An interventional study of Psychiatric Consultation in Dementia, Depression and Mood Disorder, sponsored by University of California, Davis. Completed at 2 sites in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2017-07-11.
Sponsored by University of California, Davis · Not applicable, Interventional, and Health services research
Specific Aims: This study aims to assess the acceptability of asynchronous
telepsychiatry (ATP) and synchronous (STP) in rural Skilled Nursing Facility (SNF)
population, in a 12-month randomized controlled trial. ATP relies on video recording of a
psychiatric interview, where the video is later reviewed by a psychiatrist to make a
psychiatric diagnosis and treatment recommendation to the primary treatment team.
STP is real-time, face-to-face psychiatric assessment using video conferencing to come
up with a psychiatric recommendation. People residing in SNFs generally rely on primary
and consultant physicians to visit them and rarely have outpatient psychiatrist follow-up.
SNFs offer more services than what is available to primary care office, and include 24-
hours skilled nursing services, physical therapy, nutritional consultation, occupational
therapy, social services, wound care, and psychiatric consultation when available. SNF
residents are unable to live independently due to their multiple medical comorbidities
and are therefore more medically ill than patients who are typically seen in primary care
settings. The present study aims to demonstrate feasibility and to collect pilot data in
SNFs. This study is funded by the UC Davis Behavior Health Center of Excellence grant
via the California Mental Health Services Act (Prop 63). In a larger, future study, the investigators
intend to demonstrate that ATP will be no different than STP in clinical outcomes but will
be more accessible and cost effective.
Specific Aims: This study aims to assess the acceptability of asynchronous
telepsychiatry (ATP) and synchronous (STP) in rural Skilled Nursing Facility
(SNF) population, in a 12-month randomized controlled trial. ATP relies on
video recording of a psychiatric interview, where the video is later reviewed by
a psychiatrist to make a psychiatric diagnosis and treatment recommendation
to the primary treatment team.
STP is real-time, face-to-face psychiatric assessment using video conferencing
to come up with a psychiatric recommendation. People residing in SNFs
generally rely on primary and consultant physicians to visit them and rarely
have outpatient psychiatrist follow-up. SNFs offer more services than what is
available to primary care office, and include 24-hours skilled nursing services,
physical therapy, nutritional consultation, occupational therapy, social services,
wound care, and psychiatric consultation when available. SNF residents are
unable to live independently due to their multiple medical comorbidities and are
therefore more medically ill than patients who are typically seen in primary care
settings. The present study aims to demonstrate feasibility and to collect pilot
data in SNFs. This study is funded by the University of California (UC Davis)
Behavior Health Center of Excellence grant via the California Mental Health
Services Act (Prop 63). In a larger, future study, we intend to demonstrate that
ATP will be no different than STP in clinical outcomes but will be more
accessible and cost effective.
Aim 1: To assess whether ATP and STP models improve clinical outcomes:
Hypotheses: Compared to STP, the ATP arm will: H1: show similar clinical
outcome trajectory, reflected in improvement from baseline, as measured by
Clinical Global Impression (CGI), Patient Health Questionaire-9 (PHQ-9), Brief
Interview for Mental Status (BIMS), and overall behavioral symptoms; H2: have
similar use of health care resources: psychiatric medications, additional interval
psychiatric visits, number of emergency room visits and hospitalizations
(medical, psychiatric, and overall); And H3: produce shorter waiting times for
psychiatric consultation.
Aim 2: To assess the acceptability of ATP and STP by examining satisfaction
surveys from SNF residents (who are able to complete the surveys).
Hypothesis:
Compared to STP, ATP participants will show: H1: Similar levels of satisfaction
as measured by: Telemedicine Satisfaction Survey as completed by
participants.
Aim 3: To conduct preliminary healthcare economics analysis and feasibility of
producing estimates of cost-effectiveness of ATP vs. STP in SNFs. Hypotheses:
ATP, compared to STP, will: H1: be more cost effective as measured by cost
savings from reduced need for face-to-face psychiatrist time and similar use of
other medical and psychiatric services.
2,124 studies on the registry are indexed under Substance-Related Disorders; 393 are open to participants now.
This study's enrollment of 40 is below the median of 108 across 1,727 interventional studies indexed under Substance-Related Disorders.
Browse Substance-Related Disorders studies →University of California, Davis is the lead sponsor of 798 studies on the registry; 146 are open to participants now.
Of its 65 completed or terminated interventional studies of FDA-regulated products, 43 (66%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Control Arm/Synchronous telepsychiatry (STP): After baseline assessment, subjects will be assessed by a psychiatrist using live interactive videoconferencing every 6 months for a 1 year follow up (3 STP assessments: baseline plus 2 assessments). A report with treatment recommendations following American Psychiatric Association guidelines will be sent to the PCP who will be able to have adlib telephone or email consultations with the telepsychiatrist. The telepsychiatrist will have access to all previous clinical information about the patients.
Behavioral: Psychiatric Consultation
Intervention Arm (ATP): All ATP assessments at 6 monthly intervals post baseline will be conducted by an ATP trained clinician. This interview will be video recorded.The ATP clinicians will then fill out a standardized medical template that will be reviewed by a psychiatrist who will provide a written assessment and psychiatric treatment plan. He will have access to any previous assessments and the PCP will also have continuing access to this psychiatrist by phone or email between the 3 consultations.
Behavioral: Psychiatric Consultation
Clinical Global Impression
Change in CGI will be measured from baseline to study endpoint of 12-month follow-up
Time frame: 12 months
Brief Interview for Mental Status (BIMS)
Change in BIMS will be measured from baseline to 12-month
Time frame: 12 months
This study is completed, as verified in Jul 2017. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
University of California, Davis