焦虑症和抑郁症的数字化异步远程医疗管理:一项队列研究。

IF 3.5 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Journal of Telemedicine and Telecare Pub Date : 2025-07-01 Epub Date: 2024-03-14 DOI:10.1177/1357633X241233788
Amichai Perlman, Yishai Pickman, Michael Dreyfuss, Itay Manes, Peter Bak, Daniel Souroujon, Edo Paz, Jon O Ebbert, Dan Zeltzer
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引用次数: 0

摘要

目的评估主要通过异步数字通信管理焦虑症和抑郁症的远程心理健康项目的临床效果:这项回顾性队列研究调查了 2021 年 1 月至 2022 年 5 月期间寻求远程焦虑症和抑郁症治疗的美国成年人。该项目包括临床医生主导的评估、患者教育、药物管理和持续监测,主要通过短信进行。焦虑症和抑郁症通过患者健康问卷(PHQ-9)和广泛性焦虑症(GAD-7)评分进行测量。研究结果包括分数变化、50% 分数提高率和缓解率(分数结果):在评估期间,共有 11,844 名计划参与者符合纳入标准。大多数参与者为女性(n = 8328,70.3%);年龄在 18-82 岁之间(中位数为 31 岁)。基线时,PHQ-9 和 GAD-7 评分的中位数为 13(IQR 9-17);分别有 67% 和 69% 的人符合抑郁和焦虑的评分标准。大多数参与者(80%)都服用了选择性血清素再摄取抑制剂(SSRI)。一个月后,PHQ-9 和 GAD-7 的平均得分分别显著下降了 9.2 分和 9.1 分(均为 p p 结论:使用带有数字工具的远程心理健康计划可显著改善焦虑和抑郁的临床症状。在数字心理健康项目中,保持患者参与度和确保适当的护理质量监控仍面临挑战。有必要开展更多研究,将远程数字医疗与传统的面对面模式进行比较。研究应考察长期结果、最佳护理方案,以及将这些项目整合到现有医疗保健系统和确保公平获取所面临的挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Digitally enabled asynchronous remote medical management of anxiety and depression: A cohort study.

ObjectiveTo evaluate the clinical outcomes of a remote mental health program for managing anxiety and depression, primarily using asynchronous digital communication.MethodsThis retrospective cohort study examined U.S. adults seeking remote care for anxiety and depression from January 2021 to May 2022. The program involves clinician-led assessment, patient education, medication management, and ongoing monitoring, primarily via text. Anxiety and depression were measured using Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scores. Outcomes examined were changes in scores, 50% score improvement rate, and remission rate (score <5) at 1, 3, and 6 months.ResultsDuring the period evaluated, 11,844 program participants met the inclusion criteria. Most were female (n = 8328, 70.3%); their age ranged from 18-82 years (median 31 years). At baseline, median PHQ-9 and GAD-7 scores were 13 (IQR 9-17); 67% and 69% met score criteria for depression and anxiety, respectively. Most participants (80%) were prescribed a selective serotonin reuptake inhibitor (SSRI). By one month, average PHQ-9 and GAD-7 scores decreased significantly by 9.2 and 9.1 points (both p < .01). At 1-month follow-up, the 50% score improvement rate was 66% for PHQ-9 and 69% GAD-7 (p < .01). Scores continued to decrease with follow-up. At 3 months, over half achieved remission (percent [95% CI]: 52% [51-54] for anxiety, 53% [52-55] for depression). Similar improvement was observed at 6 months and in sensitivity analyses accounting for loss to follow-up.ConclusionsUse of a remote mental health program with digital tools was associated with significant clinical improvement in anxiety and depression. Challenges remain in maintaining patient engagement and ensuring appropriate care quality monitoring in digital mental health programs. Additional research comparing remote digital care to traditional in-person models is warranted. Studies should examine long-term outcomes, optimal care protocols, and the challenges to integrating these programs into existing healthcare systems and ensuring equitable access.

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来源期刊
CiteScore
14.10
自引率
10.60%
发文量
174
审稿时长
6-12 weeks
期刊介绍: Journal of Telemedicine and Telecare provides excellent peer reviewed coverage of developments in telemedicine and e-health and is now widely recognised as the leading journal in its field. Contributions from around the world provide a unique perspective on how different countries and health systems are using new technology in health care. Sections within the journal include technology updates, editorials, original articles, research tutorials, educational material, review articles and reports from various telemedicine organisations. A subscription to this journal will help you to stay up-to-date in this fast moving and growing area of medicine.
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