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Güler KG, Uzun S, Emirza EG. Effects of Web-Based Psychotherapeutic Interventions on Depression in Mood Disorders: A Meta-Analysis Study. J Psychosoc Nurs Ment Health Serv 2025; 63:36-41. [PMID: 39508661 DOI: 10.3928/02793695-20241101-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2024]
Abstract
PURPOSE To investigate the effects of web-based psychotherapeutic interventions on depression among individuals with mood disorders. METHOD For this meta-analysis study, data were obtained from October to December 2023 by searching PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Thesis Center for articles published in the past 5 years. In the first stage of the search, 12,056 records were obtained. After removing duplicate studies, 4,910 records were considered for title and abstract review. After this evaluation, 139 studies were identified for full-text review. After the review, six studies reporting results on the effectiveness of web-based psychotherapeutic interventions on depression among individuals with mood disorders were ultimately included. RESULTS Web-based interventions had significant positive effects and provided decreases in depression levels (standardized mean difference = -0.168, 95% confidence interval [-0.315, -0.021]; Z = -2.243; p < 0.05). CONCLUSION Web-based interventions for mood disorders may play an effective role in reducing the burden of chronic mental illness and improving patient outcomes. [Journal of Psychosocial Nursing and Mental Health Services, 63(3), 36-41.].
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López-Durán A, Martínez-Vispo C, Barroso-Hurtado M, Suárez-Castro D, Becoña E. Incorporating technology in smoking cessation interventions: In-person vs. Video-call formats. Int J Med Inform 2025; 195:105774. [PMID: 39742855 DOI: 10.1016/j.ijmedinf.2024.105774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 10/29/2024] [Accepted: 12/20/2024] [Indexed: 01/04/2025]
Abstract
INTRODUCTION The use of video calls to provide health-related interventions has grown significantly, showing positive results in a broad range of psychological interventions. Scarce research has examined video-call use in smoking cessation treatments. The purpose of this study was to compare two randomised controlled trials conducting a cognitive-behavioral intervention to quit smoking in-person versus using video calls. MATERIAL AND METHODS This study is a secondary analysis of two randomised controlled trial studies (RCTs) conducted using two delivery formats: in-person vs. video calls. The sample comprised 498 adults seeking smoking cessation treatment. We analysed smoking cessation, cigarette reduction, and treatment satisfaction outcomes according to delivery format. RESULTS No significant differences were found in sex, age, and baseline smoking-related variables. A significantly higher proportion of participants in the video-call format had university studies, were actively working, and had a history of depression compared to the in-person format. No significant differences were found in cessation, smoking reduction, and satisfaction with treatment. Predictive variables of 12-month abstinence were: baseline number of cigarettes smoked per day (OR = 0.93) in the case of the in-person format; and being a woman (OR = 0.53), cigarette dependence (OR = 0.46), and last year quit attempt (OR = 0.52) in the video-call format. CONCLUSIONS Both delivery formats showed similar abstinence rates at 12 months and satisfaction with the intervention. Therefore, in-person and video calls could be used to deliver smoking cessation treatments. Given that predictors of long-term abstinence differed across these delivery formats, further research is needed. TRIALS REGISTRATION ClinicalTrials.gov IDs: NCT02844595: NCT04765813.
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Affiliation(s)
- Ana López-Durán
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain; Institute of Research in Psychology (IPsiUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain.
