scholarly journals Rapid Review on the Effectiveness of Telehealth Interventions for the Treatment of Behavioral Health Disorders

2021 ◽  
Author(s):  
Dawn M Bellanti ◽  
Marija S Kelber ◽  
Don E Workman ◽  
Erin H Beech ◽  
Brad E Belsher
Keyword(s):  
Behavioral Health ◽  
Psychological Health ◽  
Care Quality ◽  
Rapid Review ◽  
Second Person ◽  
Treatment Delivery ◽  
Face To Face ◽  
Video Teleconferencing ◽  
Single Person ◽  
Behavioral Health Disorders

ABSTRACT Introduction The Psychological Health Center of Excellence conducted a rapid review of the literature to investigate the effectiveness of behavioral health treatments (i.e., evidence-based psychotherapy and psychiatry) delivered in person compared to telehealth (TH; i.e., video teleconference and telephone). Materials and Methods The rapid review methods included a systematic search of a single database (PubMed), hand-searching of relevant systematic reviews, dual screening, single-person data abstraction verified by a second person, and dual risk of bias assessment. Due to heterogeneity across studies, no quantitative analyses were conducted. Results Twenty-two randomized controlled trials (RCTs), eight of which were non-inferiority trials, evaluated the effectiveness of TH via telephone or video teleconferencing compared to in-person (IP) delivery for patient populations with posttraumatic stress disorder, depression, and mixed diagnoses. The majority of RCTs and all but one of the eight non-inferiority trials found that clinical outcomes did not differ between TH and IP treatment delivery. Two studies found that subgroups with higher symptom severity (hopelessness and anxiety disorders, respectively) in the TH group had worse treatment-related outcomes than IP participants with similar symptom profiles. The majority of studies found no significant differences in satisfaction with care, quality of the therapeutic alliance, or study discontinuation between TH and IP groups. Conclusion Based on evidence from 22 RCTs, the use of TH platforms, including video conference and telephone modalities, generally produces similar outcomes as face-to-face provision of psychotherapy and psychiatry services.

scholarly journals Impact of COVID-19 on management of urogynaecology patients: a rapid review of the literature

2021 ◽  
Author(s):  
Jemina Loganathan ◽  
◽  
Stergios K. Doumouchtsis
Keyword(s):  
Evidence Synthesis ◽  
Horizontal Transmission ◽  
Rapid Review ◽  
Review Of The Literature ◽  
First Line ◽  
Face To Face ◽  
Manual Search ◽  
Guidance Documents ◽  
Management Recommendations

Abstract Introduction and hypothesis The coronavirus (COVID-19) pandemic has impacted health systems worldwide. There is a continuing need for clinicians to adapt practice to facilitate timely provision of medical care, whilst minimising horizontal transmission. Guidance and recommendations are increasingly available, and this rapid review aimed to provide a timely evidence synthesis on the current recommendations surrounding urogynaecological care. Methods We performed a literature review using PubMed/Medline, Embase and Cochrane and a manual search of national and international societies for management recommendations for urogynaecological patients during the COVID-19 pandemic. Results Nine guidance documents and 17 articles, including 10 reviews, were included. Virtual clinics are recommended for new and follow-up patients, to assess and initiate treatment, as well as triage patients who require face-to-face appointments. Outpatient investigations such as urodynamics and cystoscopy for benign indications can be deferred. Prolapse and continence surgery should be suspended, except in specific circumstances such as procidentia with upper tract complications and failed pessaries. There is no evidence to support a particular route of surgery, but recommendations are made to minimise COVID-19 transmission. Conclusions Urogynaecological patients face particular challenges owing to inherent vulnerabilities of these populations. Behavioural and medical therapies should be recommended as first line options and initiated via virtual or remote clinics, which are integral to management during the COVID-19 pandemic. Expanding the availability and accessibility of technology will be increasingly required. The majority of outpatient and inpatient procedures can be deferred, but the longer-term effects of such practices are unclear.

