Chandana Sabbella, Hetashri Shah, Prakyath Ravindranath Hegde, Rahul Patley, Sivakami Sundari Subramanian, Manjunatha Narayana, Naveen Kumar Channaveerachari, Suresh Bada Math
{"title":"通过持续远程辅导重新定义获得精神卫生保健的途径:与初级保健医生即时协作视频咨询的报告。","authors":"Chandana Sabbella, Hetashri Shah, Prakyath Ravindranath Hegde, Rahul Patley, Sivakami Sundari Subramanian, Manjunatha Narayana, Naveen Kumar Channaveerachari, Suresh Bada Math","doi":"10.1177/02537176251375301","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Mentoring primary care doctors (PCDs) improves their competency and aids in integrating psychiatric care into primary care, especially in resource-constrained settings. This study evaluates the socio-demographic, diagnostic, and treatment profiling of instant collaborative video consultations (i-CVCs) and the diagnostic (domain-wise and disorder-wise) and treatment concordance of PCDs with tele-psychiatrists.</p><p><strong>Methods: </strong>This was a cross-sectional study that was a part of a digitally driven capacity-building program that provided tele-mentoring to PCDs via i-CVCs with tele-psychiatrists. A total of 382 i-CVCs conducted between November 2022 and July 2024 were analyzed for diagnostic and treatment profiling. Concordance between PCDs and tele-psychiatrists was assessed using Cohen's kappa (<i>n</i> = 358).</p><p><strong>Results: </strong>Among the domain-wise diagnostic distribution by the tele-psychiatrist, the majority were classified as common mental disorders (CMDs) (47.7%), and among the disorder-wise distribution, the majority was depressive disorder (22.5%). The analysis revealed very good to good diagnostic agreement between PCDs and tele-psychiatrists across major domains: SUD (κ = 0.96), SMD (κ = 0.81), and CMD (κ = 0.75), all with <i>p</i> < .001. Disorder-wise concordance was highest for alcohol disorders (κ = 0.96). Treatment concordance also showed moderate agreement for all the major classes of psychotropic medications (κ = 0.5 to 0.6; <i>p</i> < .001), including antidepressants, antipsychotics, benzodiazepines, and nicotine replacement therapy. i-CVC support was primarily sought for diagnostic/treatment confirmation and clarification on dosage strategies.</p><p><strong>Conclusions: </strong>i-CVCs facilitate real-time learning and improve confidence in managing psychiatric disorders within live primary care clinics, demonstrating a scalable approach to address the treatment gap.</p>","PeriodicalId":13476,"journal":{"name":"Indian Journal of Psychological Medicine","volume":" ","pages":"02537176251375301"},"PeriodicalIF":2.0000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446279/pdf/","citationCount":"0","resultStr":"{\"title\":\"Redefining Access to Mental Health Care Through Sustained Tele-mentoring: A Report of the Instant Collaborative Video Consultations with Primary Care Doctors.\",\"authors\":\"Chandana Sabbella, Hetashri Shah, Prakyath Ravindranath Hegde, Rahul Patley, Sivakami Sundari Subramanian, Manjunatha Narayana, Naveen Kumar Channaveerachari, Suresh Bada Math\",\"doi\":\"10.1177/02537176251375301\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Mentoring primary care doctors (PCDs) improves their competency and aids in integrating psychiatric care into primary care, especially in resource-constrained settings. This study evaluates the socio-demographic, diagnostic, and treatment profiling of instant collaborative video consultations (i-CVCs) and the diagnostic (domain-wise and disorder-wise) and treatment concordance of PCDs with tele-psychiatrists.</p><p><strong>Methods: </strong>This was a cross-sectional study that was a part of a digitally driven capacity-building program that provided tele-mentoring to PCDs via i-CVCs with tele-psychiatrists. A total of 382 i-CVCs conducted between November 2022 and July 2024 were analyzed for diagnostic and treatment profiling. Concordance between PCDs and tele-psychiatrists was assessed using Cohen's kappa (<i>n</i> = 358).</p><p><strong>Results: </strong>Among the domain-wise diagnostic distribution by the tele-psychiatrist, the majority were classified as common mental disorders (CMDs) (47.7%), and among the disorder-wise distribution, the majority was depressive disorder (22.5%). 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Redefining Access to Mental Health Care Through Sustained Tele-mentoring: A Report of the Instant Collaborative Video Consultations with Primary Care Doctors.
Background: Mentoring primary care doctors (PCDs) improves their competency and aids in integrating psychiatric care into primary care, especially in resource-constrained settings. This study evaluates the socio-demographic, diagnostic, and treatment profiling of instant collaborative video consultations (i-CVCs) and the diagnostic (domain-wise and disorder-wise) and treatment concordance of PCDs with tele-psychiatrists.
Methods: This was a cross-sectional study that was a part of a digitally driven capacity-building program that provided tele-mentoring to PCDs via i-CVCs with tele-psychiatrists. A total of 382 i-CVCs conducted between November 2022 and July 2024 were analyzed for diagnostic and treatment profiling. Concordance between PCDs and tele-psychiatrists was assessed using Cohen's kappa (n = 358).
Results: Among the domain-wise diagnostic distribution by the tele-psychiatrist, the majority were classified as common mental disorders (CMDs) (47.7%), and among the disorder-wise distribution, the majority was depressive disorder (22.5%). The analysis revealed very good to good diagnostic agreement between PCDs and tele-psychiatrists across major domains: SUD (κ = 0.96), SMD (κ = 0.81), and CMD (κ = 0.75), all with p < .001. Disorder-wise concordance was highest for alcohol disorders (κ = 0.96). Treatment concordance also showed moderate agreement for all the major classes of psychotropic medications (κ = 0.5 to 0.6; p < .001), including antidepressants, antipsychotics, benzodiazepines, and nicotine replacement therapy. i-CVC support was primarily sought for diagnostic/treatment confirmation and clarification on dosage strategies.
Conclusions: i-CVCs facilitate real-time learning and improve confidence in managing psychiatric disorders within live primary care clinics, demonstrating a scalable approach to address the treatment gap.
期刊介绍:
The Indian Journal of Psychological Medicine (ISSN 0253-7176) was started in 1978 as the official publication of the Indian Psychiatric Society South Zonal Branch. The journal allows free access (Open Access) and is published Bimonthly. The Journal includes but is not limited to review articles, original research, opinions, and letters. The Editor and publisher accept no legal responsibility for any opinions, omissions or errors by the authors, nor do they approve of any product advertised within the journal.