Telepsychiatry Consultation for Medical and Surgical Inpatient Units
Telepsychiatry Consultation for Medical and Surgical Inpatient Units
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DOI：
10.1016/j.psym.2017.08.008
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发表时间：
2018-01-01
期刊：
影响因子：
3.4
通讯作者：
Cahalane, Jack
中科院分区：
文献类型：
--
作者：
Graziane, Julie A.;Gopalan, Priya;Cahalane, Jack
背景：远程精神病学在提供精神科护理中变得越来越普遍。远程精神病学最常用于门诊，文献中很少有关于使用远程精神病学进行住院内科/外科会诊的信息。目的：我们回顾匹兹堡大学医学中心的远程精神病学咨询计划，为偏远社区的农村医院提供咨询。方法：对2014年11月至2016年2月期间进行的69次远程精神病学会诊进行分析，分析服务患者、常见会诊问题、诊断模式和建议。结果：接受远程精神病学评估的个体年龄中位数为67岁，最常见的咨询原因是谵妄。使用《精神疾病诊断与统计手册》（第四版，文本修订）诊断，超过一半的患者的初步诊断为谵妄、痴呆或未另行说明的认知障碍。在大多数患者中，要求进行额外的实验室检查或影像学检查，或两者兼而有之，并建议改变药物（起始、剂量改变和停药）。结论：本报告提供了远程精神病学在远程住院医疗环境中使用的第一个详细观点之一。研究结果将指导初级团队的教育，并将影响未来远程精神病学干预措施的发展。
Background: Telepsychiatry is becoming more commonplace in the provision of psychiatric care. Most commonly used in the outpatient setting, there is little information available in the literature as to the use of telepsychiatry for inpatient medical/surgical consultation. Objective: We review the University of Pittsburgh Medical Center's telepsychiatry consultation program that provides consultation to an outlying community based rural hospital. Methods: This article examines the 69 telepsychiatry consultations that were performed from November 2014 through February 2016, looking at the patients served, common consultation questions, and patterns of diagnoses and recommendations. Results: The median age of individuals undergoing telepsychiatry evaluations was 67 years, and the most common reason for consultation was for delirium. Over half of the patients consulted had a primary diagnosis of delirium, dementia, or a cognitive disorder not otherwise specified, using Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) diagnoses. In most patients, additional laboratory studies or imaging or both were requested and medication changes recommended (initiation, dose changes, and discontinuation). Conclusion: This report provides one of the first detailed views of the use of telepsychiatry in a remote inpatient medical setting. Findings will guide education to primary teams and will shape the development of future telepsychiatry interventions.