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Clinical Outcomes of Asynchronous Versus Synchronous Telepsychiatry in Primary Care: Randomized Controlled Trial
Peter M Yellowlees1, Michelle Burke Parish1, Alvaro D Gonzalez1
1Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, United States.
Journal of Medical Internet Research
|May 16, 2021
Summary
Asynchronous telepsychiatry (ATP) improved patient outcomes in primary care, similar to synchronous telepsychiatry (STP). This study shows ATP is a viable option for mental health care access, addressing psychiatrist shortages.
Area of Science:
- Telepsychiatry
- Primary Care
- Mental Health Services
Background:
- Asynchronous telepsychiatry (ATP) is a novel approach for psychiatric consultations in primary care.
- Longitudinal studies comparing ATP with synchronous telepsychiatry (STP) are limited.
Purpose of the Study:
- To evaluate the effectiveness of ATP in improving clinical outcomes for English- and Spanish-speaking primary care patients compared to STP.
- To assess ATP's role in collaborative care models.
Main Methods:
- A randomized study involving 160 adult patients with nonurgent psychiatric disorders across 3 primary care clinics.
- Patients received care via collaborative model with telepsychiatrists using ATP or STP for up to 2 years.
- Primary outcomes (CGI, GAF) and secondary outcomes (self-reported health, depression) were assessed every 6 months.
Main Results:
- ATP did not demonstrate superiority over STP in improving clinician-rated outcomes (CGI, GAF) at 6 or 12 months.
- Both ATP and STP groups showed statistically and clinically significant improvements in primary outcomes.
- No significant differences were observed in patient-reported outcomes between ATP and STP.
Conclusions:
- ATP is effective in improving clinical outcomes for primary care patients, comparable to STP.
- ATP offers a potential solution to psychiatrist shortages and enhances mental health care delivery.
- ATP can be a valuable component of stepped mental health interventions in primary care settings.
Keywords:
Spanish-speakingasynchronous telepsychiatrycollaborative caredepressionprimary care physicianpsychiatric consultationpsychiatristsynchronous telepsychiatrytelehealthworkforceMore Related Videos
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