Abstract 16535: Mental and Behavioral Health Disorders Among Patients With Acute Myocardial Infarction in the United States

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jayakumar Sreenivasan ◽  
Mohammad S Khan ◽  
Safi U Khan ◽  
Wilbert S Aronow ◽  
Julio A Panza ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Bipolar Disorder ◽  
Major Depression ◽  
Anxiety Disorders ◽  
Behavioral Health ◽  
Psychotic Disorders ◽  
Hospital Outcomes ◽  
Behavioral Health Disorders ◽  
Acute Mi ◽  
Health Disorders

Background: Mental and behavioral health disorders (MBD) are associated with an increased risk of cardiovascular disease and with worse long-term outcomes after myocardial infarction (MI). Hypothesis: We hypothesized the prevalence of MBD among patients with acute MI is rising over time. Methods: Using National Inpatient Sample Database, we assessed temporal trends in the prevalence of MBD and in-hospital outcomes among patients hospitalized for acute MI in the US from 2008-2017. We used multiple logistic regression for in-hospital outcomes and examined yearly trends and estimated annual percent change (APC) in odds of MBD among MI patients. Results: We included a total of 6,117,804 patients with MI (ST elevation MI 30.4%) with a mean age of 67.2±0.04 and 39% females. Psychoactive substance use disorder (PSD) (24.9%) was the most common behavioral health disorder, and major depression (6.2%) and anxiety disorders (6.0%) were the most common mental health disorders, followed by bipolar disorder (0.9%), schizophrenia/psychotic disorders (0.8%) and post-traumatic stress disorder (PTSD) (0.3%). Between 2008 to 2018, the prevalence of PSD (23.7-25.0%, APC +0.6%), major depression (4.7-7.4%, APC +6.2%), anxiety disorders (3.2-8.9%, APC +13.5%), PTSD (0.2-0.6%, +12.5%) and bipolar disorder (0.7-1.0%, APC +4.0%) significantly increased over the time period. Major depression, bipolar disorder or schizophrenia/psychotic disorders were associated with a lower likelihood of coronary revascularization, although a co-diagnosis of MBD was associated with a lower risk of in-hospital mortality. Conclusion: MBD are common among patients with acute MI and there was a concerning increase in the prevalence of PSD, major depression, bipolar disorder, anxiety disorders and PTSD. Focused mental and behavioral health interventions and health care policy changes are warranted to address the increasing burden of comorbid MBD among acute MI.

scholarly journals Characterizing Participation and Perceived Engagement Benefits in an Integrated Digital Behavioral Health Recovery Community for Women: A Cross-Sectional Survey (Preprint)

2019 ◽  
Author(s):  
Brenda Curtis ◽  
Brandon Bergman ◽  
Austin Brown ◽  
Jessica McDaniel ◽  
Kristen Harper ◽  
...  
Keyword(s):  
Substance Use ◽  
Behavioral Health ◽  
Average Length ◽  
Mutual Aid ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Effective Manner ◽  
Behavioral Health Disorders ◽  
Health Disorders ◽  
Gender Specific

BACKGROUND Research suggests that digital recovery support services (D-RSSs) may help support individual recovery and augment the availability of in-person supports. Previous studies highlight the use of D-RSSs in supporting individuals in recovery from substance use but have yet to examine the use of D-RSSs in supporting a combination of behavioral health disorders, including substance use, mental health, and trauma. Similarly, few studies on D-RSSs have evaluated gender-specific supports or integrated communities, which may be helpful to women and individuals recovering from behavioral health disorders. OBJECTIVE The goal of this study was to evaluate the SHE RECOVERS (SR) recovery community, with the following 3 aims: (1) to characterize the women who engage in SR (including demographics and recovery-related characteristics), (2) describe the ways and frequency in which participants engage with SR, and (3) examine the perception of benefit derived from engagement with SR. METHODS This study used a cross-sectional survey to examine the characteristics of SR participants. Analysis of variance and chi-square tests, as well as univariate logistic regressions, were used to explore each aim. RESULTS Participants (N=729, mean age 46.83 years; 685/729, 94% Caucasian) reported being in recovery from a variety of conditions, although the most frequent nonexclusive disorder was substance use (86.40%, n=630). Participants had an average length in recovery (LIR) of 6.14 years (SD 7.87), with most having between 1 and 5 years (n=300). The most frequently reported recovery pathway was abstinence-based 12-step mutual aid (38.40%). Participants reported positive perceptions of benefit from SR participation, which did not vary by LIR or recovery pathway. Participants also had high rates of agreement, with SR having a positive impact on their lives, although this too did vary by recovery length and recovery pathway. Participants with 1 to 5 years of recovery used SR to connect with other women in recovery at higher rates, whereas those with less than 1 year used SR to ask for resources at higher rates, and those with 5 or more years used SR to provide support at higher rates. Lifetime engagement with specific supports of SR was also associated with LIR and recovery pathway. CONCLUSIONS Gender-specific and integrated D-RSSs are feasible and beneficial from the perspective of participants. D-RSSs also appear to provide support to a range of recovery typologies and pathways in an effective manner and may be a vital tool for expanding recovery supports for those lacking in access and availability because of geography, social determinants, or other barriers.