| | - Carmela Martínez-Vispo
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain; Institute of Research in Psychology (IPsiUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - María Barroso-Hurtado
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain
| | - Daniel Suárez-Castro
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain
| | - Elisardo Becoña
- Smoking and Addictive Disorders Unit, Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Spain; Institute of Research in Psychology (IPsiUS), University of Santiago de Compostela (USC), Santiago de Compostela, Spain
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Kramer M, Rosenkranz S, Kramer T. Depression in Pulmonary Hypertension: A Systematic Review of Clinical Outcomes, Treatment Interactions, and Emerging Technologies. J Clin Med 2025; 14:982. [PMID: 39941652 PMCID: PMC11818160 DOI: 10.3390/jcm14030982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2024] [Revised: 01/21/2025] [Accepted: 01/30/2025] [Indexed: 02/16/2025] Open
Abstract
Background: Pulmonary hypertension (PH) is characterized by elevated pulmonary artery pressure, often leading to right heart failure and poor prognosis. Depression, a common comorbidity in PH, significantly affects the quality of life. However, mechanistic insights into the bidirectional relationship between PH and depression and specific treatment interactions remain scarce. Objective: The object was to examine the clinical and therapeutic implications of depression in PH, focusing on its impact on patient outcomes and cost efficiency. Methods: A systematic review of Medline and Google Scholar was conducted to identify studies on depression in PH, emphasizing evidence-based interventions, clinical outcomes, and cost efficiency. Special consideration was given to potential drug interactions between PH medications and depression treatments and to the role of emerging technologies in managing PH-related depression. Results: While depression reduces the quality of life and exacerbates disease severity in PH, depression treatment improves outcomes, particularly when tailored to PH-targeted therapies, considering potential drug-drug interactions. Emerging technologies, including telemedicine, offer innovative approaches to manage depression in PH, enhancing access to care and improving adherence to treatment regimens. Conclusions: Depression in PH must no longer be neglected and should be acknowledged as both a critical comorbidity and a significant driver of disease progression. Interdisciplinary treatment approaches are necessary, considering potential pharmacological interactions and incorporating emerging technologies like telemedicine to improve patient care. Further research is needed to assess the long-term outcomes of depression treatment in different groups of PH.
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Affiliation(s)
- Mira Kramer
- Department of Anesthesiology and Intensive Care Medicine, Cologne-Merheim Medical Center, University of Witten Herdecke, Ostmerheimer Str. 200, D-51109 Cologne, Germany;
| | - Stephan Rosenkranz
- Clinic III for Internal Medicine, Heart Center of the University of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany;
| | - Tilmann Kramer
- Clinic III for Internal Medicine, Heart Center of the University of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany;
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Güler KG, Uzun S, Emirza EG. The effectiveness of telemedicine applications in mental health services: a meta-analysis study. Ir J Med Sci 2025; 194:233-245. [PMID: 39535666 DOI: 10.1007/s11845-024-03841-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 11/04/2024] [Indexed: 11/16/2024]
Abstract
AIM This study was conducted to reveal the effectiveness of telemedicine applications in mental health services. MATERIAL METHOD For this meta-analysis study, data were obtained by searching PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Thesis Center databases for the last 5 years in September-December 2023. After the review, 24 studies were included. FINDINGS In this meta-analysis, it was found that telemedicine interventions in mental health services decreased the depression level of individuals (SMD - 0.168, 95% CI - 0.315 to - 0.021; Z = - 2.243; p < .05). In addition, it was determined that the duration of the intervention played a role in the effectiveness of telemedicine interventions applied to individuals. In addition, it was determined that the type of intervention, the country where the research was conducted, and the patient group did not play a role in the effectiveness of telemedicine interventions applied to individuals. CONCLUSION Telemedicine applications in mental health services can play an effective role in reducing the burden of chronic mental illness and improving patient outcomes.
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Affiliation(s)
- Kübra Gülırmak Güler
- Department of Pyschiatric Nursing, Ondokuz Mayıs University Faculty of Health Sciences, Samsun, Turkey.
| | - Sevda Uzun
- Department of Pyschiatric Nursing, Gümüşhane University Faculty of Health Sciences, Gümüşhane, Turkey
| | - Elif Güzide Emirza
- Department of Pyschiatric Nursing, Ondokuz Mayıs University Faculty of Health Sciences, Samsun, Turkey
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5
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Kervinen E, Vähätalo L, Siukola A, Reho T, Winell K, Sauni R. Occupational health professionals' and HR specialists' perceptions of telemental health services in occupational health care settings: A qualitative study. Digit Health 2025; 11:20552076241297409. [PMID: 39777057 PMCID: PMC11705330 DOI: 10.1177/20552076241297409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 10/17/2024] [Indexed: 01/11/2025] Open
Abstract
Objective The rise in mental health-related work disability pensions highlights the need for more research on how occupational health care (OHC) can support mental health, including the use of telehealth (TH) services in mental health care. Methods The research, employing a descriptive qualitative approach through interviews (n = 42), focused on experiences of professionals from a private OHC service provider in Finland and human resource representatives (HRRs) of OHC client companies. Inductive content analysis was used to analyze the data. Results Our research suggests that TH services provided by OHC can enhance access to care and expedite the initiation of work ability support, particularly in mental health cases. However, potential challenges include a perceived sense of distance, superficiality in interactions, and difficulty in forming a comprehensive understanding due to few non-verbal cues. Conclusion A combined approach of TH and face-to-face services is suggested to provide flexible, and individualized support. Further studies on remote low-threshold discussion mental health services and studies comparing TH and face-to-face services are advised.
