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Telepsychiatry Substantially Improves Outcomes in Patients With Complex Psychiatric Disorders
A study designed to compare the effectiveness of 2 telepsychiatry approaches for rural patients with complex psychiatric disorders found both provided large and clinically meaningful improvements in outcomes. Researchers published their findings in JAMA Psychiatry.
“The results of our trial showed that if you give access to high-quality care for patients who are underserved, they improve their quality of life,” said lead researcher John Fortney, PhD, professor of psychiatry and behavioral sciences at the University of Washington School of Medicine in Seattle.
The pragmatic comparative effectiveness trial randomized 1004 adults who screened positive for a mood disorder or post-traumatic stress disorder (PTSD) to 1 of 2 clinic-to-clinic video approaches as follows: (1) telepsychiatry/telepsychology–enhanced referral, in which telepsychiatrists and telepsychologists were responsible for treatment, and (2) telepsychiatry collaborative care, in which telepsychiatrists provided consultation to the patient’s primary care team. Participants were patients from 12 federally qualified health centers in Washington, Arkansas, and Michigan.
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Between baseline and 12 months, patients in both groups reported substantially and statistically significant improvements in access to care, mental health symptoms, medication side effects, and quality of life, the study found. The positive outcomes did not differ with age, sex, or race/ethnicity.
Based on the success of both telepsychiatry models, researchers recommended health systems implement whichever of the 2 approaches is most sustainable. They did note, however, telepsychiatry collaborative care required less mental health specialist time.
“One of the major contributions of this study is what we knew to be effective for depression and anxiety we now know also achieves good outcomes for patients with PTSD and [a mood disorder],” said study coauthor Paul Pfeiffer, MD, associate professor of psychiatry at the University of Michigan Medical School in Ann Arbor.
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