Telemedicine journal and e-health : the official journal of the American Telemedicine Association最新文献

{"title":"Satisfaction with and Feasibility of Prenatal Counseling via Telemedicine: A Prospective Cohort Study.","authors":"Kathrin Oelmeier,&nbsp;Ralf Schmitz,&nbsp;Mareike Möllers,&nbsp;Janina Braun,&nbsp;Daniela Deharde,&nbsp;Marina Sourouni,&nbsp;Helen Ann Köster,&nbsp;Gunita Apsite,&nbsp;Maria Eveslage,&nbsp;Karen Fischhuber,&nbsp;Michael Storck,&nbsp;Franziska Emming,&nbsp;Jan Wohlmann,&nbsp;Christian Juhra","doi":"10.1089/tmj.2021.0309","DOIUrl":"https://doi.org/10.1089/tmj.2021.0309","url":null,"abstract":"<p><p><b>Introduction:</b> Telemedicine has become increasingly important over the past decade. With the pressure of the COVID-19 pandemic, demands for remote health care solutions have seen an unprecedented rise. However, many questions regarding the feasibility and benefits of telemedicine remain. The aim of our study was to evaluate both the technical feasibility and patient satisfaction with video consultations in a tertiary center for obstetric care. <b>Materials and Methods:</b> This prospective single-center trial was part of the larger open Video Service project on telemedicine at the Department of Gynecology and Obstetrics at the University of Münster. Patients requiring prenatal or prepregnancy counseling were included. A questionnaire was designed for the evaluation of patient satisfaction and filled in by both patient and health care provider at the end of the video consultation. <b>Results:</b> Of 80 eligible cases, 75 video consultations were carried out and data from the questionnaire were collected. Overall patient satisfaction was high (95%, 71/75) although technical problems occurred in 37% (29/75) of the appointments. Health care providers' satisfaction was equally high and in 88% (66/75) of cases, remote consultations avoided an in-house visit without effect on health care quality. <b>Conclusions:</b> Remote consultations are feasible and yield high satisfaction rates even in a medical field as sensitive as perinatal medicine. Further research is necessary to determine the cost-effectiveness and effects on perinatal outcome. Health care systems should be offered clear guidance on medicolegal issues and funding of remote consultations to integrate telemedicine into routine health care.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1193-1198"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39689314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utilization and Impact of Live Interactive and Store-and-Forward Teledermatology in a Veterans Affairs Medical Center During the COVID-19 Pandemic.","authors":"Francine Castillo,&nbsp;Sara Peracca,&nbsp;Dennis H Oh,&nbsp;Amanda R Twigg","doi":"10.1089/tmj.2021.0275","DOIUrl":"https://doi.org/10.1089/tmj.2021.0275","url":null,"abstract":"<p><p><b>Introduction:</b> Teledermatology has emerged as a promising method of continuing dermatologic care during the coronavirus 2019 (COVID-19) pandemic, including in the Department of Veterans Affairs (VA). Analysis of the utilization and impact of teledermatology within the San Francisco Veterans Affairs Health Care System (SFVAHCS) may elucidate the ways that teledermatology programs can continue to be optimized. <b>Methods:</b> We conducted a retrospective analysis of live interactive encounters, Veterans Affairs Video Connect (VVC), store-and-forward telehealth (SFT), and face-to-face (FTF) consultations, performed within the SFVAHCS from March 2020 to December 2020. To assess utilization, we analyzed numbers of encounters throughout 2020. To assess impact, we analyzed primary diagnoses for each encounter and rates of recommendations for medications and lesion biopsies. Additionally, we assessed diagnostic accuracy associated with each teledermatology type by measuring concordance between teledermatologists' clinical diagnoses and histopathological diagnoses. <b>Results:</b> Two thousand two hundred fifty FTF, 347 VVC, and 470 SFT encounters were conducted from March to December 2020. More female patients utilized VVC, and patients who utilized VVC were younger than SFT and FTF users (<i>p</i> < 0.01). SFT was utilized more by patients from rural areas (<i>p</i> < 0.01). Diagnoses addressed were significantly different between VVC and SFT. A majority of VVC encounters involved referrals for inflammatory conditions; primary diagnoses associated with SFT consultations were most frequently neoplasms. Comparison of VVC and SFT outcomes showed that more VVC visits resulted in a medication recommendation, while more SFT consultations resulted in a biopsy recommendation. <b>Conclusions:</b> Teledermatology contributed to meeting patient needs throughout 2020 and created an impact on clinical management. Patient characteristics, diagnoses, and type of impact associated with encounters varied between SFT and VVC. This analysis provides insight into teledermatology utilization within the VA system and can contribute to efforts to improve the quality of teledermatology care for veterans.