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Affiliation(s)
- Elina Kervinen
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Lauri Vähätalo
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Anna Siukola
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Tiia Reho
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
- Pihlajalinna, Tampere, Finland
| | | | - Riitta Sauni
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
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Gamoran J, Xu Y, Buinewicz SAP, Liu J, Mowrey W, Goldentyer G, Gabbay V, Pimentel SS. An examination of depression severity and treatment adherence among racially and ethnically minoritized, low-income individuals during the COVID-19 transition to telehealth. Psychiatry Res 2024; 342:116221. [PMID: 39378538 DOI: 10.1016/j.psychres.2024.116221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 09/29/2024] [Accepted: 09/30/2024] [Indexed: 10/10/2024]
Abstract
Mental healthcare was fundamentally altered during the COVID-19 pandemic, perhaps most prominently through the massive shift towards telehealth. Herein, we evaluated effects of the transition to teletherapy on treatment adherence and depressive symptoms for 3,476 patients at three outpatient psychiatric clinics, the majority of whom were low-income and experienced ethnoracial minoritization. Number of missed appointments decreased (mean: 6.27 vs. 3.77, p < .0001), and PHQ-9 scores decreased (mean: 8.17 vs. 6.82, p < .0001) between six months prior to and following the March 18, 2020 switch to telehealth. These conclusions held when adjusting for covariates including age, sex, race/ethnicity, and insurance status (i.e., socioeconomic status). Stratified analyses (i.e., adults, emerging adults, and youth) yielded the same conclusions, with the exception of emerging adults, for whom the PHQ-9 change was not significant. Results indicated the transition from in-person to teletherapy was associated with significantly reduced mean numbers of missed visits and depressive symptoms. Such results during this especially tumultuous period may underscore telehealth's effectiveness. Future research should explore whether there is a causal relationship between telehealth or mixed hybrid options, positive treatment outcomes, and prescriptive care delivery models, as well as applications of e-mental health tools for diverse, underserved patient populations.
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Affiliation(s)
- Jesse Gamoran
- Department of Psychology, College of Science and Health, DePaul University, Chicago, IL, United States
| | - Yingchen Xu
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Sophie A Palitz Buinewicz
- Center for the Treatment and Study of Anxiety, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jianyou Liu
- Cardiovascular Research Foundation, New York, NY, United States
| | - Wenzhu Mowrey
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | | | - Vilma Gabbay
- University of Miami, Miller School of Medicine, Miami, FL, United States; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Sandra S Pimentel
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States.
