Primary care patients’ experiences of video consultations for depression and anxiety: a qualitative interview study embedded in a randomized feasibility trial

BMC Health Services Research

Research

Justus Tönnies¹  Lydia Oeljeklaus¹  Mariell Hoffmann¹  Markus W. Haun¹  Mechthild Hartmann¹  Hans-Christoph Friederich¹  Joachim Szecsenyi²  Michel Wensing²  Frank Peters-Klimm²  Regina Krisam³  Dorothea Kronsteiner³ 

[1] Department of General Internal Medicine and Psychosomatics, Heidelberg University, Im Neuenheimer Feld 410, D-69120, Heidelberg, Germany;Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany;Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany;

关键词: Primary health care;    Telemedicine;    Remote consultations;    Depression;    Anxiety;    Qualitative research;    Mental health services;   

DOI  :  10.1186/s12913-022-09012-z

 received in 2021-09-28, accepted in 2022-12-26,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundIntegrated mental health care models that provide rapid access to video consultations with mental health specialists for primary care patients are a promising short-term, low-threshold treatment option and may reduce waiting times for specialist care. This qualitative study, nested within a randomized feasibility trial, aimed to explore participants’ views on this type of care model, its influence on the lived experience of patients, and barriers and facilitators for its delivery.MethodsIn five primary care practices, 50 adults with depression and/or anxiety were randomly assigned to either an integrated care model (maximum of five video consultations with a mental health specialist) or usual care (primary care or another treatment option). Prior to obtaining the trial results, interviews were held with participants who had received video consultations. Interviews were transcribed and analysed thematically.ResultsTwenty of the 23 patients who received video consultations participated in the interviews. Patients engaged well with the care model and reported positive effects on their most pressing needs, while denying safety concerns. Generally, they perceived the usability of video consultations as high, and temporary connectivity failures were not considered a substantial barrier. We identified two key mechanisms of impacts on the patients’ lived experience: fast access to specialist mental healthcare and the emerging rapport with the specialist. In particular, patients with no prior mental healthcare experience indicated that familiarity with the primary practice and their physician as a gatekeeper were important facilitators of proactive treatment.ConclusionsFrom the patients’ perspective, mental health care models integrating video consultations with mental health specialists into primary care are linked to positive lived experiences. Our findings imply that primary care physicians should promote their role as gatekeepers to (1) actively engage patients, (2) apply integrated care models to provide a familiar and safe environment for conducting mental health care video consultations, and (3) be able to regularly assess whether certain patients need in-person services. Scaling up such models may be worthwhile in real-world service settings, where primary care physicians are faced with high workloads and limited specialist services.Trial registrationDRKS00015812.

【 授权许可】

CC BY   
© The Author(s) 2023

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