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Feasibility and acceptability of a novel telepsychiatry-delivered precision prescribing intervention for anxiety and depression

BACKGROUND: Major Depressive Disorder and Generalized Anxiety Disorder are pervasive and debilitating conditions, though treatment is often inaccessible and based on trial-and-error prescribing methods. The present observational study seeks to describe the use of a proprietary precision prescribing...

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Autores principales: O’Callaghan, Erin, Sullivan, Scott, Gupta, Carina, Belanger, Heather G., Winsberg, Mirène
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297585/
https://www.ncbi.nlm.nih.gov/pubmed/35854281
http://dx.doi.org/10.1186/s12888-022-04113-9
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author O’Callaghan, Erin
Sullivan, Scott
Gupta, Carina
Belanger, Heather G.
Winsberg, Mirène
author_facet O’Callaghan, Erin
Sullivan, Scott
Gupta, Carina
Belanger, Heather G.
Winsberg, Mirène
author_sort O’Callaghan, Erin
collection PubMed
description BACKGROUND: Major Depressive Disorder and Generalized Anxiety Disorder are pervasive and debilitating conditions, though treatment is often inaccessible and based on trial-and-error prescribing methods. The present observational study seeks to describe the use of a proprietary precision prescribing algorithm piloted during routine clinical practice as part of Brightside’s telepsychiatry services. The primary aim is to determine the feasibility and acceptability of implementing this intervention. Secondary aims include exploring remission and symptom improvement rates. METHODS: Participants were adult patients enrolled in Brightside who completed at least 12 weeks of treatment for depression and/or anxiety and received a prescription for at least one psychiatric medication. A prescription recommendation was made by Brightside’s algorithm at treatment onset and was utilized for clinical decision support. Participants received baseline screening surveys of the PHQ-9 and GAD-7, and at weeks 2,4,6,8,10 and 12. Intent-to-treat (ITT) sensitivity analyses were conducted. Feasibility of the implementation was measured by the platform’s ability to enroll and engage participants in timely psychiatric care, as well as offer high touch-point treatment options. Acceptability was measured by patient responses to a 5-star satisfaction rating. RESULTS: Brightside accessed and treated 6248 patients from October 2018 to April 2021, treating a majority of patients within 4-days of enrollment. The average plan cost was $115/month. 89% of participants utilized Brightside’s core medication plan at a cost of $95/month. 13.4% of patients in the study rated Brightside’s services as highly satisfactory, averaging a 4.6-star rating. Furthermore, 90% of 6248 patients experienced a MCID in PHQ-9 or GAD-7 score. Remission rates were 75% (final PHQ-9 or GAD-7 score < 10) for the study sample and 59% for the ITT sample. 69.3% of Brightside patients were treated with the medication initially prescribed at intake. CONCLUSIONS: Results suggest that the present intervention may be feasible and acceptable within the assessed population. Exploratory analyses suggest that Brightside’s course of treatment, guided by precision recommendations, improved patients’ symptoms of anxiety and depression.
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spelling pubmed-92975852022-07-21 Feasibility and acceptability of a novel telepsychiatry-delivered precision prescribing intervention for anxiety and depression O’Callaghan, Erin Sullivan, Scott Gupta, Carina Belanger, Heather G. Winsberg, Mirène BMC Psychiatry Research Article BACKGROUND: Major Depressive Disorder and Generalized Anxiety Disorder are pervasive and debilitating conditions, though treatment is often inaccessible and based on trial-and-error prescribing methods. The present observational study seeks to describe the use of a proprietary precision prescribing algorithm piloted during routine clinical practice as part of Brightside’s telepsychiatry services. The primary aim is to determine the feasibility and acceptability of implementing this intervention. Secondary aims include exploring remission and symptom improvement rates. METHODS: Participants were adult patients enrolled in Brightside who completed at least 12 weeks of treatment for depression and/or anxiety and received a prescription for at least one psychiatric medication. A prescription recommendation was made by Brightside’s algorithm at treatment onset and was utilized for clinical decision support. Participants received baseline screening surveys of the PHQ-9 and GAD-7, and at weeks 2,4,6,8,10 and 12. Intent-to-treat (ITT) sensitivity analyses were conducted. Feasibility of the implementation was measured by the platform’s ability to enroll and engage participants in timely psychiatric care, as well as offer high touch-point treatment options. Acceptability was measured by patient responses to a 5-star satisfaction rating. RESULTS: Brightside accessed and treated 6248 patients from October 2018 to April 2021, treating a majority of patients within 4-days of enrollment. The average plan cost was $115/month. 89% of participants utilized Brightside’s core medication plan at a cost of $95/month. 13.4% of patients in the study rated Brightside’s services as highly satisfactory, averaging a 4.6-star rating. Furthermore, 90% of 6248 patients experienced a MCID in PHQ-9 or GAD-7 score. Remission rates were 75% (final PHQ-9 or GAD-7 score < 10) for the study sample and 59% for the ITT sample. 69.3% of Brightside patients were treated with the medication initially prescribed at intake. CONCLUSIONS: Results suggest that the present intervention may be feasible and acceptable within the assessed population. Exploratory analyses suggest that Brightside’s course of treatment, guided by precision recommendations, improved patients’ symptoms of anxiety and depression. BioMed Central 2022-07-19 /pmc/articles/PMC9297585/ /pubmed/35854281 http://dx.doi.org/10.1186/s12888-022-04113-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
O’Callaghan, Erin
Sullivan, Scott
Gupta, Carina
Belanger, Heather G.
Winsberg, Mirène
Feasibility and acceptability of a novel telepsychiatry-delivered precision prescribing intervention for anxiety and depression
title Feasibility and acceptability of a novel telepsychiatry-delivered precision prescribing intervention for anxiety and depression
title_full Feasibility and acceptability of a novel telepsychiatry-delivered precision prescribing intervention for anxiety and depression
title_fullStr Feasibility and acceptability of a novel telepsychiatry-delivered precision prescribing intervention for anxiety and depression
title_full_unstemmed Feasibility and acceptability of a novel telepsychiatry-delivered precision prescribing intervention for anxiety and depression
title_short Feasibility and acceptability of a novel telepsychiatry-delivered precision prescribing intervention for anxiety and depression
title_sort feasibility and acceptability of a novel telepsychiatry-delivered precision prescribing intervention for anxiety and depression
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297585/
https://www.ncbi.nlm.nih.gov/pubmed/35854281
http://dx.doi.org/10.1186/s12888-022-04113-9
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