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Fajnerova I, Hejtmánek L, Sedlák M, Jablonská M, Francová A, Stopková P. The Journey From Nonimmersive to Immersive Multiuser Applications in Mental Health Care: Systematic Review. J Med Internet Res 2024; 26:e60441. [PMID: 39509153 PMCID: PMC11582485 DOI: 10.2196/60441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 07/31/2024] [Accepted: 08/31/2024] [Indexed: 11/15/2024] Open
Abstract
BACKGROUND Over the past 25 years, the development of multiuser applications has seen considerable advancements and challenges. The technological development in this field has emerged from simple chat rooms through videoconferencing tools to the creation of complex, interactive, and often multisensory virtual worlds. These multiuser technologies have gradually found their way into mental health care, where they are used in both dyadic counseling and group interventions. However, some limitations in hardware capabilities, user experience designs, and scalability may have hindered the effectiveness of these applications. OBJECTIVE This systematic review aims at summarizing the progress made and the potential future directions in this field while evaluating various factors and perspectives relevant to remote multiuser interventions. METHODS The systematic review was performed based on a Web of Science and PubMed database search covering articles in English, published from January 1999 to March 2024, related to multiuser mental health interventions. Several inclusion and exclusion criteria were determined before and during the records screening process, which was performed in several steps. RESULTS We identified 49 records exploring multiuser applications in mental health care, ranging from text-based interventions to interventions set in fully immersive environments. The number of publications exploring this topic has been growing since 2015, with a large increase during the COVID-19 pandemic. Most digital interventions were delivered in the form of videoconferencing, with only a few implementing immersive environments. The studies used professional or peer-supported group interventions or a combination of both approaches. The research studies targeted diverse groups and topics, from nursing mothers to psychiatric disorders or various minority groups. Most group sessions occurred weekly, or in the case of the peer-support groups, often with a flexible schedule. CONCLUSIONS We identified many benefits to multiuser digital interventions for mental health care. These approaches provide distributed, always available, and affordable peer support that can be used to deliver necessary help to people living outside of areas where in-person interventions are easily available. While immersive virtual environments have become a common tool in many areas of psychiatric care, such as exposure therapy, our results suggest that this technology in multiuser settings is still in its early stages. Most identified studies investigated mainstream technologies, such as videoconferencing or text-based support, substituting the immersive experience for convenience and ease of use. While many studies discuss useful features of virtual environments in group interventions, such as anonymity or stronger engagement with the group, we discuss persisting issues with these technologies, which currently prevent their full adoption.
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Affiliation(s)
- Iveta Fajnerova
- Research Center for Virtual Reality in Mental Health and Neuroscience, National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lukáš Hejtmánek
- Research Center for Virtual Reality in Mental Health and Neuroscience, National Institute of Mental Health, Klecany, Czech Republic
- Faculty of Humanities, Charles University, Prague, Czech Republic
| | - Michal Sedlák
- Research Center for Virtual Reality in Mental Health and Neuroscience, National Institute of Mental Health, Klecany, Czech Republic
| | - Markéta Jablonská
- Research Center for Virtual Reality in Mental Health and Neuroscience, National Institute of Mental Health, Klecany, Czech Republic
| | - Anna Francová
- Research Center for Virtual Reality in Mental Health and Neuroscience, National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavla Stopková
- Research Center for Virtual Reality in Mental Health and Neuroscience, National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
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Al Dweik R, Ajaj R, Kotb R, Halabi DE, Sadier NS, Sarsour H, Elhadi YAM. Opportunities and challenges in leveraging digital technology for mental health system strengthening: a systematic review to inform interventions in the United Arab Emirates. BMC Public Health 2024; 24:2592. [PMID: 39334131 PMCID: PMC11429924 DOI: 10.1186/s12889-024-19980-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 09/04/2024] [Indexed: 09/30/2024] Open
Abstract
Digital technology offers scalable, real-time interventions for mental health promotion and treatment. This systematic review explores the opportunities and challenges associated with the use of digital technology in mental health, with a focus on informing mental health system strengthening interventions in the United Arab Emirates (UAE). Following PRISMA guidelines, a systematic search of databases was conducted up to August 2023 and identified a total of 8479 citations of which 114 studies were included in the qualitative analysis. The included studies encompass diverse digital interventions, platforms, and modalities used across various mental health conditions. The review identifies feasible, acceptable, and efficacious interventions, ranging from telehealth and mobile apps to virtual reality and machine learning models. Opportunities for improving access to care, reducing patients' transfers, and utilizing real-world interaction data for symptom monitoring are highlighted. However, challenges such as digital exclusion, privacy concerns, and potential service replacement caution policymakers. This study serves as a valuable evidence base for policymakers and mental health stakeholders in the UAE to navigate the integration of digital technology in mental health services effectively.
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Affiliation(s)
- Rania Al Dweik
- Department of Public Health, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates.
| | - Rahaf Ajaj
- Department of Public Health, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Reham Kotb
- Department of Public Health, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Dima El Halabi
- Department of Public Health, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | | | | | - Yasir Ahmed Mohammed Elhadi
- Department of Public Health, College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates.
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AL Ain, United Arab Emirates.
