J Telemed Telecare - Agreement between telepsychiatry assessment and face-to-face assessment for Emergency Department psychiatry patients.

Tópicos

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Resumo

We compared psychiatrists' evaluations of Emergency Department (ED) mental health patients made face-to-face or by telemedicine. In a 39-month study, 73 patients presenting in the ED were enrolled after initial screening. Patients were interviewed by a psychiatrist either face-to-face in the ED or remotely by video. A second psychiatrist, acting as an observer, was in the room with the patient and independently completed the assessment. Based on the primary diagnosis of the interviewer, 48% of patients had a depressive disorder, 18% a substance use disorder, 14% a bipolar disorder, 11% a psychotic disorder, 6% an anxiety disorder and 4% other disorders. The raw agreement between the psychiatrists about disposition when both used face-to-face assessment was 84% and it was 86% when one used telemedicine. Using Cohen's kappa to evaluate agreement, there were no significant differences for disposition recommendation, strength of recommendation, diagnosis or the HCR-20 dangerousness scale. There was no significant difference for the intraclass correlation coefficients for the suicide scale. The results provide preliminary support for the safe use of telepsychiatry in the ED to determine the need for admission to inpatient care.

Resumo Limpo

compar psychiatrist evalu emerg depart ed mental health patient made facetofac telemedicin month studi patient present ed enrol initi screen patient interview psychiatrist either facetofac ed remot video second psychiatrist act observ room patient independ complet assess base primari diagnosi interview patient depress disord substanc use disord bipolar disord psychot disord anxieti disord disord raw agreement psychiatrist disposit use facetofac assess one use telemedicin use cohen kappa evalu agreement signific differ disposit recommend strength recommend diagnosi hcr danger scale signific differ intraclass correl coeffici suicid scale result provid preliminari support safe use telepsychiatri ed determin need admiss inpati care

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