Integrating assisted tele-psychiatry into primary healthcare in Goa, India: a feasibility study.
Integrating assisted tele-psychiatry into primary healthcare in Goa, India: a feasibility study.
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DOI：
10.1017/gmh.2021.47
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Nadkarni, Abhijit
中科院分区：
文献类型：
--
作者：
Garg, Ankur;Agrawal, Ravindra;Velleman, Richard;Rane, Anil;Costa, Sheina;Gupta, Devika;Dsouza, Ethel;Jambhale, Abhijeet;Sabnis, Akshada;Fernandes, Godwin;Bhatia, Urvita;Nadkarni, Abhijit
远程精神病学是一个越来越被接受和可行的提供精神保健的平台，有可能增加在低资源环境中获得保健的机会。我们的目的是检查的可接受性和初步的影响，提供辅助远程精神病学服务，在印度果阿的初级卫生保健设置。非对照治疗前后队列研究。总共有161名患有精神或酒精使用障碍的成年人接受了精神科医生通过定制的视频会议平台提供的远程咨询，沿着药物或咨询（通过训练有素的非专业顾问）或两者兼而有之。在基线和基线后3个月收集社会人口统计学、临床结局和过程指标数据。使用一般健康问卷-12（GHQ-12）和世界卫生组织残疾适应量表（WHODAS）2.0进行配对t检验，以评估治疗前后的临床结局，并使用logistic回归来发现这些评分变化与各种因素之间的相关性。最常见的诊断是抑郁症（35%）。治疗后，GHQ-12和WHODAS 2.0评分均显著降低。参与者对远程精神病学服务和技术平台表示高度满意。GHQ-12评分的改善与就业[OR 8.74（1.92-39.75，p = 0.005）]和家庭主妇[OR 6.42（CI 1.61-25.57，p = 0.008）]相关。通过远程精神病学平台治疗精神障碍似乎是高度可接受的，并与改善临床结果有关。考虑到其可扩展性的潜力，辅助远程精神病学模式整合到初级保健可以是一个重要的战略，以增加获得精神卫生保健在低资源环境。
Tele-psychiatry is an increasingly acceptable and feasible platform to deliver mental health care with the potential to increase access to care in low-resource settings. We aim to examine the acceptability and preliminary impact of the delivery of assisted tele-psychiatry services in primary healthcare settings in Goa, India. Before-after uncontrolled treatment cohort study. In total, 161 adults with either a mental or alcohol use disorder were provided tele-consultation by psychiatrists through a customised video conferencing platform, along with medication or counselling (via trained lay counsellors) or both as needed. Data on socio-demographics, clinical outcomes and process indicators were collected at baseline and 3 months post-baseline. Paired t tests were used to assess clinical outcomes pre- and post-treatment using the General Health Questionnaire-12 (GHQ-12) and World Health Organisation Disability Adjustment Schedule (WHODAS) 2.0, and logistic regression was used to find associations between changes in these scores and various factors. The most common diagnosis was depression (35%). Post-treatment, there was a significant reduction in both GHQ-12 and WHODAS 2.0 scores. Participants showed high satisfaction with the tele-psychiatry services and technology platform. Improvement in GHQ-12 score was associated with being employed [OR 8.74 (1.92–39.75, p = 0.005)] and being a homemaker [OR 6.42 (CI 1.61–25.57, p = 0.008)]. Treatment of mental disorders through a tele-psychiatry platform appears to be highly acceptable and is associated with improved clinical outcomes. Considering its potential for scalability, a model of assisted tele-psychiatry integrated into primary care can be an important strategy to increase access to mental healthcare in low-resource settings.
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影响因子：
168.9
作者：
Nadkarni, Abhijit;Weobong, Benedict;Patel, Vikram
通讯作者：
Patel, Vikram
影响因子：
2.8
作者：
Naskar S;Victor R;Das H;Nath K
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Nath K
影响因子：
3.1
作者：
Lahariya, Chandrakant;Singhal, Shyam;Mishra, Ashok
通讯作者：
Mishra, Ashok
影响因子：
9.5
作者：
Endsley, Paige;Weobong, Benedict;Nadkarni, Abhijit
通讯作者：
Nadkarni, Abhijit
影响因子：
0.5
作者：
Hilty, DM;Servis, ME;Hales, RE
通讯作者：
Hales, RE