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Ettman CK, Brantner CL, Albert M, Goes FS, Mojtabai R, Spivak S, Stuart EA, Zandi PP. Trends in Telepsychiatry and In-Person Psychiatric Care for Depression in an Academic Health System, 2017-2022. Psychiatr Serv 2024; 75:178-181. [PMID: 37554006 PMCID: PMC10862532 DOI: 10.1176/appi.ps.20230064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
OBJECTIVE The authors aimed to assess differences in appointment completion rates between telepsychiatry and in-person outpatient psychiatric care for patients with depression in an academic health system. METHODS Electronic health records of encounters for patients (ages ≥10) with a depression diagnosis and at least one scheduled outpatient psychiatric appointment (N=586,266 appointments; November 2017-October 2022) were assessed for appointment volume and completion of telepsychiatry versus in-person sessions. RESULTS Telepsychiatry became the dominant care modality after the onset of the COVID-19 pandemic, although the number of telepsychiatry and in-person appointments nearly converged by October 2022. Logistic regression showed that telepsychiatry appointments (July 2020-October 2022) were more likely (OR=1.30, 95% CI=1.27-1.34) to be completed than in-person appointments. CONCLUSIONS Telepsychiatry appointments were less likely to be canceled or missed than in-person appointments, suggesting that telepsychiatry improved efficiency and continuity of care. As in-person operations resume following the pandemic, maintaining telepsychiatry services may optimize hospital-level and patient outcomes.
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Affiliation(s)
- Catherine K Ettman
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Carly L Brantner
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Michael Albert
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Fernando S Goes
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Stanislav Spivak
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Elizabeth A Stuart
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
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Sousa J, Smith A, Richard J, Rabinowitz M, Raja P, Mehrotra A, Busch AB, Huskamp HA, Uscher-Pines L. Choosing Or Losing In Behavioral Health: A Study Of Patients' Experiences Selecting Telehealth Versus In-Person Care. Health Aff (Millwood) 2023; 42:1275-1282. [PMID: 37669481 PMCID: PMC10762624 DOI: 10.1377/hlthaff.2023.00487] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
It is not known how the growth of telehealth has affected patients' choice of visit modalities (telehealth versus in person). In 2023 we conducted a mixed-methods study that paired a nationally representative survey of 2,071 adults (including 571 who used behavioral health services) and semistructured interviews with twenty-six people with depression or bipolar disorder. We explored patients' experiences with visit modality selection and their agency in the decision. Approximately one-third of patients receiving therapy or medication visits reported that their clinicians did not offer both modalities. Thirty-two percent reported that they did not typically receive their preferred modality, and 45 percent did not believe that their clinician considered their modality preferences. Qualitative findings revealed that some clinicians did not elicit patients' modality preferences. Perceived lack of choice affected satisfaction and rapport with clinicians and encouraged some people to seek care elsewhere. These findings highlight trade-offs in policies to preserve patient choice and approaches that clinicians can take to identify and accommodate patients' preferences.
