The purpose of this project is to compare the effectiveness between face-to-face consultations and consultations via videoconferencing among patients treated in the Institute of Psychiatry (IPq).
Introduction: Within the emergence of the Internet and for the purposes of providing psychiatric services across distances, the provision of mental health service via video counseling has become a possible way of mental health service delivery. An appropriate systematization of the propaedeutic methods in psychiatry, according to the interactive resources of telemedicine, and a standardized assessment based on clinical records turn this method to a viable alternative for service delivery all over the world. The main benefit of video counseling is an increased access to care services. But, so far, there is still limited research regarding to the effectiveness of telepsychiatry in the management of mental illnesses. Objective: To verify the applicability of psychiatric attendance via Interned-based videoconferencing, comparing various quality characteristics between this method and face-to-face attendance, on the basis of a one-year follow-up study with a randomized clinical trial (RCT) design. Material and methods: 100 patients of the Institute of Psychiatry (IPq) between 18 to 55 years old with depressive disorders are randomly allocated to a control (monthly face-to-face consultation with the attending psychiatrist) or intervention group. The intervention group will have consultations with the attending psychiatrist through internet-based videoconference. For reasons of patient safety, consultations at baseline, and after 6 and 12 months will be realized in a face-to-face form for all patients. At baseline, and after 6 and 12 months mental health, satisfaction with treatment, therapeutic relationship, and medical compliance will be assessed. Depression will be assessed at baseline, and after 3, 6, 9 and 12 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
107
Patients in the online consultation (intervention) group have monthly consultation with their attending psychiatrist through videoconferencing during one year. After each consultation, the medication is sent to the patient through a home delivery program. For reasons of patient safety, consultations at baseline, and after 6 and 12 months will be realized in a face-to-face form at the Institute of Psychiatry (IPq).
Patients in the face-to-face consultation (control) group have monthly face-to-face consultation with their attending psychiatrist during one year at the Institute of Psychiatry (IPq).
Institute of Psychiatry, School of Medicine, University of Sao Paulo
São Paulo, São Paulo, Brazil
Baseline Depression Severity
Instrument: Hamilton Depression Rating Scale
Time frame: 0 months (baseline)
Change from Baseline in Depression Severity at 6 months
Instrument: Hamilton Depression Rating Scale
Time frame: 6 months
Change from Baseline and 6-months Follow-up in Depression Severity at 12 months
Instrument: Hamilton Depression Rating Scale
Time frame: 12 months
Baseline Satisfaction with Treatment
Instrument: Client Satisfaction Questionnaire (CSQ-8)
Time frame: 0 months (baseline)
Change from Baseline in Satisfaction with Treatment at 6 months
Instrument: Client Satisfaction Questionnaire (CSQ-8)
Time frame: 6 months
Change from Baseline and 6-months Follow-up in Satisfaction with Treatment at 12 months
Instrument: Client Satisfaction Questionnaire (CSQ-8)
Time frame: 12 months
Baseline Mental Health
Instrument: Mental Health Inventory (MHI)
Time frame: 0 months (baseline)
Change from Baseline in Mental Health at 6 months
Instrument: Mental Health Inventory (MHI)
Time frame: 6 months
Change from Baseline and 6-months Follow-up in Mental Health at 12 months
Instrument: Mental Health Inventory (MHI)
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Time frame: 12 months
Baseline Quality of Therapeutic Relationship
Instrument: Working Alliance Inventory (WAI)
Time frame: 0 months (baseline)
Change from Baseline in Quality of Therapeutic Relationship at 6 months
Instrument: Working Alliance Inventory (WAI)
Time frame: 6 months
Change from Baseline and 6-months Follow-up in Quality of Therapeutic Relationship at 12 months
Instrument: Working Alliance Inventory (WAI)
Time frame: 12 months
Baseline Medical Adherence
Instrument: self-reported measure of medication adherence with four items: * Do you forget to take your medication? * Are you careless at times about taking your medicine? * When you feel better, do you sometimes stop taking your medicine? * Sometimes when you feel worse, do you stop taking your medicine? Response categories are yes/no for each item with a dichotomous response and a 5-point Likert response for the last item.
Time frame: 0 months (baseline)
Change from Baseline in Medical Adherence at 6 months
Instrument: self-reported measure of medication adherence with four items: * Do you forget to take your medication? * Are you careless at times about taking your medicine? * When you feel better, do you sometimes stop taking your medicine? * Sometimes when you feel worse, do you stop taking your medicine? Response categories are yes/no for each item with a dichotomous response and a 5-point Likert response for the last item.
Time frame: 6 months
Change from Baseline and 6-months Follow-up in Medical Adherence at 12 months
Instrument: self-reported measure of medication adherence with four items: * Do you forget to take your medication? * Are you careless at times about taking your medicine? * When you feel better, do you sometimes stop taking your medicine? * Sometimes when you feel worse, do you stop taking your medicine? Response categories are yes/no for each item with a dichotomous response and a 5-point Likert response for the last item.
Time frame: 12 months