Amichai Perlman, Yishai Pickman, Michael Dreyfuss, Itay Manes, Peter Bak, Daniel Souroujon, Edo Paz, Jon O Ebbert, Dan Zeltzer
{"title":"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。","authors":"Amichai Perlman, Yishai Pickman, Michael Dreyfuss, Itay Manes, Peter Bak, Daniel Souroujon, Edo Paz, Jon O Ebbert, Dan Zeltzer","doi":"10.1177/1357633X241233788","DOIUrl":null,"url":null,"abstract":"<p><p>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 <i>p</i> < .01). At 1-month follow-up, the 50% score improvement rate was 66% for PHQ-9 and 69% GAD-7 (<i>p</i> < .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.</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"882-890"},"PeriodicalIF":3.5000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Digitally enabled asynchronous remote medical management of anxiety and depression: A cohort study.\",\"authors\":\"Amichai Perlman, Yishai Pickman, Michael Dreyfuss, Itay Manes, Peter Bak, Daniel Souroujon, Edo Paz, Jon O Ebbert, Dan Zeltzer\",\"doi\":\"10.1177/1357633X241233788\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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 <i>p</i> < .01). At 1-month follow-up, the 50% score improvement rate was 66% for PHQ-9 and 69% GAD-7 (<i>p</i> < .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.</p>\",\"PeriodicalId\":50024,\"journal\":{\"name\":\"Journal of Telemedicine and Telecare\",\"volume\":\" \",\"pages\":\"882-890\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Telemedicine and Telecare\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/1357633X241233788\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/14 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Telemedicine and Telecare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/1357633X241233788","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/14 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
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.
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.