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Affiliation(s)
- Jessica Sousa
- Jessica Sousa , RAND Corporation, Boston, Massachusetts
| | - Andrew Smith
- Andrew Smith, Depression and Bipolar Support Alliance, Chicago, Illinois
| | | | | | - Pushpa Raja
- Pushpa Raja, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California
| | - Ateev Mehrotra
- Ateev Mehrotra, Harvard University and Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Alisa B Busch
- Alisa B. Busch, Harvard University and McLean Hospital, Belmont, Massachusetts
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Esposito S, Rosafio C, Antodaro F, Argentiero A, Bassi M, Becherucci P, Bonsanto F, Cagliero A, Cannata G, Capello F, Cardinale F, Chiriaco T, Consolaro A, Dessì A, Di Mauro G, Fainardi V, Fanos V, Guarino A, Li Calzi G, Lodi E, Maghnie M, Manfredini L, Malorgio E, Minuto N, Modena MG, Montori R, Moscatelli A, Patrone E, Pescio E, Poeta M, Ravelli A, Spelta M, Suppiej A, Vai S, Villa L, Zanini R, Botti R, Gaddi AV. Information and Training on the Use of Telemedicine in Pediatric Population: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP), and of the Syndicate of Family Pediatrician Doctors (SIMPeF). J Pers Med 2023; 13:jpm13020314. [PMID: 36836548 PMCID: PMC9958783 DOI: 10.3390/jpm13020314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/25/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Telemedicine has entered the daily lives of doctors, although the digital skills of healthcare professionals still remain a goal to be achieved. For the purpose of a large-scale development of telemedicine, it is necessary to create trust in the services it can offer and to favor their acceptance by healthcare professionals and patients. In this context, information for the patient regarding the use of telemedicine, the benefits that can be derived from it, and the training of healthcare professionals and patients for the use of new technologies are fundamental aspects. This consensus document is a commentary that has the aim of defining the information on and training aspects of telemedicine for pediatric patients and their caregivers, as well as pediatricians and other health professionals who deal with minors. For the present and the future of digital healthcare, there is a need for a growth in the skills of professionals and a lifelong learning approach throughout the professional life. Therefore, information and training actions are important to guarantee the necessary professionalism and knowledge of the tools, as well as a good understanding of the interactive context in which they are used. Furthermore, medical skills can also be integrated with the skills of various professionals (engineers, physicists, statisticians, and mathematicians) to birth a new category of health professionals responsible for building new semiotics, identifying criteria for predictive models to be integrated into clinical practice, standardizing clinical and research databases, and defining the boundaries of social networks and new communication technologies within health services.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Correspondence:
| | | | | | - Alberto Argentiero
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Marta Bassi
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | | | | | | | - Giulia Cannata
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Fabio Capello
- UO Territorial Pediatrics, Primary Care Department, AUSL Bologna, 40126 Bologna, Italy
| | - Fabio Cardinale
- Department of Pediatrics and Emergency, Pediatric Hospital Giovanni XXIII, University of Bari, 70124 Bari, Italy
| | - Tiziana Chiriaco
- Health Department, ASL Roma 3, 00125 Rome, Italy
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Alessandro Consolaro
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences (DINOGMI), University of Genoa,16126 Genoa, Italy
| | - Angelica Dessì
- Department of Surgical Sciences, University of Cagliari, 09127 Cagliari, Italy
| | | | - Valentina Fainardi
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Vassilios Fanos
- Department of Surgical Sciences, University of Cagliari, 09127 Cagliari, Italy
| | - Alfredo Guarino
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Giada Li Calzi
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Elisa Lodi
- P.A.S.C.I.A. Center (Heart Failure Care Program, Childhood Heart Diseases and Those at Risk), University of Modena and Reggio Emilia, AOU Polyclinic of Modena, 41124 Modena, Italy
| | - Mohamad Maghnie
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | - Luca Manfredini
- Pediatric Pain and Palliative Care Service, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | | | - Nicola Minuto
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | - Maria Grazia Modena
- P.A.S.C.I.A. Center (Heart Failure Care Program, Childhood Heart Diseases and Those at Risk), University of Modena and Reggio Emilia, AOU Polyclinic of Modena, 41124 Modena, Italy
| | - Rossano Montori
- Community Medicine and Primary Care, AUSL Modena, 41124 Modena, Italy
| | - Andrea Moscatelli
- UOC Anesthesia and Intensive Care, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Elisa Patrone
- UOSID Trial Center, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy
| | - Elena Pescio
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Marco Poeta
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Angelo Ravelli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences (DINOGMI), University of Genoa,16126 Genoa, Italy
- Scientific Directorate, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Maddalena Spelta
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Agnese Suppiej
- Pediatric Clinic, Department of Medical Sciences, University of Ferrara, 44124 Ferrara, Italy
