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Patients, Social Workers, and Pharmacists' Perceptions of Barriers to Providing HIV Care in Community Pharmacies in the United States. PHARMACY 2021; 9:pharmacy9040178. [PMID: 34842829 PMCID: PMC8628938 DOI: 10.3390/pharmacy9040178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022] Open
Abstract
Retaining people living with HIV (PLWH) in clinical care is a global priority to end the HIV epidemic. Community pharmacies in the United States have structural influences on the success or failure of retention in HIV care by supporting patients’ complex needs. However, to date, barriers to retention in care in the community pharmacy setting have not been examined beyond pharmacy services of medication therapy management. We utilized the patient-centered medical home model to examine the barriers to HIV care in the community pharmacy setting. We utilized semi-structured interviews to collect data from 15 participants: five PLWH, five community pharmacists, and five social workers from a midwestern state. Interview data were transcribed and analyzed using directed content analysis. Four key themes emerged regarding the barriers that impact utilization of community pharmacy services by PLWH: the perception of the role of community pharmacists in HIV care, perceptions of pharmacists’ HIV knowledge, perceptions of pharmacy operation and services, and negative experiences within the community pharmacy space. Participants’ perceptions of solutions for improving HIV care in the community pharmacy focused on improving the relationship between pharmacists and patients, ensuring that the community pharmacy is a private and safe space for patients, and having a diverse pharmacy staff that is equipped to take care of the diverse and marginalized HIV population, such as transgender people.
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Zhao X, Bhattacharjee S, Innes KK, LeMasters TJ, Dwibedi N, Sambamoorthi U. The impact of telemental health use on healthcare costs among commercially insured adults with mental health conditions. Curr Med Res Opin 2020; 36:1541-1548. [PMID: 32609549 PMCID: PMC7535072 DOI: 10.1080/03007995.2020.1790345] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To determine the impact of telemental health (TMH) use on total healthcare costs and mental health (MH)-related costs paid by a third party among adults with mental health conditions (MHC). METHOD This study employed a pre-post design with a non-equivalent control group. The cohort comprised adults with MHCs identified using diagnosis codes from de-identified claims data of the Optum Clinformatics DataMart (2010 January 01 to 2017 June 30). We identified mental health (MH) service users and TMH users (N = 348) based on procedure codes. Non-users (N = 238,595) were defined as those who only used in-person MH services. A Difference-in-Differences (DID) analysis was performed within a multivariable two-part model (TPM) framework to examine the impact of TMH use on adjusted standardized costs (2018 US $) of all healthcare services and MH services. Patient-level and state-level factors were adjusted in TPM. RESULTS TMH use was associated with significantly higher MH-related costs [Marginal effect = $461.3, 95% confidence interval: $142.4-$780.2] and an excess of $370 increase in MH-related costs at follow-up as compared to baseline. However, TMH use was not associated with an increase in total third-party healthcare costs nor with changes in total costs from baseline to follow-up. CONCLUSIONS Despite having a higher likelihood of MH services use and MH-related costs, TMH users did not have higher total costs as compared to adults using only in-person MH services. Our findings suggest that TMH can increase access to MH care without increasing total healthcare costs among adults with MHC. Future studies exploring whether TMH use can lead to cost-savings over a longer period are warranted.
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Affiliation(s)
- Xiaohui Zhao
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Sandipan Bhattacharjee
- Department of Pharmacy Practice & Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA
| | - Kim K. Innes
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Traci J. LeMasters
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Nilanjana Dwibedi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
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Myers K, Cummings JR, Zima B, Oberleitner R, Roth D, Merry SM, Bohr Y, Stasiak K. Advances in Asynchronous Telehealth Technologies to Improve Access and Quality of Mental Health Care for Children and Adolescents. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s41347-018-0055-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Yellowlees P, Burke Parish M, González Á, Chan S, Hilty D, Iosif AM, McCarron R, Odor A, Scher L, Sciolla A, Shore J, Xiong G. Asynchronous Telepsychiatry: A Component of Stepped Integrated Care. Telemed J E Health 2017; 24:375-378. [PMID: 29024612 DOI: 10.1089/tmj.2017.0103] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Integrated behavioral healthcare models typically involve a range of consultation options for mental healthcare. Asynchronous telepsychiatry (ATP) consults may be an additional potential choice, so we are conducting a 5-year clinical trial comparing ATP with synchronous telepsychiatry (STP) consultations. METHODS Patients referred by primary care providers are randomly assigned to one of the two treatment groups, ATP or STP. Clinical outcome, satisfaction, and economic data are being collected from patients for 2 years at 6-month intervals. RESULTS Baseline characteristics for the first 158 patients and case examples of ATP are presented. CONCLUSION Implementing ATP in existing integrated behavioral healthcare models could make mental healthcare more efficient.
