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article imageEssential Science: Why telemedicine works with mental health

By Tim Sandle     Sep 4, 2017 in Science
Telemedicine can trump face-to-face care in some situations. A new study shows how a telephone-delivered collaborative care program for treating panic and generalized anxiety disorders in primary care proves more successful than conventional care.
Telemedicine is a about different approaches, using communications technology, for the remote diagnosis and treatment of patients. In recent years, healthcare providers have become interested in the technology as a means to overcome distance barriers and to improve access to medical services. One area where this has been tested out in is with distant rural communities. This subject was explored by Digital Journal in a recent article titled "Telemedicine or in-person care for Parkinson's Disease?"
This is the ARC pen that helps sufferers of Parkinson s Disease write clrearly again.
This is the ARC pen that helps sufferers of Parkinson's Disease write clrearly again.
Photo from Dopa Solutions
Pros and cons of telemedicine
Telemedicine divides medical opinion, with some medics reporting on the advantages and others expressing concerns about the inability of a trained medic to assess a patient face-to-face. There are also concerns about some telemedicine services being fronted by poorly trained or junior staff. There is also a growing interest within the patient community for telemedicine services, especially from young people. In the U.S., for example, a recent Cisco global survey found that 74 percent of patients prefer easy access to healthcare services over in-person interactions with providers. Furthermore, Ernst & Young Senior Advisory Services Manager Jan Oldenburg told Healthcare IT News that telemedicine can assist with patient engagement. In terms of treatment effectiveness, a study in 2016 found that providing an online computerized cognitive behavioral therapy program both alone and in combination with Internet support groups was a more effective treatment for anxiety and depression than doctors' usual primary care.
A telephone
A telephone
Via Flickr Camilo Rueda López
In less developed parts of the world, telemedicine uses information and communication technologies to to overcome geographical barriers, and increase access to health care services. According to the World Health Organization (WHO), this is "particularly beneficial for rural and underserved communities in developing countries – groups that traditionally suffer from lack of access to health care."
Clinical benefits of telemedicine
Focusing on the clinical benefits, a new study from University of Pittsburgh Schools of the Health Sciences has found that a telephone-delivered collaborative care program designed for treating panic and generalized anxiety disorders in primary care is actually more effective than traditional approaches to medical care. This is as measured by improving health-related quality of life and with reducing anxiety and mood symptoms.
To assess this, medics recruited 329 patients who were aged 18 to 64 years old for the study. The patients had been referred by a primary care physicians. Of the 329 participants, 250 were assessed as "highly anxious." These patients were placed into one of two groups. One group consisted of those who were to receive telephone-delivered intervention; the second group received care in a conventional way from a doctor. The remaining 79 other patients, who were assessed as having "moderate" levels of anxiety were placed into one of the two groups if their anxiety symptoms deteriorated.
Mobile roaming charges account for around five percent of sales for telephone operators in Europe
Mobile roaming charges account for around five percent of sales for telephone operators in Europe
Oli SCARFF, AFP/File
With the telemedicine group, a medic regularly called the patients in the intervention group to provide basic counselling, such as encouraging healthy habits including sleep and exercise. The medics also asked questions about treatment progress using anti-anxiety medications and discussed general feelings with the patient. After twelve months the results were assessed. It was found that 53 percent of the patients who were treated via telemedicine showed a reduction in anxiety symptoms compared with just 32 percent treated via the conventional face-to-face route.
Commenting on the research, one of the lead scientists Professor Bruce L. Rollman said: "Effective collaborative care for anxiety can be provided via telephone by college-educated, non-mental health care managers who follow an evidence-based treatment algorithm and work under the direction of a primary care physician."
The new research has been published in the Journal of General Internal Medicine, with the research paper titled "Telephone-Delivered Stepped Collaborative Care for Treating Anxiety in Primary Care: A Randomized Controlled Trial."
File photo.
File photo.
Ingolfson
In a further example of the benefits of telemedicine, a separate study found that when experiencing a stroke, people who are brought to the hospital in an ambulance with a CT scanner and telemedicine capabilities are evaluated and treated nearly two times faster than people taken in a regular ambulance (as published in the journal Neurology "Reduction in time to treatment in prehospital telemedicine evaluation and thrombolysis").
Essential Science
Two species of colonial tunicates. Clavelina robusta black and white. Pycnoclavella flava orange.
Two species of colonial tunicates. Clavelina robusta black and white. Pycnoclavella flava orange.
Nhobgood
This article is part of Digital Journal's regular Essential Science columns. Each week Tim Sandle explores a topical and important scientific issue. Last week we looked at developments with bioeful production and the use of a special group of microbes called cyanobacteria. The week before various innovations in digital health were presented, including the factors that can sometimes lead to poorly designed devices and apps.
More about essential science, telemedicine, collaborative care, Mental health
 
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