The Use of Telepsychiatry during Coronavirus Disease 2019: A Cross-sectional Study on Demographic and Clinical Profile of Those who Sought Help by Using this Facility
Resumen
Aim: We aimed to study the demographic and clinical profile of patients who sought teleconsultation for psychiatric disorders from august 2020 to January 2021.
Materials & Methods: In this cross-sectional descriptive study, data was retrieved from the telepsychiatry services and was analyzed to examine the demographic and clinical parameters of patients.
Results: A total of 3444 teleconsultations were sought with a mean age of 37.78 ± 15.08. About 80% of the patients were in the age group of 20-60 years. Females outnumbered males with 1938 (56.3%) females and 1538 (43.7%) males. Mood disorders were the most frequent diagnosis with Major Depressive Disorder in 1572 (45.6%) and Bipolar Disorder in 636 (18.5%). Co-morbidity was present in 234 (6.8%) of the study group. The mean psychotropics prescribed were 1.95 ± 0.84. One, two, three and four psychotropics were prescribed in 918 (26.7%), 1470 (42.7%), 900 (26.1%) and 42 (1.2%) respectively. Those aged < 20 years or ≥ 60 years prescribed psychotropics at lower rates in comparison to the 20-60 years age group. Female patients had a significantly higher rate of psychotropic prescription than male patients. Three or four psychotropics were prescribed to those with co-morbidity at a significantly higher rate.
Conclusion: Demographic and clinical profile of patients seeking treatment through telepsychiatry was found to be comparable with face-to-face outpatient consultations.
Clinical Significance: With the development of clinical, operational, legal, and ethical guidelines for telepsychiatry practice, the systematic application of Information and Communication Technologies to the practice of mental healthcare is being rapidly adopted.
Descargas
Citas
2. TELEMEDICINE - WHO | World Health Organization Available from: https://www.who.int/goe/publications/goe_telemedicine_2010.pdf [Last accessed on 6th April2021]
3. American Psychiatric Association. What is Telepsychiatry? Available from: https://www.psychiatry.org/patients-families/what-is-telepsychiatry. [Last accessed on 6th April2021]
4. Sauers‐Ford HS, Hamline MY, Gosdin MM, Kair LR, Weinberg GM, Marcin JP, Rosenthal JL. Acceptability, usability, and effectiveness: a qualitative study evaluating a pediatric telemedicine program. Acad Emerg Med. 2019 Sep;26(9):1022-33.
5. De Las Cuevas C, Arredondo MT, Cabrera MF, Sulzenbacher H, Meise U. Randomized clinical trial of telepsychiatry through videoconference versus face-to-face conventional psychiatric treatment. Telemed J E Health. 2006 Jun;12(3):341-50.
6. Telemedicine Practice Guidelines - Enabling Registered Medical Practitioners to Provide Healthcare Using Telemedicine. Appendix 5 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics Regulation) 2002. Available from: https://www.mohfw.gov.in/pdf/Telemedicine.pdf. [Last accessed on 6th April 2021].
7. Gautham MS, Gururaj G, Varghese M, Benegal V, Rao GN, Kokane A, Chavan BS, Dalal PK, Ram D, Pathak K, Lenin Singh RK. The National Mental Health Survey of India (2016): Prevalence, socio-demographic correlates and treatment gap of mental morbidity. Int J Soc Psychiatry. 2020 Jun;66(4):361-72.
8. Dinakaran D, Basavarajappa C, Manjunatha N, Kumar CN, Math SB. Telemedicine practice guidelines and telepsychiatry operational guidelines, India—A commentary. Indian J Psychol Med. 2020 Oct;42(5_suppl):1S-3S.
9. Chakrabarti S. Usefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches. World J Psychiatry. 2015 Sep 22;5(3):286-04.
10. Math SB, Moirangthem S, Kumar NC. Telepsychiatry: After mars, can we reach the unreached?. Indian J Psychol Med. 2015;37:120-1.
