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Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts
BACKGROUND: The effects of COVID-19 on the shift to remote consultations remain to be properly investigated. OBJECTIVE: To quantify the extent, nature and clinical impact of the use of telepsychiatry during the COVID-19 pandemic and compare it with the data in the same period of the 2 years before t...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483920/ https://www.ncbi.nlm.nih.gov/pubmed/34583940 http://dx.doi.org/10.1136/ebmental-2021-300287 |
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author | Hong, James SW Sheriff, Rebecca Smith, Katharine Tomlinson, Anneka Saad, Fathi Smith, Tanya Engelthaler, Tomas Phiri, Peter Henshall, Catherine Ede, Roger Denis, Mike Mitter, Pamina D'Agostino, Armando Cerveri, Giancarlo Tomassi, Simona Rathod, Shanaya Broughton, Nick Marlowe, Karl Geddes, John Cipriani, Andrea |
author_facet | Hong, James SW Sheriff, Rebecca Smith, Katharine Tomlinson, Anneka Saad, Fathi Smith, Tanya Engelthaler, Tomas Phiri, Peter Henshall, Catherine Ede, Roger Denis, Mike Mitter, Pamina D'Agostino, Armando Cerveri, Giancarlo Tomassi, Simona Rathod, Shanaya Broughton, Nick Marlowe, Karl Geddes, John Cipriani, Andrea |
author_sort | Hong, James SW |
collection | PubMed |
description | BACKGROUND: The effects of COVID-19 on the shift to remote consultations remain to be properly investigated. OBJECTIVE: To quantify the extent, nature and clinical impact of the use of telepsychiatry during the COVID-19 pandemic and compare it with the data in the same period of the 2 years before the outbreak. METHODS: We used deidentified electronic health records routinely collected from two UK mental health Foundation Trusts (Oxford Health (OHFT) and Southern Health (SHFT)) between January and September in 2018, 2019 and 2020. We considered three outcomes: (1) service activity, (2) in-person versus remote modalities of consultation and (3) clinical outcomes using Health of the Nation Outcome Scales (HoNOS) data. HoNOS data were collected from two cohorts of patients (cohort 1: patients with ≥1 HoNOS assessment each year in 2018, 2019 and 2020; cohort 2: patients with ≥1 HoNOS assessment each year in 2019 and 2020), and analysed in clusters using superclasses (namely, psychotic, non-psychotic and organic), which are used to assess overall healthcare complexity in the National Health Service. All statistical analyses were done in Python. FINDINGS: Mental health service activity in 2020 increased in all scheduled community appointments (by 15.4% and 5.6% in OHFT and SHFT, respectively). Remote consultations registered a 3.5-fold to 6-fold increase from February to June 2020 (from 4685 to a peak of 26 245 appointments in OHFT and from 7117 to 24 987 appointments in SHFT), with post-lockdown monthly averages of 23 030 and 22 977 remote appointments/month in OHFT and SHFT, respectively. Video consultations comprised up to one-third of total telepsychiatric services per month from April to September 2020. For patients with dementia, non-attendance rates at in-person appointments were higher than remote appointments (17.2% vs 3.9%). The overall HoNOS cluster value increased only in the organic superclass (clusters 18–21, n=174; p<0.001) from 2019 to 2020, suggesting a specific impact of the COVID-19 pandemic on this population of patients. CONCLUSIONS AND CLINICAL IMPLICATIONS: The rapid shift to remote service delivery has not reached some groups of patients who may require more tailored management with telepsychiatry. |
format | Online Article Text |
id | pubmed-8483920 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-84839202021-10-01 Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts Hong, James SW Sheriff, Rebecca Smith, Katharine Tomlinson, Anneka Saad, Fathi Smith, Tanya Engelthaler, Tomas Phiri, Peter Henshall, Catherine Ede, Roger Denis, Mike Mitter, Pamina D'Agostino, Armando Cerveri, Giancarlo Tomassi, Simona Rathod, Shanaya Broughton, Nick Marlowe, Karl Geddes, John Cipriani, Andrea Evid Based Ment Health Digital Mental Health BACKGROUND: The effects of COVID-19 on the shift to remote consultations remain to be properly investigated. OBJECTIVE: To quantify the extent, nature and clinical impact of the use of telepsychiatry during the COVID-19 pandemic and compare it with the data in the same period of the 2 years before the outbreak. METHODS: We used deidentified electronic health records routinely collected from two UK mental health Foundation Trusts (Oxford Health (OHFT) and Southern Health (SHFT)) between January and September in 2018, 2019 and 2020. We considered three outcomes: (1) service activity, (2) in-person versus remote modalities of consultation and (3) clinical outcomes using Health of the Nation Outcome Scales (HoNOS) data. HoNOS data were collected from two cohorts of patients (cohort 1: patients with ≥1 HoNOS assessment each year in 2018, 2019 and 2020; cohort 2: patients with ≥1 HoNOS assessment each year in 2019 and 2020), and analysed in clusters using superclasses (namely, psychotic, non-psychotic and organic), which are used to assess overall healthcare complexity in the National Health Service. All statistical analyses were done in Python. FINDINGS: Mental health service activity in 2020 increased in all scheduled community appointments (by 15.4% and 5.6% in OHFT and SHFT, respectively). Remote consultations registered a 3.5-fold to 6-fold increase from February to June 2020 (from 4685 to a peak of 26 245 appointments in OHFT and from 7117 to 24 987 appointments in SHFT), with post-lockdown monthly averages of 23 030 and 22 977 remote appointments/month in OHFT and SHFT, respectively. Video consultations comprised up to one-third of total telepsychiatric services per month from April to September 2020. For patients with dementia, non-attendance rates at in-person appointments were higher than remote appointments (17.2% vs 3.9%). The overall HoNOS cluster value increased only in the organic superclass (clusters 18–21, n=174; p<0.001) from 2019 to 2020, suggesting a specific impact of the COVID-19 pandemic on this population of patients. CONCLUSIONS AND CLINICAL IMPLICATIONS: The rapid shift to remote service delivery has not reached some groups of patients who may require more tailored management with telepsychiatry. BMJ Publishing Group 2021-11 2021-09-28 /pmc/articles/PMC8483920/ /pubmed/34583940 http://dx.doi.org/10.1136/ebmental-2021-300287 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Digital Mental Health Hong, James SW Sheriff, Rebecca Smith, Katharine Tomlinson, Anneka Saad, Fathi Smith, Tanya Engelthaler, Tomas Phiri, Peter Henshall, Catherine Ede, Roger Denis, Mike Mitter, Pamina D'Agostino, Armando Cerveri, Giancarlo Tomassi, Simona Rathod, Shanaya Broughton, Nick Marlowe, Karl Geddes, John Cipriani, Andrea Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts |
title | Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts |
title_full | Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts |
title_fullStr | Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts |
title_full_unstemmed | Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts |
title_short | Impact of COVID-19 on telepsychiatry at the service and individual patient level across two UK NHS mental health Trusts |
title_sort | impact of covid-19 on telepsychiatry at the service and individual patient level across two uk nhs mental health trusts |
topic | Digital Mental Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483920/ https://www.ncbi.nlm.nih.gov/pubmed/34583940 http://dx.doi.org/10.1136/ebmental-2021-300287 |
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