What Nonpsychiatrists Want From Psychiatrists: Data From Chart Review Consultation Requests in a Rural Health Care System.

IF 3.3 3区医学 Q1 HEALTH POLICY & SERVICES

Psychiatric services Pub Date : 2025-05-28 DOI:10.1176/appi.ps.20240263

Evan M Calvo, Lauren K Walsh, Victoria M T Tyrell, Christopher F Chabris, Joanne A Byars

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引用次数: 0

Abstract

Objective: Given the growing need for novel psychiatric service delivery, this study sought to characterize the use of an outpatient electronic consultation service, Ask-A-Doc (AAD), in a rural health care system.

Methods: A qualitative codebook was developed (final interrater agreement=92%) and applied to the free text of all AAD questions (N=707) received by a psychiatry department during a 12-month period.

Results: Primary care was the principal source of AAD questions (95%), with most submitted by physicians (56%) and advanced practitioners (44%). Medication management was the most common reason for AAD submission (90%). Submissions mentioned psychiatric symptoms (85%) more than diagnoses (52%). Commonly mentioned symptoms included anxiety and depression; frequently mentioned diagnoses included bipolar disorder, attention-deficit hyperactivity disorder, and major depressive disorder.

Conclusions: Nonpsychiatrists find benefit in psychiatrist assistance in managing patients with mental health conditions; they generally want recommendations for medication management to target specific symptoms, not assistance with making or treating specific diagnoses.

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非精神科医生想从精神科医生那里得到什么：来自农村卫生保健系统的图表审查咨询请求的数据。

目的：鉴于对新型精神病学服务的需求日益增长，本研究试图描述农村卫生保健系统中门诊电子咨询服务Ask-A-Doc （AAD）的使用特征。方法：开发定性代码本（最终通译者一致性=92%），并将其应用于精神科12个月期间收到的所有AAD问题（N=707）的免费文本。结果：初级保健是AAD问题的主要来源（95%），大多数由医生（56%）和高级执业医师（44%）提交。药物管理是提交AAD最常见的原因（90%）。提交者提到精神症状（85%）多于诊断（52%）。常见的症状包括焦虑和抑郁；常被提及的诊断包括双相情感障碍、注意力缺陷多动障碍和重度抑郁症。结论：非精神科医生发现精神科医生在管理精神疾病患者方面的帮助是有益的；他们通常需要针对特定症状的药物管理建议，而不是帮助做出或治疗特定的诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychiatric services 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.80

自引率

7.90%

发文量

295

审稿时长

3-8 weeks

期刊介绍： Psychiatric Services, established in 1950, is published monthly by the American Psychiatric Association. The peer-reviewed journal features research reports on issues related to the delivery of mental health services, especially for people with serious mental illness in community-based treatment programs. Long known as an interdisciplinary journal, Psychiatric Services recognizes that provision of high-quality care involves collaboration among a variety of professionals, frequently working as a team. Authors of research reports published in the journal include psychiatrists, psychologists, pharmacists, nurses, social workers, drug and alcohol treatment counselors, economists, policy analysts, and professionals in related systems such as criminal justice and welfare systems. In the mental health field, the current focus on patient-centered, recovery-oriented care and on dissemination of evidence-based practices is transforming service delivery systems at all levels. Research published in Psychiatric Services contributes to this transformation.