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Sperling SA, Acheson SK, Fox-Fuller J, Colvin MK, Harder L, Cullum CM, Randolph JJ, Carter KR, Espe-Pfeifer P, Lacritz LH, Arnett PA, Gillaspy SR. Tele-Neuropsychology: From Science to Policy to Practice. Arch Clin Neuropsychol 2024; 39:227-248. [PMID: 37715508 DOI: 10.1093/arclin/acad066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to accelerate the number of randomized experimental studies of the reliability and validity in-home tele-neuropsychological testing (tele-np-t). METHOD We conducted a critical review of the tele-neuropsychology literature. We discuss this research in the context of the United States' public and private healthcare payer systems, including the Centers for Medicare & Medicaid Services (CMS) and Current Procedural Terminology (CPT) coding system's telehealth lists, and existing disparities in healthcare access. RESULTS The number of tele-np publications has been stagnant since the onset of the COVID-19 pandemic. There are less published experimental studies of tele-neuropsychology (tele-np), and particularly in-home tele-np-t, than other tele-np publications. There is strong foundational evidence of the acceptability, feasibility, and reliability of tele-np-t, but relatively few studies of the reliability and validity of in-home tele-np-t using randomization methodology. CONCLUSIONS More studies of the reliability and validity of in-home tele-np-t using randomization methodology are necessary to support inclusion of tele-np-t codes on the CMS and CPT telehealth lists, and subsequently, the integration and delivery of in-home tele-np-t services across providers and institutions. These actions are needed to maintain equitable reimbursement of in-home tele-np-t services and address the widespread disparities in healthcare access.
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Affiliation(s)
- Scott A Sperling
- Department of Neurology, Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA
| | | | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lana Harder
- Children's Health, Children's Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | | | - Patricia Espe-Pfeifer
- Department of Psychiatry and Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peter A Arnett
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
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Smith KA, Ostinelli EG, Ede R, Allard L, Thomson M, Hewitt K, Brown P, Zangani C, Jenkins M, Hinze V, Ma G, Pothulu P, Henshall C, Malhi GS, Every-Palmer S, Cipriani A. Assessing the Impact of Evidence-Based Mental Health Guidance During the COVID-19 Pandemic: Systematic Review and Qualitative Evaluation. JMIR Ment Health 2023; 10:e52901. [PMID: 38133912 PMCID: PMC10760515 DOI: 10.2196/52901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/30/2023] [Accepted: 11/03/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the Oxford Precision Psychiatry Lab (OxPPL) developed open-access web-based summaries of mental health care guidelines (OxPPL guidance) in key areas such as digital approaches and telepsychiatry, suicide and self-harm, domestic violence and abuse, perinatal care, and vaccine hesitancy and prioritization in the context of mental illness, to inform timely clinical decision-making. OBJECTIVE This study aimed to evaluate the practice of creating evidence-based health guidelines during health emergencies using the OxPPL guidance as an example. An international network of clinical sites and colleagues (in Australia, New Zealand, and the United Kingdom) including clinicians, researchers, and experts by experience aimed to (1) evaluate the clinical impact of the OxPPL guidance, as an example of an evidence-based summary of guidelines; (2) review the literature for other evidence-based summaries of COVID-19 guidelines regarding mental health care; and (3) produce a framework for response to future global health emergencies. METHODS The impact and clinical utility of the OxPPL guidance were assessed using clinicians' feedback via an international survey and focus groups. A systematic review (protocol registered on Open Science Framework) identified summaries or syntheses of guidelines for mental health care during and after the COVID-19 pandemic and assessed the accuracy of the methods used in the OxPPL guidance by identifying any resources that the guidance had not included. RESULTS Overall, 80.2% (146/182) of the clinicians agreed or strongly agreed that the OxPPL guidance answered important clinical questions, 73.1% (133/182) stated that the guidance was relevant to their service, 59.3% (108/182) said that the guidelines had or would have a positive impact on their clinical practice, 42.9% (78/182) that they had shared or would share the guidance, and 80.2% (146/182) stated that the methodology could be used during future health crises. The focus groups found that the combination of evidence-based knowledge, clinical viewpoint, and visibility was crucial for clinical implementation. The systematic review identified 2543 records, of which 2 syntheses of guidelines met all the inclusion criteria, but only 1 (the OxPPL guidance) used evidence-based methodology. The review showed that the OxPPL guidance had included the majority of eligible guidelines, but 6 were identified that had not been included. CONCLUSIONS The study identified an unmet need for web-based, evidence-based mental health care guidance during the COVID-19 pandemic. The OxPPL guidance was evaluated by clinicians as having a real-world clinical impact. Robust evidence-based methodology and expertise in mental health are necessary, but easy accessibility is also needed, and digital technology can materially help. Further health emergencies are inevitable and now is the ideal time to prepare, including addressing the training needs of clinicians, patients, and carers, especially in areas such as telepsychiatry and digital mental health. For future planning, guidance should be widely disseminated on an international platform, with allocated resources to support adaptive updates.
