Psychiatric Care Via Videoconferencing

New Information and Communication Technologies in the Delivery of Mental Health Treatment: Psychiatric Care Via Videoconferencing

The purpose of this project is to compare the effectiveness between face-to-face consultations and consultations via videoconferencing among patients treated in the Institute of Psychiatry (IPq).

Study Overview

• Status: Completed
• Conditions: Depression
• Intervention / Treatment: Procedure: Online consultation; Procedure: Face-to-face consultation

Detailed Description

Introduction: Within the emergence of the Internet and for the purposes of providing psychiatric services across distances, the provision of mental health service via video counseling has become a possible way of mental health service delivery. An appropriate systematization of the propaedeutic methods in psychiatry, according to the interactive resources of telemedicine, and a standardized assessment based on clinical records turn this method to a viable alternative for service delivery all over the world. The main benefit of video counseling is an increased access to care services. But, so far, there is still limited research regarding to the effectiveness of telepsychiatry in the management of mental illnesses.

Objective: To verify the applicability of psychiatric attendance via Interned-based videoconferencing, comparing various quality characteristics between this method and face-to-face attendance, on the basis of a one-year follow-up study with a randomized clinical trial (RCT) design.

Material and methods: 100 patients of the Institute of Psychiatry (IPq) between 18 to 55 years old with depressive disorders are randomly allocated to a control (monthly face-to-face consultation with the attending psychiatrist) or intervention group. The intervention group will have consultations with the attending psychiatrist through internet-based videoconference. For reasons of patient safety, consultations at baseline, and after 6 and 12 months will be realized in a face-to-face form for all patients. At baseline, and after 6 and 12 months mental health, satisfaction with treatment, therapeutic relationship, and medical compliance will be assessed. Depression will be assessed at baseline, and after 3, 6, 9 and 12 months.

• Study Type: Interventional
• Enrollment (Actual): 107
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Brazil
  • Sao Paulo, Brazil, 05403-010
    • Institute of Psychiatry, School of Medicine, University of Sao Paulo

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 55 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• depressive disorder
• between 18 to 55 years
• broadband Internet access

Exclusion Criteria:

• Hamilton Depression Rating Scale total score > 15
• severe cognitive limitations

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Online consultation; Monthly video consultations with psychiatrist	Procedure: Online consultation; Patients in the online consultation (intervention) group have monthly consultation with their attending psychiatrist through videoconferencing during one year. After each consultation, the medication is sent to the patient through a home delivery program. For reasons of patient safety, consultations at baseline, and after 6 and 12 months will be realized in a face-to-face form at the Institute of Psychiatry (IPq).
Experimental: Face-to-face consultation; Monthly face-to-face consultations with psychiatrist	Procedure: Face-to-face consultation; Patients in the face-to-face consultation (control) group have monthly face-to-face consultation with their attending psychiatrist during one year at the Institute of Psychiatry (IPq).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Baseline Depression Severity	Instrument: Hamilton Depression Rating Scale	0 months (baseline)
Change from Baseline in Depression Severity at 6 months	Instrument: Hamilton Depression Rating Scale	6 months
Change from Baseline and 6-months Follow-up in Depression Severity at 12 months	Instrument: Hamilton Depression Rating Scale	12 months
Baseline Satisfaction with Treatment	Instrument: Client Satisfaction Questionnaire (CSQ-8)	0 months (baseline)
Change from Baseline in Satisfaction with Treatment at 6 months	Instrument: Client Satisfaction Questionnaire (CSQ-8)	6 months
Change from Baseline and 6-months Follow-up in Satisfaction with Treatment at 12 months	Instrument: Client Satisfaction Questionnaire (CSQ-8)	12 months
Baseline Mental Health	Instrument: Mental Health Inventory (MHI)	0 months (baseline)
Change from Baseline in Mental Health at 6 months	Instrument: Mental Health Inventory (MHI)	6 months
Change from Baseline and 6-months Follow-up in Mental Health at 12 months	Instrument: Mental Health Inventory (MHI)	12 months
Baseline Quality of Therapeutic Relationship	Instrument: Working Alliance Inventory (WAI)	0 months (baseline)
Change from Baseline in Quality of Therapeutic Relationship at 6 months	Instrument: Working Alliance Inventory (WAI)	6 months
Change from Baseline and 6-months Follow-up in Quality of Therapeutic Relationship at 12 months	Instrument: Working Alliance Inventory (WAI)	12 months
Baseline Medical Adherence	Instrument: self-reported measure of medication adherence with four items: Do you forget to take your medication?; Are you careless at times about taking your medicine?; When you feel better, do you sometimes stop taking your medicine?; Sometimes when you feel worse, do you stop taking your medicine? Response categories are yes/no for each item with a dichotomous response and a 5-point Likert response for the last item.	0 months (baseline)
Change from Baseline in Medical Adherence at 6 months	Instrument: self-reported measure of medication adherence with four items: Do you forget to take your medication?; Are you careless at times about taking your medicine?; When you feel better, do you sometimes stop taking your medicine?; Sometimes when you feel worse, do you stop taking your medicine? Response categories are yes/no for each item with a dichotomous response and a 5-point Likert response for the last item.	6 months
Change from Baseline and 6-months Follow-up in Medical Adherence at 12 months	Instrument: self-reported measure of medication adherence with four items: Do you forget to take your medication?; Are you careless at times about taking your medicine?; When you feel better, do you sometimes stop taking your medicine?; Sometimes when you feel worse, do you stop taking your medicine? Response categories are yes/no for each item with a dichotomous response and a 5-point Likert response for the last item.	12 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Demographics	Age, Gender, Nationality, Marital Satus, Education, and Employment	0 months (baseline)
Technical Control of Online Consultations at 6 an 12 months	Assessment of technical aspects regarding to online consultations: sound quality, video quality, speed, technical support	6 and 12 months

Collaborators and Investigators

• Sponsor: University of Sao Paulo General Hospital
• Investigators: Study Director: Wagner F Gattaz, Prof. Dr., Institute of Psychiatry (IPq)

Publications and helpful links

General Publications

• Hungerbuehler I, Valiengo L, Loch AA, Rossler W, Gattaz WF. Home-Based Psychiatric Outpatient Care Through Videoconferencing for Depression: A Randomized Controlled Follow-Up Trial. JMIR Ment Health. 2016 Aug 3;3(3):e36. doi: 10.2196/mental.5675.

Study record dates

Study Major Dates

• Study Start: March 1, 2012
• Primary Completion (Actual): April 1, 2015
• Study Completion (Actual): May 1, 2015

Study Registration Dates

• First Submitted: July 10, 2013
• First Submitted That Met QC Criteria: July 12, 2013
• First Posted (Estimate): July 17, 2013

Study Record Updates

• Last Update Posted (Estimate): May 22, 2015
• Last Update Submitted That Met QC Criteria: May 21, 2015
• Last Verified: July 1, 2013

More Information

Terms related to this study

• Keywords: Telemedicine; depression; Remote Consultation; health care delivery; telepsychiatry; Videoconferencing; telemental health; Community Mental Health Services; teleassistance
• Additional Relevant MeSH Terms: Behavioral Symptoms; Depression
• Other Study ID Numbers: IPQ-0782/11