, PE;Silver-Aylaian, M;Hauser, P
目的：远程精神治疗是一种越来越普遍的提供精神病护理的方法，但远程精神治疗与面对面治疗相比的随机试验尚未完成。本研究的主要目的是比较抑郁症患者的治疗结果，通过远程精神病学治疗的抑郁症患者的人治疗的结果。次要目标是确定患者的坚持率和治疗满意度是一样高的远程精神病学与在人的治疗和远程精神病学治疗的费用比较成本在人的treatment.Method：在这个随机对照试验中，119抑郁症退伍军人转介门诊治疗被随机分配到远程治疗的远程精神病学或在人的治疗。精神科治疗持续6个月，包括精神药物，心理教育和简短的支持性咨询。患者的治疗结果，满意度，依从性和治疗费用进行了比较，两个conditions.Results：汉密尔顿抑郁量表和贝克抑郁量表评分在治疗期间改善，并没有治疗组之间的差异。两组患者均坚持预约和药物治疗。两组之间在退出率和患者对治疗的满意度方面没有差异。远程精神病学每次治疗的费用更高，但如果考虑到精神科医生前往距离医疗中心超过22英里的偏远诊所的费用，这种差异就消失了。Telepsychiatry并没有增加整体的医疗资源消耗的patients在study period.Conclusions：远程治疗抑郁症的手段telepsychiatry和人治疗抑郁症有可比的结果和同等水平的患者依从性，患者满意度，和医疗保健成本。
Objective: Telepsychiatry is an increasingly common method of providing psychiatric care, but randomized trials of telepsychiatric treatment compared to in-person treatment have not been done. The primary objective of this study was to compare treatment outcomes of patients with depressive disorders treated remotely by means of telepsychiatry to outcomes of depressed patients treated in person. Secondary objectives were to determine if patients' rates of adherence to and satisfaction with treatment were as high with telepsychiatric as with in-person treatment and to compare costs of telepsychiatric treatment to costs of in-person treatment.Method: In this randomized, controlled trial, 119 depressed veterans referred for outpatient treatment were randomly assigned to either remote treatment by means of telepsychiatry or in-person treatment. Psychiatric treatment lasted 6 months and consisted of psychotropic medication, psychoeducation, and brief supportive counseling. Patients' treatment outcomes, satisfaction, and adherence and the costs of treatment were compared between the two conditions.Results: Hamilton Depression Rating Scale and Beck Depression inventory scores improved over the treatment period and did not differ between treatment groups. The two groups were equally adherent to appointments and medication treatment. No between-group differences in dropout rates or patients' ratings of satisfaction with treatment were found. Telepsychiatry was more expensive per treatment session, but this difference disappeared if the costs of psychiatrists' travel to remote clinics more than 22 miles away from the medical center were considered. Telepsychiatry did not increase the overall health care resource consumption of the patients during the study period.Conclusions: Remote treatment of depression by means of telepsychiatry and in-person treatment of depression have comparable outcomes and equivalent levels of patient adherence, patient satisfaction, and health care cost.