Study finds telehealth a viable depression treatment alternative
12/17/21 11:25:am
In a new study published in the Journal of Psychiatric Research, Rogers explored the effectiveness, benefits, and challenges of telehealth in high-intensity mental health treatment.
In reviewing partial hospitalization (PHP) and intensive outpatient (IOP) outcomes from Rogers Connect Care compared with in-person treatment results, investigators found that telehealth is a viable alternative with no significant differences in depressive symptom reduction and quality of life improvement.
“We began offering telehealth out of pandemic necessity, but we went into it knowing that validating treatment quality and patient outcomes would be a top priority,” says Kelly Piacsek, PhD, vice president, Research. “Based on the study results, the team revealed that telehealth could be offered without compromising care at a time when so many people needed access to treatment.”
How the study was conducted
Prior to Rogers’ research, the behavioral health field had limited data on the efficacy of telehealth, and patient satisfaction with remote treatment was mixed.
The transition to Rogers Connect Care in March 2020, however, provided the opportunity to compare PHP and IOP patients receiving remote treatment delivery with those receiving in-person treatment prior to the onset of the pandemic.
“What’s unique about this project is that COVID required us to move quickly to a telehealth delivery model, so it wasn’t a typically well-controlled research experiment,” says Dr. Piacsek. “But, we were able to evaluate real-world conditions that are often over-simplified in prospective, controlled trials.”
The Rogers Research Center explored two questions:
How did treatment delivery (in-person versus telehealth) affect patient outcomes across Rogers?
Does treatment delivery affect therapeutic response for patients in different levels of care (PHP or IOP)?
Since the effectiveness of treatment techniques, such as exposure therapy and behavioral activation exercises, were thought to be difficult to implement virtually, the investigators’ hypothesis was that patients receiving in-person treatment would show greater symptom reduction than those in telehealth.
Leveraging Rogers’ analytical expertise and comprehensive automated outcomes assessment system to obtain robust patient outcomes data, the study statistically matched the telehealth group to an equally sized and characteristic subsample of 1,192 in-person patients treated from May 2013 to December 2019.
“Rogers Outcomes Assessment System (ROAS) is really innovative, and it allows us to leverage the principles of measurement-based care to study the effects of changes in treatment delivery over time,” says Brian Kay, PhD, vice president, continuous improvement. “No other organization could have conducted a study like this.”
In utilizing outcome measures related to depressive symptoms and quality of life, the analysis found no significant differences in admission or discharge scores between the in-person and telehealth groups.
The only exception was PHP telehealth patients stayed in treatment an average of 2.9 days longer than those who received in-person treatment. Dr. Piacsek says this is an interesting finding that may help the field further understand the comparative cost effectiveness of telehealth in the long run.
Next steps
While telehealth appears to be a viable care alternative, in-person treatment may be more effective for certain individuals, service lines, and levels of care.
Rogers has several more studies underway now to learn more, including for adult OCD and addiction and another to specifically look at how children responded to telehealth.
Additionally, future research is needed to replicate these findings in other healthcare systems and in more diverse patient populations.
“Overall, it’s important to remember that our telehealth options employ the same evidence-based treatment as our in-person programs,” Dr. Piacsek says.
*****
The study was authored by Nyssa Bulkes, PhD, data scientist; Kaley Davis, research associate; Brian Kay, PhD, vice president, continuous improvement; and Bradley Riemann, PhD, chief clinical officer/chief operating officer.
