Comparison of Asynchronous Telepsychiatry vs. Synchronous Telepsychiatry in Skilled Nursing Facilities

NCT03264560 | Completed

• 2 other identifiers: 10782201R01HS025395
• Study Type: interventional
• Target: 235
• Locations: 1 country
• Sites: 1

Brief Summary

There is a critical shortage of psychiatric services to people with mental illness who live in Skilled Nursing Facilities (SNFs), especially those in rural settings. Although real-time video conferencing psychiatric consultation, termed Synchronous Telepsychiatry (STP), has been around for almost 3 decades, its adaptation is met with logistic and other challenges. In this context, the investigators investigate a novel method of psychiatric consultation termed Asynchronous Telepsychiatry (ATP). The main hypotheses are that that ATP will be as clinically effective as STP, and that it will be acceptable to patients. This study aims to evaluate the comparative clinical effectiveness of ATP vs. STP in SNF population, in a 12-month non-inferiority, randomized, controlled trial.

Conditions

Psychiatric Disorder

Keywords

Telepsychiatry; Synchronous; Asynchronous; SNF

Outcome Measures

Primary Outcomes (1)

• Clinical Global Impression (CGI)- severity scale

  Clinical outcomes from MDS 3.0 form to be collected at each consult. The primary endpoint is improvement from baseline at the 6-month visit. We will also assess long term effects of ATP, by examining 12-month outcomes.

  Change from baseline measure at 1-, 2-, 3-, 6- and 12-months

Secondary Outcomes (1)

• Patient Satisfaction Rating

  Change from baseline measure at 1-, 2-, 3-, 6- and 12-months

Study Arms (2)

Synchronous Telepsychiatry (STP) group

ACTIVE COMPARATOR

Behavioral: Telepsychiatry

Asynchronous Telepsychiatry (ATP) group

EXPERIMENTAL

Behavioral: Telepsychiatry

Interventions

Telepsychiatry BEHAVIORAL

A total of 6 synchronous or asynchronous telepsychiatry interventions conducted via telecommunications done at baseline, 1 month, 2 months, 3 months, 6 months, and 12 months.

Asynchronous Telepsychiatry (ATP) group; Synchronous Telepsychiatry (STP) group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants must be residents of SNF that has been approved by University of California, Davis IRB, and adults aged ≥18, with non-emergent psychiatric issues, including:
• depression, schizophrenia, bipolar disorder, PTSD, dementia behavioral problems, management of psychiatric medications, and others mental health problems. Chronic medical disorders are not excluded. Study PI or co-PI will be available by phone to help with screening.

You may not qualify if:

• Residents with imminent suicidal and/or violence risks that require emergency psychiatric referrals or patients who cannot wait until the next ATP/STP evaluation,
• Residents with imminent risks will be referred to the local emergency department as is the current practice at both SNFs, and 3) Residents who are unable to consent to the study and who do not have surrogate decisional makers to provide informed consent will not be able to participate.

Sponsors & Collaborators

• University of California, Davis: lead
• Agency for Healthcare Research and Quality (AHRQ): collaborator

Study Sites (1)

University of California, Davis Medical Center

Sacramento, California, 95816, United States

Location

Related Links

• Learn more or sign up for the study here!

MeSH Terms

Conditions

Mental Disorders

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 23, 2017
• First Posted: August 29, 2017
• Study Start: June 27, 2017
• Primary Completion: June 24, 2022
• Study Completion: June 24, 2022
• Last Updated: December 27, 2022

Record last verified: 2022-12

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)