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Affiliation(s)
- Peter Yellowlees
- 1 Department of Psychiatry, University of California, Davis , Sacramento, California
| | - Michelle Burke Parish
- 1 Department of Psychiatry, University of California, Davis , Sacramento, California.,2 The Betty Irene Moore School of Nursing, University of California, Davis , Sacramento, California
| | - Álvaro González
- 1 Department of Psychiatry, University of California, Davis , Sacramento, California
| | - Steven Chan
- 1 Department of Psychiatry, University of California, Davis , Sacramento, California
| | - Don Hilty
- 3 Department of Psychiatry, Keck School of Medicine, University of Southern California , Visalia, California
| | - Ana-Maria Iosif
- 1 Department of Psychiatry, University of California, Davis , Sacramento, California
| | - Robert McCarron
- 1 Department of Psychiatry, University of California, Davis , Sacramento, California
| | - Alberto Odor
- 1 Department of Psychiatry, University of California, Davis , Sacramento, California
| | - Lorin Scher
- 1 Department of Psychiatry, University of California, Davis , Sacramento, California
| | - Andrés Sciolla
- 1 Department of Psychiatry, University of California, Davis , Sacramento, California
| | - Jay Shore
- 4 Department of Psychiatry, University of Colorado Denver , Aurora, Colorado
| | - Glen Xiong
- 1 Department of Psychiatry, University of California, Davis , Sacramento, California
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Myers K, Nelson EL, Rabinowitz T, Hilty D, Baker D, Barnwell SS, Boyce G, Bufka LF, Cain S, Chui L, Comer JS, Cradock C, Goldstein F, Johnston B, Krupinski E, Lo K, Luxton DD, McSwain SD, McWilliams J, North S, Ostrowski J, Pignatiello A, Roth D, Shore J, Turvey C, Varrell JR, Wright S, Bernard J. American Telemedicine Association Practice Guidelines for Telemental Health with Children and Adolescents. Telemed J E Health 2017; 23:779-804. [DOI: 10.1089/tmj.2017.0177] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Kathleen Myers
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
- Department of Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, Washington
| | - Eve-Lynn Nelson
- KU Center for Telemedicine & Telehealth, University of Kansas Medical Center, Kansas City, Kansas
- Department of Pediatrics, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Terry Rabinowitz
- Department of Psychiatry, Larner College of Medicine, University of Vermont, Burlington, Vermont
- Department of Family Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Donald Hilty
- Psychiatry & Addiction Medicine, Kaweah Delta Medical Center, UC Irvine Affiliate, Visalia, California
- Department of Psychiatry, Keck School of Medicine at University of Southern California, Los Angeles, California
- Research and Health Services, Aligned Telehealth, Calabasas, California
| | - Deborah Baker
- Office of Legal and Regulatory Affairs, Practice Directorate, American Psychological Association, Washington, District of Columbia
| | - Sara Smucker Barnwell
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
- Seattle Psychology PLLC, Seattle, Washington
| | | | - Lynn F. Bufka
- Practice Research and Policy, Practice Directorate, American Psychological Association, Washington, District of Columbia
| | - Sharon Cain
- Child and Adolescent Psychiatry Division, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Lisa Chui
- Department of Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, Washington
| | - Jonathan S. Comer
- Center for Children and Families, Florida International University, Miami, Florida
- Mental Health Interventions and Technology (MINT) Program, Florida International University, Miami, Florida
| | | | | | | | - Elizabeth Krupinski
- Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia
| | - Katherine Lo
- Department of Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, Washington
| | - David D. Luxton
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
- Office of Forensic Mental Health Services, State of Washington, Olympia, Washington
| | - S. David McSwain
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
- Department of Telehealth Optimization, Medical University of South Carolina, Charleston, South Carolina
| | | | - Steve North
- Center for Rural Health Innovation, Spruce Pine, North Carolina
- Mission Virtual Care, Spruce Pine, North Carolina
| | - Jay Ostrowski
- Behavioral Health Innovation, Charlotte, North Carolina
| | - Antonio Pignatiello
