Exploratory Study Providing Telepsychiatry in the Home With a Clinician Present
Team-based Telemedicine
調査の概要
詳細な説明
The goal of this project is to document the benefits and barriers to expanding reimbursement for telemedicine to older patient's home as the originating site. The objectives are:
- Develop training module for midlevel clinicians to be ready for dissemination
- Improved patient outcomes measures on satisfaction with care; functioning and symptoms (anxiety, depression, traumatic stress, sleep apnea, alcohol use and problems)
- Reductions in emergency healthcare utilization and medications prescribed as obtained from electronic health record (EHR) at the Federally Qualified Health Center (FQHC) and self-reports
- Summarize activities and barriers, including communication with primary care provider, identification and improvement of home environmental risks, and assistance to support system
This is an observational study of team-based telepsychiatry in the home for one group and team-based psychiatry in the clinic for the comparison group. The initial assessment will include information and informed consent for treatment, biopsychosocial assessment, summary for the psychiatrist, psychiatric evaluation and recommendations (all standard of care). To that the investigators are adding informed consent for program evaluation with 6 month follow-up with information for re-contacting (3 sources, addresses, email-telephone numbers), and brief administration of selected instruments before informed consent for treatment. If an eligible patient does not want to participate in the research study, the patient would still receive services.
Additional telemedicine sessions and/or therapy sessions will be conducted as medically needed in accordance with quality care. At six months (with one month window on either side) the evaluation packet will be re-administered by the clinician if convenient or by the research assistant either in person or by phone.
The sample size was selected to provide robust indicators of barriers to home based assessments. The comparison group was included to provide a context for the findings. It is anticipated that the home group will have greater problems at baseline than the clinic based comparison group but both will show improvements.
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
研究場所
-
-
Michigan
-
Detroit、Michigan、アメリカ、48201
- Wayne State University
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- patient at FQHC
- referred for psychiatric services
- 50 or older
Exclusion Criteria:
- does not speak English
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:他の
- 割り当て:非ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
実験的:Home-based
Clinicians at the FQHC will identify and offer the opportunity to receive telepsychiatry in the home with 2 clinicians present.
The patients are not required to agree to the evaluation to receive the services.
The services are entered into their EHR but are not eligible for Medicaid reimbursement.
|
Receive telepsychiatry with clinician obtaining initial data and presenting it to the psychiatrist
|
アクティブコンパレータ:Clinic-based
Clinicians at the FQHC will identify and offer the opportunity to receive telepsychiatry in the clinic with 1 clinican present.
The patients are not required to agree to the evaluation to receive the services.
The services are entered into their EHR and eligible for Medicaid reimbursement.
|
Receive telepsychiatry with clinician obtaining initial data and presenting it to the psychiatrist
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
PHQ-9
時間枠:6 months
|
depressiive symptoms
|
6 months
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
GAD7
時間枠:6 months
|
anxiety symptoms
|
6 months
|
Home checklist
時間枠:6 months
|
Problems detected in the home
|
6 months
|
協力者と研究者
スポンサー
捜査官
- 主任研究者:Cynthia L Arfken, PhD、Wayne State University
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。