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1186-1192"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39734369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Desperate Need for Psoriasis Health Care in Remote Regions as Revealed by a Live Interactive Teledermatology Program Serving Penghu Islands in Taiwan Strait.","authors":"Yu-Wen Cheng,&nbsp;Chia-Ying Wu,&nbsp;Bing-Chang Wang,&nbsp;Kuo-Chung Lan,&nbsp;Su-Yun Ou,&nbsp;Li-Man Lin,&nbsp;Hung-Chang Liao,&nbsp;Chih-Chi Wang,&nbsp;Chih-Hung Lee","doi":"10.1089/tmj.2021.0349","DOIUrl":"https://doi.org/10.1089/tmj.2021.0349","url":null,"abstract":"<p><p><b>Introduction:</b> Several studies indicated that teledermatology is good for people living on offshore islands. However, what disease benefits the most from interactive dermatology geographically in offshore islands remain uncertain. <b>Objectives:</b> This study aimed to investigate the seasonal and geographical distribution with different diseases in remote regions of Penghu islands in Taiwan Strait, thus to study the medical needs for specific disease in remote islands. The cost differences among three models by professional dermatologists were analyzed. <b>Methods:</b> This interactive teledermatology program serving Penghu Hospital, Ministry of Health and Welfare (MOHW-PH, March 2020 to February 2021) from a medical center in Taiwan recruited 145 patients with 280 patient-visits. The seasons, the timing from residential houses to MOHW-PH, the number of disease diagnosis, and the numbers of teledermatology visits are compared. The association of the distance from residential houses to MOHW-PH with different disease diagnosis was analyzed. <b>Results:</b> Eczema (33%), dermatophytosis (13%), and psoriasis (11%) were most common. Seasonal analysis showed dermatophytosis and eczema are more common in summer and winter, respectively. Geographical analysis showed that psoriasis has relatively higher case numbers, higher visits per case, with cases living in longer distances. The patient satisfaction was good (>95%). Among the three care modes of dermatologist, the cost estimation of interactive teledermatology and in-person clinic were similar yearly (2.4-2.9 million New Taiwan Dollars, roughly 80,000-90,000 USD). <b>Conclusions:</b> The study indicates that health care for psoriasis, being underprivileged but in desperate need in distant regions, could be delivered with quality and satisfaction by interactive teledermatology.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1109-1116"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39751699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Portal Message Language Use Prior to Suicide, Suicide Attempts, and Hospitalization for Depression.","authors":"Michelle J Duvall,&nbsp;Nathaniel E Miller,&nbsp;Frederick North,&nbsp;William B Leasure,&nbsp;Jennifer L Pecina","doi":"10.1089/tmj.2021.0318","DOIUrl":"https://doi.org/10.1089/tmj.2021.0318","url":null,"abstract":"<p><p><b>Introduction:</b> Previous research suggests patients may be willing to communicate serious psychiatric concerns through patient portals. <b>Methods:</b> Retrospective chart review of portal messages sent by patients who had an emergency department (ED) visit or hospitalization for depression, self-harm, or suicidality or had a completed suicide (cases) was reviewed for content that was suggestive of depression or self-harm and language indicating emotional distress. Comparison with a randomly selected group (controls) was performed. <b>Results:</b> During the study period 420 messages were sent by 149 patients within 30 days of death by suicide, ED visit, and/or hospitalization related to depression, suicidality, or suicide attempt. Thirteen patients died by suicide but only 23% (3 of 13) sent one or more portal messages within 30 days before their death. None mentioned thoughts of self-harm. There were 271 messages sent by patients who were hospitalized, 142 messages by those who presented to the ED, and 56 messages patients who attempted suicide. Patient messages from cases were more likely than messages from controls to convey a depressed mood (17.1% vs. 3.1%, odds ratio 6.5; 95% confidence interval 3.6-11.9, <i>p</i> < 0.0001), thoughts of suicide or self-harm (4.8% vs. 0% <i>p</i> < 0.0001), or have a distressed tone (24.0% vs. 1.7%, odds ratio 18.7; 95% confidence interval 8.6-41, <i>p</i> < 0.0001). <b>Conclusions:</b> Patient portal messages from patients with subsequent hospitalizations for depression and suicidality do report thoughts of depression, distress, and thoughts of self-harm. However, portal use before completed suicide was not helpful at identifying at-risk patients although total numbers were small.