- TeleLink Mental Health Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Medical Psychiatry Alliance, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - David Roth
- Mind and Body Works, Inc., Honolulu, Hawaii
| | - Jay Shore
- Department of Psychiatry, Center for American Indian and Alaska Native Health, University of Colorado, Denver, Colorado
- Telepsychiatry Committee, American Psychiatric Association, Arlington, Virginia
| | - Carolyn Turvey
- Department of Psychiatry, Carver School of Medicine, University of Iowa, Iowa City, Iowa
| | | | - Shawna Wright
- KU Center for Telemedicine & Telehealth, University of Kansas Medical Center, Kansas City, Kansas
- Wright Psychological Services, Chanute, Kansas
| | - Jordana Bernard
- American Telemedicine Association, Washington, District of Columbia
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Nelson EL, Cain S, Sharp S. Considerations for Conducting Telemental Health with Children and Adolescents. Child Adolesc Psychiatr Clin N Am 2017; 26:77-91. [PMID: 27837944 DOI: 10.1016/j.chc.2016.07.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Innovative technologies are increasingly used in order to address gaps in access to child behavioral health care. Telemental health is one technological modality in which child behavioral services can be practiced successfully across psychiatry, psychology, and developmental medicine. The authors discuss relevant issues related to delivering telemental health, including why this modality is necessary for delivery, what models and evidence for telemental health exist, when it should be considered across legal/regulatory and ethical considerations, where telemental health services are delivered, who is involved in delivery, and how best telemental health practices may be implemented with diverse youth.
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Affiliation(s)
- Eve-Lynn Nelson
- Pediatrics Department, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA; KU Center for Telemedicine and Telehealth, University of Kansas Medical Center, 4330 Shawnee Mission Parkway, Suite 136, MS 7001, Fairway, KS 66205, USA.
| | - Sharon Cain
- Psychiatry & Behavioral Sciences Department, University of Kansas Medical Center, MS 4015, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
| | - Susan Sharp
- Psychiatry & Behavioral Sciences Department, University of Kansas Medical Center, MS 4015, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
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Langarizadeh M, Tabatabaei MS, Tavakol K, Naghipour M, Rostami A, Moghbeli F. Telemental Health Care, an Effective Alternative to Conventional Mental Care: a Systematic Review. Acta Inform Med 2017; 25:240-246. [PMID: 29284913 PMCID: PMC5723163 DOI: 10.5455/aim.2017.25.240-246] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background and Objectives Due to the high costs of conventional mental health care, there has been a rise in the application of web-based technologies in recent years, i.e., telemental health care. We conducted this systematic review in 2017, using high quality research articles on the applications, technologies, advantages and challenges associated with telemental health care published since year 2000. Methods We used a combination of relevant key words to search four major databases, such as "Web of Sciences, Embase, PubMed and Science Direct". From among 156 articles, which had been published since 2000, twenty five articles met all of the inclusion criteria and were selected for the final review. The information extracted from these articles were used to construct Tables 1 and 2. Also, the materials derived from 55 credible articles were used as further support and complementary facts to substantiate the information presented in the Discussion section. Results The findings revealed that telemental health care is an extended domain supportive of conventional mental health services. Currently, telemental health care has multiple capabilities and technologies for providing effective interventions to patients with various mental illnesses. It provides clinicians with a wide variety of innovative choices and strategies for mental interventions, in addition to significant future potentials. Conclusions Telemental health care can provide effective and adaptable solutions to the care of mental illnesses universally. While being comparable to in-person services, telemental health care is particularly advantageous and inexpensive through the use of current technologies and adaptable designs, especially in isolated communities.
