Study into COVID-19 Crisis Using Primary Care Mental Health Consultations and Prescriptions Data

The effect of the 2020 pandemic, and of the national measures introduced to control it, is not yet fully understood. The aim of this study was to investigate how different types of primary care data can help quantify the effect of the coronavirus disease (COVID-19) crisis on mental health. A retrospective cohort study investigated changes in weekly counts of mental health consultations and prescriptions. The data were extracted from one the UK’s largest primary care databases between January 1st 2015 and October 31st 2020 (end of follow-up). The 2020 trends were compared to the 2015-19 average with 95% confidence intervals using longitudinal plots and analysis of covariance (ANCOVA). A total number of 504 practices (7,057,447 patients) contributed data. During the period of national restrictions, on average, there were 31% (3957 ± 269, p < 0.001) fewer events and 6% (4878 ± 1108, p < 0.001) more prescriptions per week as compared to the 2015-19 average. The number of events was recovering, increasing by 75 (± 29, p = 0.012) per week. Prescriptions returned to the 2015-19 levels by the end of the study (p = 0.854). The significant reduction in the number of consultations represents part of the crisis. Future service planning and quality improvements are needed to reduce the negative effect on health and healthcare.

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Uptake and patient and provider communication modality preferences of virtual visits in primary care: a retrospective cohort study in Canada

BMJ Open ◽

10.1136/bmjopen-2020-037064 ◽

2020 ◽

Vol 10 (7) ◽

pp. e037064 ◽

Cited By ~ 1

Author(s):

Vess Stamenova ◽

Payal Agarwal ◽

Leah Kelley ◽

Jamie Fujioka ◽

Megan Nguyen ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Secure Messaging ◽

Communication Modality ◽

Care Services ◽

Virtual Care ◽

Virtual Visits

ObjectivesTo evaluate the uptake of a platform for virtual visits in primary care, examine patient and physician preferences for virtual communication methods and report on characteristics of visits and patients experience of care.DesignA retrospective cohort study.SettingPrimary care practices within five regions in Ontario, Canada after 18 months of access to virtual care services.Participants326 primary care providers and 14 291 registered patients.InterventionsProviders used a platform that allowed them to connect with their patients through synchronous (audio/video) and/or asynchronous (secure messaging) communication.Main outcome measuresUser-level data from the platforms including patient demographics, practice characteristics, communication modality used, visit characteristics and patients’ satisfaction.ResultsAmong the participants, 44% of registered patients and 60% of registered providers used the platform at least once. Among patient users, 51% completed at least one virtual visit. The majority of virtual visits (94%) involved secure messaging. The most common patient requests were for medication prescriptions (24%) and follow-up from previous appointment (22%). The most common provider request was to follow-up on test results (59%). Providers indicated that 81% of virtual visits required no follow-up for that issue and 99% of patients reported that they would use virtual care services again.ConclusionsWhile there are a growing number of primary care video visit services, our study found that both patients and providers in rostered practices prefer secure messaging over video. Despite fears that virtual visits would be overused by patients, when patients connected with their own primary care provider, many virtual visits appeared to replace in-person visits, and patients did not overwhelm physicians with requests. This approach may improve access and continuity in primary care.

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Hypertension screening and follow-up in children and adolescents in a Canadian primary care population sample: a retrospective cohort study

CMAJ Open ◽

10.9778/cmajo.20150016 ◽

2016 ◽

Vol 4 (2) ◽

pp. E230-E235 ◽

Cited By ~ 5

Author(s):

B. Aliarzadeh ◽

C. Meaney ◽

R. Moineddin ◽

D. White ◽

C. Birken ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

Children And Adolescents ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Population Sample ◽

Primary Care Population ◽

Hypertension Screening

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Occupational Therapy in Mental Health via Telehealth during the COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18137138 ◽

2021 ◽

Vol 18 (13) ◽

pp. 7138

Author(s):

Antonio José Sánchez-Guarnido ◽

Esther Domínguez-Macías ◽

José Antonio Garrido-Cervera ◽

Roberto González-Casares ◽

Silvia Marí-Boned ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Mental Disorders ◽

Occupational Therapy ◽

Retrospective Cohort ◽

Face To Face ◽

Day Hospitals ◽

Therapy Interventions ◽

Occupational Therapy Interventions

The COVID-19 pandemic has brought about changes in mental health occupational therapy. Research into these changes and the associated risks of relapse is insufficient. To explore the changes that have taken place in forms of occupational intervention (face-to-face and online) during the pandemic, and to analyze their association with subsequent relapses, a multicenter retrospective cohort study was carried out of 270 patients with mental disorder diagnoses under follow-up in day hospitals during 2020. Our results show that the frequency of face-to-face occupational therapy interventions decreased during lockdown and subsequently recovered. Interventions via telehealth increased during lockdown and have since been continued to a greater extent than before lockdown. Patients who received occupational intervention via telehealth relapsed less in the following six months (10.7% vs. 26.3%; χ2 = 10.372; p = 0.001), especially those who received intervention via videoconferencing (4.2% vs. 22%; χ2 = 5.718; p = 0.017). In conclusion, lockdown subsequent to the COVID-19 outbreak led to a reduction in face-to-face occupational therapy interventions, putting people with prior mental disorders at risk, while the implementation of telehealth tools helped reduce relapses.