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1143-1150"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39748171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Health Technology for Remote Care in Primary Care During the COVID-19 Pandemic: Experience from Dubai.","authors":"Mahera AbdulRahman,&nbsp;Fatema Al-Tahri,&nbsp;Mouza Khalifa AlMehairi,&nbsp;Frederick Robert Carrick,&nbsp;Alia Mohammad Rafi Aldallal","doi":"10.1089/tmj.2021.0459","DOIUrl":"https://doi.org/10.1089/tmj.2021.0459","url":null,"abstract":"<p><p><b>Introduction:</b> We aimed to provide an insight on the feasibility and impact of telemedicine use among primary health care (PHC) providers and on nonurgent health care delivery during the coronavirus disease 2019 (COVID-19) outbreak in the United Arab Emirates (UAE). <b>Methods:</b> This observational study was conducted using telemedicine data from Dubai Health Authority from January 2020 to July 2021. <b>Results:</b> Of 123,944 individuals who booked an appointment for the telemedicine service, 106,408 (86%) showed up. Most patients were 19-59 years old, UAE nationals, female, and having government insurance. The telemedicine care volume grew from 188 visits in January 2020 to 11,757 in April 2020. The most common diagnosis was general health consultation (55,672; 52%), followed by COVID-19-related consultation (18,523; 17%) and laboratory test requests (11,064; 10%). Around 4,997 (5%) telemedicine consultations were for a medication refill. A multiple linear regression model predicting the types of diagnosis-related telemedicine needs by age and the interaction of gender and nationality was statistically significant for dermatology (<i>p</i> = 0.0000), respiratory (<i>p</i> = 0.0000), and cardiovascular (<i>p</i> = 0.0000) diseases. <b>Conclusions:</b> Virtual care services in PHC clinics have been highly successful in meeting the needs of patients during the COVID-19 pandemic. Telemedicine has enabled clinicians to continue providing care to patients while maintaining the necessary public health measures adopted in the fight against COVID-19. However, will the switch to telemedicine be sustainable in the long term and what will be the level and degree of telemedicine adoption beyond COVID-19? This requires more studies to explore how the PHC organizations will provide further support and guidance on the suitability of telemedicine in various circumstances and clinical conditions.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1100-1108"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39896442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopedic Asynchronous Teleconsultation for Primary Care Patients by a Large-Scale Telemedicine Service in Minas Gerais, Brazil.","authors":"Letícia Baião Silva,&nbsp;Daniella Nunes Pereira,&nbsp;Victor Schulthais Chagas,&nbsp;Cristiane Guimarães Pessoa,&nbsp;Kaíque Amancio Alvim Gouvea,&nbsp;Marco Antonio Percope de Andrade,&nbsp;Thiago Barbabela de Castro Soares,&nbsp;Milena Soriano Marcolino","doi":"10.1089/tmj.2021.0293","DOIUrl":"https://doi.org/10.1089/tmj.2021.0293","url":null,"abstract":"<p><p><b>Background:</b> Telemedicine was implemented in Brazil as a way to support primary health care (PHC). Orthopedic complaints are common in PHC, and, because musculoskeletal diseases are the most frequent causes of chronic pain, it is important to explore knowledge gaps of PHC as well as to understand the teleconsultations' impact on reducing referrals to secondary care. <b>Materials and Methods:</b> Observational, retrospective study that analyzed consecutive orthopedic asynchronous teleconsultations from the Telehealth Network of Minas Gerais, a large-scale public telehealth service, performed from September 17, 2013 to June 18, 2020. Teleconsultations were analyzed based on the type of query. <b>Results:</b> Throughout the study, 1,174 teleconsultations from 254 municipalities were analyzed. Most requests for teleconsultations were from nurses (37.8%) and physicians (48.7%). In 58.3%, challenges could be solved by a general practitioner, meanwhile 38.4% needed referral to an orthopedic specialist. Most queries related to a specific case (assistencial teleconsultation, 66.0%), and the others were classified as educational (34%). With regard to the motivation for the assistencial teleconsultations, 72% approached treatment options, 49.5% surrounded possible diagnosis, and 20.1% discussed patient's rehabilitation. In addition, 95.5% of requests could be solved by teleconsultation, without the need for referral to in-person consultation with the specialist. <b>Conclusions:</b> Teleconsultations can help investigate the most frequent queries in PHC. Most of them were solved without the need for referral, showing the potential of teleconsultations in daily practice as a way to manage patients and guarantee better access to first-rate health care. As for the public health system, teleconsultations represent a way to overcome the distance barrier to health care access.