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Affiliation(s)
- Mostafa Langarizadeh
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences. Tehran, Iran
| | - Mohsen S Tabatabaei
- Department of Health Information Management, School of Health Management and Information Sciences, International Campus (IUMS-IC), Iran University of Medical Sciences. Tehran, Iran
| | - Kamran Tavakol
- School of Medicine, University of Maryland Baltimore. Baltimore, MD, USA
| | - Majid Naghipour
- Department of Health Information Management, School of Health Management and Information Sciences, International Campus (IUMS-IC), Iran University of Medical Sciences. Tehran, Iran
| | - Alireza Rostami
- Department of Cardiac Surgery, Arak University of Medical sciences. Arak, Iran
| | - Fatemeh Moghbeli
- Department of Health Information Management, School of Health Management and Information Sciences, International Campus (IUMS-IC), Iran University of Medical Sciences. Tehran, Iran
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Abstract
Because of the widening gap between need for child mental health services and availability of child specialists, secure videoconferencing options are more needed than ever to address access challenges across underserved settings. This article reviews real-time videoconferencing evidence across telemental health with children and adolescents. It summarizes emerging guidelines that inform best practices for child telemental health using videoconferencing. It presents a case example of best practices across behavioral health specialties. Videoconferencing is an effective approach to improving access to behavioral health interventions for children and adolescents. Telemental health shows promise for disseminating evidence-based treatments to underserved communities.
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Affiliation(s)
- Eve-Lynn Nelson
- KU Pediatrics, University of Kansas Medical Center, Kansas City, KS, USA; University of Kansas Center for Telemedicine & Telehealth, 4330 Shawnee Mission Parkway, Suite 136, MS 7001, Fairway, KS 66205, USA.
| | - Susan Sharp
- Psychiatry & Behavioral Sciences Department, University of Kansas Medical Center, MS 4015, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
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Comer JS, Myers K. Future Directions in the Use of Telemental Health to Improve the Accessibility and Quality of Children's Mental Health Services. J Child Adolesc Psychopharmacol 2016; 26:296-300. [PMID: 26859722 PMCID: PMC4841075 DOI: 10.1089/cap.2015.0079] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES This concluding commentary offers a brief overview of progress to date in providing telemental health services to children, and then offers a critical vision for future research needed to provide the rigorous empirical foundation for telemental health to be considered a well-established format for the delivery of children's mental health services. METHODS We review how recent years have witnessed advances in the science and practice of children's telemental health, and the articles in this special series collectively offered a critical step forward in the establishment of a guiding literature to provide informed direction for child providers incorporating remote technologies to extend their practices. RESULTS Researchers must be cautious not to develop a "horse race" mentality and a misguided search for a decisive "winner" regarding the ultimate effectiveness of child telemental health versus traditional clinic-based treatments. Instead, research efforts are needed to examine key mediators and moderators of telemental health treatment response. The question should not be simply whether telemental health strategies are supported, but rather when, under what circumstances, and for whom telemental health formats may be most indicated. Barriers to the continued evolution of children's telemental health are discussed, and we consider issues of telemental health reimbursement and matters of cross-state professional jurisdiction. CONCLUSIONS Continued efforts are needed in order to fully actualize the potential of children's telemental health to optimize the quality and transform the accessibility of mental health services for all children, regardless of income or geography.
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Affiliation(s)
- Jonathan S. Comer
- Mental Health Interventions and Technology (MINT) Program, Department of Psychology, Florida International University, Miami, Florida
| | - Kathleen Myers
- Seattle Children's Hospital and Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
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Abstract
Telemental health, which involves clinicians connecting remotely to patients via teleconferencing, has seen growing interest. In addition to providing in-home treatment, this technology allows specialists to provide care in remote and underserved areas. Current research suggests that both patients and clinicians are satisfied with telemental health services and that it is comparable in terms of quality to in-person care. Nonetheless, concerns still exist regarding its effects on the role of clinicians and the care they provide.
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Affiliation(s)
- Peter M Vernig
- Peter M. Vernig, PhD, Friends Hospital, Philadelphia, PA, USA
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