Feasibility of a video-delivered mental health course for primary care patients: a single-group prospective cohort study

BMC Primary Care

Research Article

Anne H. Berman¹  Karoline Kolaas²  Erik Hedman-Lagerlöf³  Anastasiya Zakrevska⁴  Sandra af Winklerfelt Hammarberg⁵  Majken Epstein⁶  Erland Axelsson⁷ 

[1] Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Norra Stationsgatan 69, SE-113 64, Stockholm, Sweden;Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden;Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Norra Stationsgatan 69, SE-113 64, Stockholm, Sweden;Liljeholmen Primary Health Care Center, Region Stockholm, Stockholm, Sweden;Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden;Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;Gustavsberg Primary Health Care Clinic, Region Stockholm, Stockholm, Sweden;Liljeholmen Primary Health Care Center, Region Stockholm, Stockholm, Sweden;Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden;Liljeholmen Primary Health Care Center, Region Stockholm, Stockholm, Sweden;Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden;Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden;Liljeholmen Primary Health Care Center, Region Stockholm, Stockholm, Sweden;Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden;Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;Liljeholmen Primary Health Care Center, Region Stockholm, Stockholm, Sweden;Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden;Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden;Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden;

关键词: Anxiety disorders;    Depression;    Primary health care;    Transdiagnostic;    eHealth;    Telepsychiatry;    Video;    Cognitive behavioral therapy;   

DOI  :  10.1186/s12875-023-01989-8

 received in 2022-09-08, accepted in 2023-01-18,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn many health care systems, primary care is tasked with offering psychological treatment for common mental disorders. Resources are often limited, which complicates widespread dissemination of traditional psychological treatments. Stepped care models where the less resource-intensive interventions are delivered first, can be employed, but often do not eliminate the need for a thorough diagnostic assessment, which can be time-consuming, has the potential to bottleneck patient intake, and can add to waiting times. Novel low-threshold formats are needed to improve access to mental health care in the primary care setting.MethodsThis was a single-group prospective cohort study (N = 91). We assessed the feasibility of a video-delivered course as a first-line intervention for patients seeking help for mental health problems at a primary care center. The course had a transdiagnostic approach, suitable for both depression and anxiety disorders, and was based on cognitive behavioral techniques. Patients in need of psychosocial assessment, which usually entailed a four- to six-week wait, were referred by physicians or triage nurses. Study participants could start within a week, without the need for conventional diagnostic assessment, and were informed that they would be offered assessment after the course if needed. Key feasibility outcomes included participant satisfaction, attendance rates, the proportion of participants in need of additional clinical intervention after the course, and the rate of clinically significant improvement in anxiety and depression symptoms.ResultsParticipants scored a mean of 21.8 (SD = 4.0, 9–32, n = 86) on the Client Satisfaction Questionnaire-8; just below our target of 22. The mean attendance rate was 5.0/6 lectures (SD = 1.6, range: 0–6, n = 91). Forty-six percent (37/81) reported experiencing no need of further clinical intervention after the course. The rate of clinically significant improvement was 59% (27/46) for anxiety and 48% (22/46) for depression. No serious adverse event was reported.ConclusionsDelivering a low-threshold online video-delivered mental health course in primary care appears to be feasible. Adjustments to further improve patient satisfaction are warranted, such as offering the choice of participating online or face-to-face.Trial Registration(ClinicalTrials.gov NCT04522713) August 21, 2020.

【 授权许可】

CC BY   
© The Author(s) 2023

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