Feasibility of Accessible Video Mental Healthcare Triage and Assessment - A Clinical Pilot Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 172
- 试验地点
- 2
- 主要终点
- Patient characteristics
研究概览
简要总结
This study aims to describe the immediate psychiatry (IP) service, patient population, and patient flow, as well as investigate the experiences, acceptability, and feasibility of the IP triage service implemented in Region Stockholm, Sweden.
Patients aged 18 years and older who were registered at participating primary care centers were eligible to access the IP through a regional healthcare app. IP comprised a brief digital screening followed by a 45-minute video consultation with a mental health professional. The study will employ a mixed methods design with data from medical records, patient surveys, interviews with the IP team, and clinician acceptability questionnaires. The quantitative data will be analyzed via descriptive statistics, and the qualitative data will be analyzed via content analysis.
详细描述
Study Design, Setting, and Ethical Considerations This pilot study, initiated in May 2022, was conducted at a psychiatric clinic affiliated with Karolinska Huddinge Hospital, in collaboration with eight primary care centers in southern Stockholm, Sweden. Data collection occurred from December 19, 2022, to June 30, 2023. The study was ethically approved by the Swedish Ethical Review Authority (2022-03893-01) and adhered to ethical guidelines. Participants were informed about the study's purpose and procedures, with an option to opt out at any time without affecting their care.
The specific research questions were as follows:
- How many patients received IP, on the basis of the selected recruitment strategy?
- What were the subsequent care needs in primary and psychiatric care settings identified for patients after using the service?
- What were the demographics of participants included in the study, such as age, gender, type of psychiatric problems?
- How did the participants rate their psychiatric concerns in terms of the type of symptoms, symptom severity, symptom onset, and symptom duration?
- How did the IP team assess patients' psychiatric symptoms and suicidality?
- How did the participants rate their satisfaction with the IP?
- Did patient groups recommended for subsequent care in primary and psychiatric care differ in terms of demographics and clinical aspects explored in C-F?
- How did the IP team experience their work with the intervention?
- How did participating primary care centers rate the acceptability of IP?
Recruitment Process Participants were recruited through multiple channels including information on the participating primary healthcare websites, posters, verbal information from healthcare providers, and local advertisements. Recruitment was limited to Swedish speakers due to the app's language and logistical issues with interpreter availability.
Participants Inclusion criteria required participants to be 18 years or older and registered with one of the eight participating primary healthcare centers. No exclusion criteria were applied, enabling the study to include patients with both subclinical and severe psychiatric symptoms.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Other
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
结局指标
主要结局
Patient characteristics
时间窗: Study period of 7 months
Patient characteristics and patient flow Data on patient characteristics were collected through self-reported psychiatric concerns as well as preliminary diagnoses and actions initiated by the IP team, as indicated by information from the medical records. Patient flow was monitored through patient medical records.
Brief screening of psychiatric concerns
时间窗: Study period of 7 months
The 9-item brief self-reported screening of psychiatric concerns (Supplement A) was used to gather initial information from patients (patient-rated symptoms and the impact of these symptoms on daily life and relationships via a combination of multiple-choice and open-ended questions.) It assesses a range of psychiatric symptoms, including those related to mood disorders, anxiety disorders, stress-related disorders, obsessive-compulsive disorders, and psychotic disorders. Additionally, it screens for self-harm or suicidal thoughts, psychiatric history, and current use of psychopharmaceuticals. The scale is descriptive without numeric score.
次要结局
- Patients demographics(Pre intervention)
- Clinical assessments(Study period of 7 months])
- Patient satisfaction(Study period of 7 months)
- Interviews with the IP Team(Study period of 7 months)
- Clinician acceptability at primary care centers(Study period of 7 months)