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Mental Health Services Use Trends in Canadian Veterans: A Population-Based Retrospective Cohort Study in Ontario

The Canadian Journal of Psychiatry ◽

10.1177/0706743717730826 ◽

2017 ◽

Vol 63 (6) ◽

pp. 378-386 ◽

Cited By ~ 7

Author(s):

Alyson L. Mahar ◽

Alice B. Aiken ◽

Heidi Cramm ◽

Marlo Whitehead ◽

Patti Groome ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Mental Illness ◽

Cohort Study ◽

Mental Health Services ◽

Health Services ◽

Retrospective Cohort ◽

Care Physician ◽

Health Related

Objective: A substantial evidence base in the peer-reviewed literature exists investigating mental illness in the military, but relatively less is documented about mental illness in veterans. This study uses provincial, administrative data to study the use of mental health services by Canadian veterans in Ontario. Method: This was a retrospective cohort study of Canadian Armed Forces and Royal Canadian Mounted Police veterans who were released between 1990 and 2013 and resided in Ontario. Mental health–related primary care physician, psychiatrist, emergency department (ED) visits, and psychiatric hospitalisations were counted. Repeated measures were presented in 5-year intervals, stratified by age at release. Results: The cohort included 23,818 veterans. In the first 5 years following entry into the health care system, 28.9% of veterans had ≥1 mental health–related primary care physician visit, 5.8% visited a psychiatrist at least once, and 2.4% received acute mental health services at an ED. The use of mental health services was consistent over time. Almost 8% of veterans aged 30 to 39 years saw a psychiatrist in the first 5 years after release, compared to 3.5% of veterans aged ≥50 years at release. The youngest veterans at release (<30 years) were the most frequent users of ED services for a mental health–related reason (5.1% had at least 1 ED visit). Conclusion: Understanding how veterans use the health care system for mental health problems is an important step to ensuring needs are met during the transition to civilian life.

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Primary Care Utilization and Mental Health Diagnoses Among Adult Patients Requiring Interpreters: a Retrospective Cohort Study

Journal of General Internal Medicine ◽

10.1007/s11606-012-2159-5 ◽

2012 ◽

Vol 28 (3) ◽

pp. 386-391 ◽

Cited By ~ 9

Author(s):

Priscilla M. Flynn ◽

Jennifer L. Ridgeway ◽

Mark L. Wieland ◽

Mark D. Williams ◽

Lindsey R. Haas ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Adult Patients ◽

Care Utilization ◽

Mental Health Diagnoses ◽

Primary Care Utilization

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Mental health of young adult patients who do not attend appointments in primary care: a retrospective cohort study

Family Practice ◽

10.1093/fampra/cmr053 ◽

2011 ◽

Vol 29 (1) ◽

pp. 24-29 ◽

Cited By ~ 10

Author(s):

A. Moscrop ◽

D. Siskind ◽

R. Stevens

Keyword(s):

Mental Health ◽

Primary Care ◽

Cohort Study ◽

Young Adult ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Adult Patients

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Accuracy of the French Administrative Database to Describe Patients’ Medication and Primary Care Visits: A Validation Study

Studies in Health Technology and Informatics - Public Health and Informatics ◽

10.3233/shti210180 ◽

2021 ◽

Author(s):

Anaïs Payen ◽

Claire Godard-Sebillotte ◽

Julien Soula ◽

David Verloop ◽

Marie-Marguerite Defebvre ◽

...

Keyword(s):

Primary Care ◽

Cohort Study ◽

General Practitioner ◽

Retrospective Cohort ◽

Medication Reconciliation ◽

Transitional Care ◽

Patient Discharge ◽

Administrative Database ◽

Care Intervention

Objective: To evaluate the accuracy of the French health administrative database to describe patients’ medication and primary care visits, in the context of a transitional care intervention including an in-hospital medication reconciliation followed by a structured community follow-up by the patient’s general practitioner and pharmacist. Design: A retrospective cohort study of older persons enrolled in the transitional care intervention between January 1st, 2015 and December 31st, 2018. Results: Only 46.1% of the community follow-up were timely billed, in the 3 months after the patient discharge. The sensitivity of the health administrative database to identify medications was 90.0%. Its positive predictive value was 50.1%. Conclusion: This study reveals that the French health administrative database was poorly reliable to identify both community follow-up and chronic medications.

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