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Affiliation(s)
- Katharine A Smith
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Edoardo G Ostinelli
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Roger Ede
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Lisa Allard
- Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia
| | | | - Kiran Hewitt
- Lincolnshire Partnership NHS Foundation Trust, Lincoln, United Kingdom
| | - Petra Brown
- Pennine Care NHS Foundation Trust, Manchester, United Kingdom
- Department of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom
| | - Caroline Zangani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - Matthew Jenkins
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Verena Hinze
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
| | - George Ma
- Pharmacy Department, The Prince Charles Hospital, Metro North Health, Brisbane, Australia
| | - Prajnesh Pothulu
- Pharmacy Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Catherine Henshall
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Institute of Applied Health Research, Oxford Brookes University, Oxford, United Kingdom
- Nursing and Midwifery Office, National Institute for Health and Care Research, London, United Kingdom
| | - Gin S Malhi
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Academic Department of Psychiatry, Faculty of Medicine and Health, Kolling Institute, Northern Clinical School, The University of Sydney, Sydney, Australia
- CADE Clinic and Mood-T, Royal North Shore Hospital, Northern Sydney Local Health District, St. Leonards, New South Wales, Australia
| | - Susanna Every-Palmer
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
- Oxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, Oxford, United Kingdom
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Serrano-Juárez CA, Reyes-Méndez C, Prieto-Corona B, Seubert-Ravelo AN, Moreno-Villagómez J, Cabañas-Tinajero JÁ, Yáñez-Téllez MG, Quezada-Torres RA, Téllez-Rodríguez M, Barrera-Rodríguez B, Soto-Jiménez MP, González-Gutiérrez FA, Castillo-Tejeda E. A Systematic Review and a Latin American Clinical Model for Teleneuropsychological Assessment. Arch Clin Neuropsychol 2022; 38:283-300. [PMID: 36196778 PMCID: PMC9619713 DOI: 10.1093/arclin/acac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The objective of this study is to propose a TeleNP model for remote assessment and offer practical recommendations for clinical practice with patients in Mexico and Latin America, based on a systematic literature review and clinical experience. METHOD A systematic review of studies from 2011 to 2021 in English and Spanish used TeleNP, teleneuropsychology, telepsychology, online, assessment, teleneuropsicología, and evaluación for the search; the databases examined included PubMed, BiDi UNAM, ScienceDirect, Google Scholar, and Wiley One Library; the Oxford Centre for Evidence-Based Medicine system was used to grade the levels of evidence. The experience of the last two years of students and faculty in the Master's and Doctoral Programs in Psychology, Clinical Neuropsychology Residency Program, was also used as a basis for this guide. RESULTS We propose a clinical model for TeleNP assessment in Mexico and Latin America based on the review of 31 articles and the practice of professors and students of clinical neuropsychology. CONCLUSION The proposed model describes a procedure and adaptations for home-to-home clinical practice in the neuropsychological assessment of Mexican patients that could also be used in other Latin American countries. Its reliability remains to be assessed, but this model and the suggestions proposed could be used in future studies and clinical trials for Mexican and Latin American populations.
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Affiliation(s)
- Carlos Alberto Serrano-Juárez
- Corresponding author at: Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Av. De los Barrios #1, Los Reyes Ixtacala, Edo de México, México. E-mail address: (C.A. Serrano-Juárez.)
| | - Carolina Reyes-Méndez
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
| | - Belén Prieto-Corona
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
| | - Ana Natalia Seubert-Ravelo
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
| | - Julieta Moreno-Villagómez
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
| | - José-Ángel Cabañas-Tinajero
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
| | - Ma Guillermina Yáñez-Téllez
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
| | - Rocío Alejandra Quezada-Torres
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
| | - Marybeth Téllez-Rodríguez
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
| | - Bárbara Barrera-Rodríguez
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
| | - Martha Paola Soto-Jiménez
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
| | - Fátima Aideé González-Gutiérrez
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
| | - Elena Castillo-Tejeda
- Residencia de Neuropsicología Clínica, División de Investigación y Posgrado, Facultad de Estudios Superiores Iztacala, UNAM, Tlalnepantla de Baz, México
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