11. Moirangthem S, Rao S, Kumar CN, Narayana M, Raviprakash N, Math SB. Telepsychiatry as an economically better model for reaching the unreached: A retrospective report from South India. Indian J Psychol Med. 2017 May;39(3):271-5.
12. Das S, Manjunatha N, Kumar CN, Math SB, Thirthalli J. Tele-psychiatric after care clinic for the continuity of care: A pilot study from an academic hospital. Asian J Psychiatry. 2020 Feb 1;48:101886.
13. Kharadi D, Patel K, Rana D, Patel V. Off-label drug use in Psychiatry Outpatient Department: A prospective study at a Tertiary Care Teaching Hospital. J Basic Clin Pharm. 2015;6:45-9.
14. Mukherjee S, Sen S, Chatterjee SS, Biswas A, Sinha S, Ghosal M, Tripathi SK. Prescribing pattern of psychotropic medications in psychiatry outpatients at a tertiary care teaching hospital in India: A prospective cross-sectional study. Int J Hosp Res. 2014 Sep 1;3(3):113-22.
15. Thakkar KB, Jain MM, Billa G, Joshi A, Khobragade AA. A drug utilization study of psychotropic drugs prescribed in the Psychiatry Outpatient Department of a Tertiary Care Hospital. J Clin Diagn Res. 2013;7:2759–64.
16. Piparva KG, Parmar DM, Singh AP, Gajera MV, Trivedi HR. Drug utilization study of psychotropic drugs in outdoor patients in a teaching hospital. Indian J Psychol Med. 2011;33:54–8.
17. Malhotra S, Shah R. Women and mental health in India: An overview. Indian J Psychiatry. 2015 Jul;57(Suppl 2):S205-11.
18. Lahon K, Shetty H, Paramel A, Sharma G. A retrospective drug utilization study of antidepressants in the psychiatric unit of a tertiary care hospital. J Clin Diagn Res. 2011 Oct;5(5):1069-75.
19. Allan GM, Lexchin J, Wiebe N. Physician awareness of drug cost: a systematic review. PloS med. 2007 Sep 25;4(9):e283.
20. Dutta SB, Dhasmana DC, Bhardwaj R. Psychotropic drug utilization pattern among patients with schizophrenia. Indian J Psychiatry. 2005 Oct;47(4):243-4.
21. Nobili A, Garattini S, Mannucci PM. Multiple diseases and polypharmacy in the elderly: challenges for the internist of the third millennium. J Comorb. 2011 Dec 27;1:28-44.
22. Bushardt RL, Massey EB, Simpson TW, Ariail JC, Simpson KN. Polypharmacy: misleading, but manageable. Clin Interv Aging. 2008;3(2):383-9.
23. Bakken MS, Ranhoff AH, Engeland A, Ruths S. Inappropriate prescribing for older people admitted to an intermediate-care nursing home unit and hospital wards. Scand J Prim Health Care. 2012 Sep;30(3):169-75.
24. Bloch F, Thibaud M, Dugué B, Brèque C, Rigaud AS, Kemoun G. Psychotropic drugs and falls in the elderly people: updated literature review and meta-analysis. J Aging Health. 2011 Mar;23(2):329-46.
25. Ćurković M, Dodig-Ćurković K, Erić AP, Kralik K, Pivac N. Psychotropic medications in older adults: a review. Psychiatr Danub. 2016 Mar;28(1):13-24.
26. Sarkar P, Chakraborty K, Misra A, Shukla R, Swain SP. Pattern of psychotropic prescription in a tertiary care center: a critical analysis. Indian J Pharmacol. 2013 May-Jun;45(3):270-3.
27. Mojtabai R, Olfson M. National trends in psychotropic medication polypharmacy in office-based psychiatry. Arch Gen Psychiatry. 2010 Jan;67(1):26-36.
28. Viola R, Csukonyi K, Doró P, Janka Z, Soós G. Reasons for polypharmacy among psychiatric patients. Pharm World Sci. 2004 Jun;26(3):143-7.

