Messaging Online as Useful as Face to Face in Depression Treatment Follow Up

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The efficiencies of using online means of communication in organising follow up care for depression patients are quite effective, it has been found by a new trial.

The randomized trial soliciting feedback from 208 patients found that the results of the online process met with strong results after a 5 month period.

The findings here were against those who received ‘usual care,’ with the half of the trial patients sampled who were given three online care management contacts showing a marked decrease in depression symptoms. These persons were treated online via a trained psychiatric nurse. They were also found to be more likely to actually take their anti depressant medication, and most gave feedback that declared they were ‘very satisfied’ with their treatment.

All of the respondents in the trial were in the opening phase of taking their prescribed medications, with the online group more likely to have taken the medication as prescribed. “While more Americans are taking antidepressants, the quality of care for depression remains among the lowest scores on the U.S. health care report card,” it was stated by Gregory E. Simon, MD, MPH, a Group Health psychiatrist and Group Health Research Institute senior investigator. He felt that especially with regard to primary care, the place where the treatment for depression begins by and large there is a failure for many patients on the side of the health provider to give adequate follow up communication.

It had been noted as a consequence of previous studies that telephone calls had allowed for a greater delivery of follow on communication. It is a means of reaching out to patients, a means to determine advancement and a means to access how well they are observing the guidelines of taking their medication. The follow on contact is the method by which continuity of care is assured if you will.

The frequency and the changing of doses can be directed over the phone or via the online. Switches to other medications can be directed, and the side effects of the antidepressants can be determined from these points of contact. The continuity allows in essence the tailoring of medication usage to bolster an individual’s response. The findings show that this is all possible without direct face to face contact with the patient

The reasoning behind the move from phone based follow up care is the inefficiencies of what the doctors call ‘phone tag.’ Much time is lost in trying to connect over the phone at times which may not suit the patient. Online does not require the two persons to be in instantaneous contact, as a result there is no time lost in tracking the individual down, and with that result comes efficiency of care.

There are protocols of course that must be followed in providing medical advice online, but the team has discovered that their existing electronic medical record can improve care for chronic medical conditions. It was also uncovered in the findings that it is the patients suffering from depression who are most likely to respond to this form of communication.

“We worried that patients might need live voice contact in real time to be understood, and feel supported,” Dr. Simon admitted, however he also stated. “But this online care management helped these patients, even though they never met the trained psychiatric nurse in person or talked with her on the phone. And because she spent only one hour per patient to deliver this intervention, it promises to make high-quality depression care more affordable.”

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