Pilot Study of Asynchronous and Synchronous Telepsychiatry for Skilled Nursing Facilities

Completed · Not applicable

Conditions studied: Dementia, Depression, Mood Disorder, Anxiety Disorder, Substance Use Disorder

In brief

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.

Key facts

Study ID

NCT02537093

Run by

University of California, Davis

People needed

40

Starts

2015-08-01

Expected to finish

2017-05-01

Last updated by the study team

2017-07-11

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Aged ≥18, with non-emergent psychiatric symptoms: depression, schizophrenia, bipolar disorder, Post-Traumatic Stress Disorder (PTSD), dementia-related behavioral problems, management of psychiatric medications, and other mental health problems that the Skilled Nursing Facility (SNF) Primary Care Provider (PCP) and team deems necessary to obtain psychiatric consultation.
• referred by SNF staff and PCP at participating site

You may not qualify if…

• Residents with imminent suicide and/or violence risks that require emergency psychiatric referrals or residents who cannot wait until the next ATP/STP evaluation
• Residents with other psychiatric emergencies will be referred to the local emergency department as is the current practice at both SNFs.
• less than 18 years
• immediate violent intentions or plans
• incarceration
• patient whose PCP recommends not participating.
• PCP not at participating site

Where it is running

• Norwood Pines Care Center — Sacramento, California, United States
• Cottonwood Post-Acute Rehabilitation Center — Woodland, California, United States

Full record on ClinicalTrials.gov

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