Home care packages: insights into the experiences of older people leading up to the introduction of consumer directed care in Australia

2017 ◽  
Vol 23 (2) ◽  
pp. 162 ◽  
Author(s):  
Jenny Day ◽  
Ann Clare Thorington Taylor ◽  
Peter Summons ◽  
Pamela Van Der Riet ◽  
Sharyn Hunter ◽  
...  
Keyword(s):  
Home Care ◽  
Older People ◽  
Study Data ◽  
Care Quality ◽  
Two Phase ◽  
Face To Face ◽  
Before And After ◽  
Qualitative Descriptive ◽  
Care Coordinators ◽  
Field Notes

This paper reports phase one, conducted from March to June 2015, of a two-phase, qualitative descriptive study designed to explore the perceptions and experiences of older people before and after the introduction of consumer directed care (CDC) to home care packages (HCP) in Australia. Eligible consumers with a local HCP provider were mailed information about the study. Data collection occurred before the introduction of CDC and included face-to-face, in-depth interviews, summaries of interviews, field notes and reflective journaling. Semi-structured questions and ‘emotional touchpoints’ relating to home care were used to guide the interview conversation. Line-by-line data analysis, where significant statements were highlighted and clustered to reveal emergent themes, was used. Five older people, aged 81 to 91 years, participated in the study. The four emergent themes were: seeking quality and reciprocity in carer relationships; patchworking services; the waiting game; and technology with utility. Continuity of carers was central to the development of a trusting relationship and perceptions of care quality among older consumers. Care coordinators and workers should play a key role in ensuring older people receive timely information about CDC and their rights and responsibilities. Participants’ use of contemporary technologies suggests opportunities to improve engagement of HCP clients in CDC.

Intersubjectivity, Sociality, Community

2018 ◽  
Author(s):  
Dan Zahavi
Keyword(s):  
Interpersonal Relations ◽  
Second Person ◽  
Face To Face ◽  
Alternative Approaches ◽  
Social Units

The chapter discusses how various early phenomenologists by starting from an examination of empathy and other forms of dyadic interpersonal relations went on to develop analyses of larger social units in order to address questions concerning the nature of our communal being-together. More specifically, it shows how an investigation of dyadic empathic encounters figures prominently in not only Husserl’s, but also Scheler’s and Walther’s subsequent analyses of experiential sharing and we-intentionality. Not all phenomenologists, however, agreed with this prioritization of second-person engagement and face-to-face relationships. The chapter concludes with a brief discussion of Gurwitsch’s and Heidegger’s criticisms and alternative approaches.

Innovative Adaptation of Training and Technical Assistance

2022 ◽  
pp. 239-264
Author(s):  
Holly N. Hagle ◽  
Yifei Liu ◽  
Deena M. Murphy ◽  
Laurie Krom
Keyword(s):  
Substance Use ◽  
Behavioral Health ◽  
Community Involvement ◽  
Technical Assistance ◽  
Mental Illnesses ◽  
Evidence Based ◽  
Telecommunication Services ◽  
Face To Face ◽  
Rapid Transition ◽  
Behavioral Health Workforce

The behavioral health workforce is pivotal to provide evidence-based services (EBPs) for patients with mental illnesses or substance use disorders. The COVID-19 pandemic has exacerbated existing healthcare issues for these patients and highlighted the need for a well-trained workforce. The stay-at-home orders compelled a rapid transition to delivering behavioral health services from traditional face-to-face encounters to telehealth/telecommunication services. Training and technical assistance (TTA) networks supporting the behavioral health workforce's educational needs quickly moved to virtual delivery. This shift has resulted in innovations and adaptations categorized into four areas: adapting is crucial, convening stakeholders is essential, resources (human and technological) are needed, and community involvement is integral. Future TTA efforts should focus on sharing the successful virtual adaptations to EBPs.

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