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1172-1177"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39688898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Office-Based Treatment to Telehealth: Comparing Clinical Outcomes and Patient Participation in a Psychiatric Intensive Outpatient Program with a Large Transdiagnostic Sample.","authors":"Jessica M Gannon,&nbsp;Jaspreet S Brar,&nbsp;Susanna Zawacki,&nbsp;Tiffany Painter,&nbsp;Kelly O'Toole,&nbsp;K N Roy Chengappa","doi":"10.1089/tmj.2021.0421","DOIUrl":"https://doi.org/10.1089/tmj.2021.0421","url":null,"abstract":"<p><p><b>Introduction:</b> Patient participation and clinical outcomes of a precoronavirus disease 2019 (COVID-19) office-based transdiagnostic psychiatric intensive outpatient program (IOP) were compared with those of telehealth IOP during COVID-19. <b>Materials and Methods:</b> Weeks of enrollment, Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) assessments, and sociodemographic and clinical factors (including group track and diagnosis) were collected during pre-COVID-19 (n = 191) and during COVID-19 (<i>n</i> = 200). Continuous and categorical measures of GAD-7 and PHQ-9 were analyzed; potential sociodemographic and clinical covariates to scores were also explored. <b>Results:</b> There were no statistically significant differences in participation between time periods. Associations were observed between PHQ-9/GAD-7 score improvement and number of assessments. Significant score reductions occurred in both periods, and differences in change scores were not significant. Sociodemographic and clinical factors were not significantly different between time periods. Patients with commercial insurance had significantly higher improvement in both mean and categorical PHQ-9 scores (<i>t</i> = 2.77, <i>p</i> = 0.006; χ² = 10.47, df = 1, <i>p</i> = 0.001) and GAD-7 scores (<i>t</i> = 2.29, <i>p</i> = 0.023; χ² = 8.58, df = 1, <i>p</i> = 0.003) than those with public insurance. Patients with anxiety disorders had significantly greater improvements (<i>F</i> = 4.49, <i>p</i> = 0.004; χ² = 9.15, df = 3, <i>p</i> = 0.027) in GAD-7 during COVID-19. <b>Discussion:</b> Significant improvements in PHQ-9/GAD-7 scores and measures of participation were not significantly different between telehealth and office-based IOP, nor were they greatly influenced by clinical or sociodemographic factors. Further study is needed of possible care disparities for publicly insured patients. <b>Conclusion:</b> Despite some limitations, telehealth IOP appears to be a clinically appropriate option for a diverse sociodemographic and diagnostically heterogeneous psychiatric population.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1126-1133"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39770587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth Use Before and During the COVID-19 Pandemic Among Children with Sickle Cell Anemia.","authors":"Sarah L Reeves,&nbsp;Pooja N Patel,&nbsp;Brian Madden,&nbsp;Sophia Ng,&nbsp;Susan E Creary,&nbsp;Dominic Smith,&nbsp;Chad Ellimoottil","doi":"10.1089/tmj.2021.0132","DOIUrl":"https://doi.org/10.1089/tmj.2021.0132","url":null,"abstract":"<p><p><b>Introduction:</b> Sickle cell anemia (SCA) is a genetic condition that predominantly affects minority populations in the United States. A lack of access to care is strongly associated with poor outcomes and quality of care among children and adolescents with SCA. The use of telehealth, which has rapidly expanded during the COVID-19 pandemic, has been shown to improve access to care for many conditions. However, the adoption of telehealth among children and adolescents with SCA is unknown. <b>Methods:</b> We identified children 1-17 years old with SCA continuously enrolled in Michigan Medicaid from January 2019 to December 2020. The number of in-person and telehealth outpatient visits (both urgent and routine) were summarized prepandemic (January 2019-February 2020) and during the pandemic (March 2020-December 2020); National Provider Identifier was used to identify provider specialty for telehealth visits. <b>Results:</b> The study population comprised 493 children with SCA with a mean age of 8.7 (±4.9) years at study entry. Prepandemic, there were 4,367 outpatient visits; 4,348 (99.6%) were in-person and 19 (0.4%) were telehealth. During the pandemic, there were 2,307 outpatient visits; 2,059 (89.3%) were in-person and 248 (10.7%) were telehealth. Telehealth visits peaked in April 2020 and declined thereafter. The majority of telehealth visits were to hematology (49%), followed by adult subspecialists (27%) and pediatrics/family medicine (14%). <b>Discussion/Conclusions:</b> While the overall number of outpatient visits declined during the initial months of the pandemic compared with 2019, use of telehealth rapidly increased among children and adolescents with SCA. Additional research is needed to understand patient and provider preferences for telehealth and the roles that federal and state policies can play in facilitating telehealth adoption among children and adolescents with SCA.