Exploratory Study Providing Telepsychiatry in the Home With a Clinician Present
Team-based Telemedicine
Studieöversikt
Detaljerad beskrivning
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.
Studietyp
Inskrivning (Förväntat)
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
-
-
Michigan
-
Detroit, Michigan, Förenta staterna, 48201
- Wayne State University
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- patient at FQHC
- referred for psychiatric services
- 50 or older
Exclusion Criteria:
- does not speak English
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Övrig
- Tilldelning: Icke-randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: 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
|
|
Aktiv komparator: 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
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
PHQ-9
Tidsram: 6 months
|
depressiive symptoms
|
6 months
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
GAD7
Tidsram: 6 months
|
anxiety symptoms
|
6 months
|
|
Home checklist
Tidsram: 6 months
|
Problems detected in the home
|
6 months
|
Samarbetspartners och utredare
Sponsor
Utredare
- Huvudutredare: Cynthia L Arfken, PhD, Wayne State University
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Förväntat)
Avslutad studie (Förväntat)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- MHEF 2018
Plan för individuella deltagardata (IPD)
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