| | - Sergio Vai
- Alma Mater University, 40126 Bologna, Italy
| | - Luca Villa
- UOSID Trial Center, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy
| | - Rinaldo Zanini
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Renato Botti
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Antonio Vittorino Gaddi
- Center for Metabolic Diseases and Atherosclerosis, University of Bologna, 40126 Bologna, Italy
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12
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Esposito S, Rosafio C, Antodaro F, Argentiero A, Bassi M, Becherucci P, Bonsanto F, Cagliero A, Cannata G, Capello F, Cardinale F, Chiriaco T, Consolaro A, Dessì A, Di Mauro G, Fainardi V, Fanos V, Guarino A, Li Calzi G, Lodi E, Maghnie M, Manfredini L, Malorgio E, Minuto N, Modena MG, Montori R, Moscatelli A, Patrone E, Pescio E, Poeta M, Ravelli A, Spelta M, Suppiej A, Vai S, Villa L, Zanini R, Botti R, Gaddi AV. Use of Telemedicine Healthcare Systems in Children and Adolescents with Chronic Disease or in Transition Stages of Life: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF). J Pers Med 2023; 13:jpm13020235. [PMID: 36836469 PMCID: PMC9965862 DOI: 10.3390/jpm13020235] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/01/2023] Open
Abstract
Telemedicine is considered an excellent tool to support the daily and traditional practice of the health profession, especially when referring to the care and management of chronic patients. In a panorama in which chronic pathologies with childhood onset are constantly increasing and the improvement of treatments has allowed survival for them into adulthood, telemedicine and remote assistance are today considered effective and convenient solutions both for the chronic patient, who thus receives personalized and timely assistance, and for the doctors, who reduce the need for direct intervention, hospitalizations and consequent management costs. This Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, has the objectives to propose an organizational model based on the relationships between the actors who participate in the provision of a telemedicine service aimed at minors with chronic pathologies, identifying specific project links between the areas of telemedicine in the developmental age from the first 1000 days of life to the age adult. The future scenario will have to be able to integrate digital innovation in order to offer the best care to patients and citizens. It will have to be able to provide the involvement of patients from the very beginning of the design of any care pathway, increasing where possible the proximity of the health service to citizens.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Correspondence:
| | | | | | - Alberto Argentiero
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Marta Bassi
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | | | | | | | - Giulia Cannata
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Fabio Capello
- UO Territorial Pediatrics, Primary Care Department, AUSL Bologna, 40126 Bologna, Italy
| | - Fabio Cardinale
- UOC of Pediatrics and ED with an Allergy-Pneumological and Immuno-Rheumatological Focus, Giovanni XXIII Pediatric Hospital, University of Bari, 70124 Bari, Italy
| | - Tiziana Chiriaco
- Health Department, ASL Roma 3, 00125 Rome, Italy
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Alessandro Consolaro
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences (DINOGMI), University of Genoa, 16126 Genoa, Italy
| | - Angelica Dessì
- Department of Surgical Sciences, University of Cagliari, 09127 Cagliari, Italy
| | | | - Valentina Fainardi
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Vassilios Fanos
- Department of Surgical Sciences, University of Cagliari, 09127 Cagliari, Italy
| | - Alfredo Guarino
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Giada Li Calzi
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Elisa Lodi
- P.A.S.C.I.A. Center (Heart Failure Care Program, Childhood Heart Diseases and Those at Risk), University of Modena and Reggio Emilia, AOU Polyclinic of Modena, 41124 Modena, Italy
| | - Mohamad Maghnie
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | - Luca Manfredini
- Pediatric Pain and Palliative Care Service, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | | | - Nicola Minuto
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | - Maria Grazia Modena
- P.A.S.C.I.A. Center (Heart Failure Care Program, Childhood Heart Diseases and Those at Risk), University of Modena and Reggio Emilia, AOU Polyclinic of Modena, 41124 Modena, Italy
| | - Rossano Montori
- Community Medicine and Primary Care, AUSL Modena, 41124 Modena, Italy
| | - Andrea Moscatelli
- UOC Anesthesia and Intensive Care, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Elisa Patrone
- UOSID Trial Center, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy
| | - Elena Pescio
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Marco Poeta
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Angelo Ravelli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences (DINOGMI), University of Genoa, 16126 Genoa, Italy
- Scientific Directorate, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Maddalena Spelta
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Agnese Suppiej
- Pediatric Clinic, University of Ferrara, 44124 Ferrara, Italy
| | | | - Luca Villa
- UOSID Trial Center, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy
| | | | - Renato Botti
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Antonio Vittorino Gaddi
- Center for Metabolic Diseases and Atherosclerosis, University of Bologna, 40126 Bologna, Italy
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