Susanne Inez Steinberg
Medical Director & Psychiatrist Penn Med Princeton House Behavioral Health, Moorestown, NJ 08057, United States
Robert Gallop
Applied Statistics Program, Department of Mathematics, West Chester University, West Chester, PA 19383, United States
Few studies examine the benefits from geriatric telepsychiatry in rural retirement communities. Objectives: 1. To demonstrate that using telepsychiatry a) standard approaches to psychiatric evaluation would yield diagnoses in Diagnostic and Statistical Manual of Mental Disorders (DSM-V); b. psychotherapies and pharmacotherapy could be effectively administered. 2. To examine the relationships among cognition, mood, agitation and functions at baseline and the response to treatment over time. Design: Prospective longitudinal study. Measures: Geriatric Depression scale (GDS), Mini Mental State Exam (MMSE), Barthel Index (BI), Pittsburgh Agitation Scale (PAS). Setting: Video Teleconferencing. Interventions: Psychotherapy, psychopharmacology. Participants: 428 Seniors over 55, met criteria for at least one DSM-V diagnosis. Results: Treatments were administered for a full range of psychiatric diagnoses and age-related medical conditions. The most frequently prescribed pharmacological agents were: antidepressants (78%) antipsychotics (64%), memory enhancers (38%). Participants (66%) received psychotherapy: individual (31%), couple (7%), family (13%). Variation in the MMSE scores were observed: 55% remained stable, 11% declined, 18% improved. GDS Scores improved from baseline to 26 weeks (p=0.02, d=0.99: 95% CI 0.39-1.56). PAS scores declined from baseline to 52 weeks (McNemar’s S= 11.27, p=0.0008, d=1.17: 95% CI 0.63-1.68). Function (BI) at week 26 was not statistically significantly different from baseline (t(26)=1.66, p=0.11, d=0.65: 95%CI -0.16-1.42). Participants maintained independence (64.5%) at 52 weeks (McNemar’s S = 6.23, p=0.013, d=0.79: 95%CI 0.19-1.36) Conclusion: This study demonstrates the feasibility and benefit of providing a full complement of services via telepsychiatry to seniors and provides a rationale for more comprehensive reimbursement plans .
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Copyright © 2020 Susanne Inez Steinberg, Robert Gallop
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