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1166-1171"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39899297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teletherapy Versus In-Person Psychotherapy for Depression: A Meta-Analysis of Randomized Controlled Trials.","authors":"Annaleis K Giovanetti,&nbsp;Stephanie E W Punt,&nbsp;Eve-Lynn Nelson,&nbsp;Stephen S Ilardi","doi":"10.1089/tmj.2021.0294","DOIUrl":"https://doi.org/10.1089/tmj.2021.0294","url":null,"abstract":"<p><p><b>Introduction:</b> The recent surge in telehealth service delivery represents a promising development in the field's ability to address access gaps in health care across underserved populations. Telehealth also carries the potential to help reduce the societal burden of mental illnesses such as major depression, which often go untreated. There is now a sufficiently large corpus of randomized controlled trials to examine the comparative effectiveness of teletherapy and in-person services meta-analytically. <b>Methods:</b> We searched the PubMed, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) databases for articles from January 1, 2000 to February 1, 2021 to identify randomized head-to-head trials of video-based versus in-person delivery of psychotherapy to reduce depressive symptoms. We conducted a random-effects meta-analysis to evaluate potential differences in efficacy rates. We calculated and meta-analyzed odds ratios to examine differential attrition rates between video and in-person conditions. Finally, we conducted subgroup analyses based on the primary treatment focus (depression or another condition) of each trial. <b>Results:</b> Primary study analyses yielded evidence that video-based psychotherapy is roughly comparable in efficacy with in-person psychotherapy for reducing depressive symptoms (<i>g</i> = 0.04, 95% confidence interval [CI = -0.12 to 0.20], <i>p</i> = 0.60, <i>I</i>² = 5%). Likewise, attrition rates between the two conditions were not significantly different (odds ratio = 1.07, 95% CI = [0.78 to 1.49], <i>p</i> = 0.63, <i>I</i>² = 25%). Finally, we did not observe significant subgroup differences in either efficacy (<i>p</i> = 0.38) or attrition (<i>p</i> = 0.94). <b>Conclusions:</b> The present findings suggest that video-based teletherapy may be a feasible and effective alternative to in-person services for reducing depressive symptoms. Continued research on the effectiveness of telehealth in clinically depressed samples, and further elucidation of the access barriers entailed by each delivery modality, can help the field better determine which patients will derive the greatest benefit from each mode of intervention.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1077-1089"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39665373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Most Important Telemedicine Patient Satisfaction Dimension: Patient-Centered Care.","authors":"Andrew N Mason","doi":"10.1089/tmj.2021.0322","DOIUrl":"https://doi.org/10.1089/tmj.2021.0322","url":null,"abstract":"<p><p><b>Background:</b> Telemedicine provider success requires patient satisfaction. The SERVQUAL model was used to identify the most salient telemedicine patient satisfaction dimensions. <b>Materials and Methods:</b> The author surveyed 440 telemedicine patients using Likert items to examine satisfaction levels. Four performance dimensions of telemedicine service were identified and examined. Factor analysis was used to validate the telemedicine performance dimensions measured, and regression analysis was used to test the effects of the service performance dimensions on telemedicine patient satisfaction. <b>Results:</b> The SERVQUAL model provided reliable measures of satisfaction dimensions. Four dimensions of satisfaction were identified, and patient-centered care was shown to be the most significant dimension. Patient perceptions of health benefits received from the telemedicine service were also found to impact patient satisfaction. The other two dimensions, monetary and non-monetary costs, did not have a significant effect on patient satisfaction. <b>Discussion:</b> Patient satisfaction was effectively measured as a multidimensional construct by using the service-marketing SERVQUAL model. The value that patients place on provider \"soft skills\" (i.e., bedside manner) during provider-patient interactions was demonstrated. Therefore, health care providers could develop and embrace patient-centered communication, such as having an empathetic and caring attitude, showing responsiveness to the emotional needs of the patient, and providing assurance to the patient to improve telemedicine patient satisfaction. <b>Conclusions:</b> The SERVQUAL model is useful to create a comprehensive, multidimensional construct for telemedicine patient satisfaction, which can lead to improved telemedicine patient satisfaction. The multidimensional approach highlights satisfaction dimensions where targeted improvements are most appropriate and, thus, can provide more focused practice guidance to providers.</p>","PeriodicalId":520784,"journal":{"name":"Telemedicine journal and e-health : the official journal of the American Telemedicine Association","volume":" ","pages":"1206-1214"},"PeriodicalIF":4.7,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39817963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}