1
|
Parthasarathi A, George T, Kalimuth MB, Jayasimha S, Kaleem Ullah M, Patil R, Nair A, Pai U, Inbarani E, Jacob AG, Chandy V, John O, Sudarsanam TD, Mahesh PA. Exploring the potential of telemedicine for improved primary healthcare in India: a comprehensive review. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 27:100431. [PMID: 38957222 PMCID: PMC11215096 DOI: 10.1016/j.lansea.2024.100431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 05/09/2024] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
Telemedicine is a promising solution to the challenges of delivering equitable and quality primary healthcare, especially in LMICs. This review evaluated peer-reviewed literature on telehealth interventions in Indian primary care published from Jan 1, 2011 to Dec 31, 2021, from PubMed, Scopus, TRIP, Google Scholar, Indian Kanoon, and Cochrane database The majority of Indian studies focus on key health issues like maternal and child health, mental health, diabetes, infectious diseases, and hypertension, mainly through patient education, monitoring, and diagnostics. Yet, there's a lack of research on telemedicine's cost-effectiveness, communication among providers, and the role of leadership in its quality and accessibility. The current research has gaps, including small sample sizes and inconsistent methodologies, which hamper the evaluation of telemedicine's effectiveness. India's varied healthcare landscape, technological limitations, and social factors further challenge telemedicine's adoption. Despite regulatory efforts, issues like the digital divide and data privacy persist. Addressing these challenges with a context-aware, technologically driven approach is crucial for enhancing healthcare through telemedicine in India.
Collapse
Affiliation(s)
- Ashwaghosha Parthasarathi
- Rutgers University Institute for Health, Healthcare Policy, and Aging Research, The State University of New Jersey, 112 Paterson Street, New Brunswick, NJ 08901, USA
| | - Tina George
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Sudhindra Jayasimha
- Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mohammed Kaleem Ullah
- Centre for Excellence in Molecular Biology and Regenerative Medicine (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education and Research, Mysore 570015, India
- Division of Infectious Disease and Vaccinology, School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Rutuja Patil
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Ajay Nair
- Swasth Digital Health Foundation, Bangalore, Karnataka, India
| | - Urvi Pai
- Swasth Digital Health Foundation, Bangalore, Karnataka, India
| | - Esther Inbarani
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anil G. Jacob
- The George Institute for Global Health, University of New South Wales, New Delhi, India
| | - V.J. Chandy
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Oommen John
- The George Institute for Global Health, University of New South Wales, New Delhi, India
| | | | - Padukudru Anand Mahesh
- Department of Respiratory Medicine, JSS Medical College, JSSAHER, Mysore, Karnataka 570015, India
| |
Collapse
|
2
|
Ganesh S, Sharma LP, Das B. Hybrid Tele-cognitive Behavioural Therapy (Ht-CBT) for Obsessive-compulsive Disorder: An Innovation Integrating In-person and Online Psychotherapy. Indian J Psychol Med 2024; 46:276-278. [PMID: 38699761 PMCID: PMC11062316 DOI: 10.1177/02537176231219768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Affiliation(s)
- Suhas Ganesh
- Central Institute of Psychiatry, Ranchi, Jharkhand, India
- Schizophrenia Neuropharmacology Research Group, Yale School of Medicine, New Haven, Connecticut, USA
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Lavanya P. Sharma
- National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Basudeb Das
- Central Institute of Psychiatry, Ranchi, Jharkhand, India
| |
Collapse
|
3
|
Lemon CA, Svob C, Bonomo Y, Dhungana S, Supanya S, Sittanomai N, Diatri H, Haider II, Javed A, Chandra P, Herrman H, Hoven CW, Sartorius N. Priorities for research promoting mental health in the south and east of Asia. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 23:100287. [PMID: 38404519 PMCID: PMC10884971 DOI: 10.1016/j.lansea.2023.100287] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/11/2023] [Accepted: 09/16/2023] [Indexed: 02/27/2024]
Abstract
Progress in promoting mental health, preventing mental illness, and improving care for people affected by mental illness is unlikely to occur if efforts remain separated from existing public health programs and the principles of public health action. Experts met recently to discuss integrating public health and mental health strategies in the south and east of Asia, especially in low- and middle-income countries. Areas of research identified as high priority were: 1) integrating mental health into perinatal care; 2) providing culturally-adjusted support for carers of people with mental and physical disorders; 3) using digital health technologies for mental health care in areas with limited resources and 4) building local research capacity. Selection of these areas was informed by their relative novelty in the region, ease of implementation, likely widespread benefit, and potential low costs. In this article, we summarise available evidence, highlight gaps and call for collaborations with research centres, leaders and persons with lived experience within and beyond the region.
Collapse
Affiliation(s)
- Christopher A. Lemon
- NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Connie Svob
- Department of Psychiatry, College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, United States of America
| | - Yvonne Bonomo
- Department of Medicine, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Victoria, Australia
- Department of Addiction Medicine, St Vincent's Hospital, Melbourne, Australia
| | - Saraswati Dhungana
- Department of Psychiatry, Institute of Medicine, Tribhuvan University, Nepal
| | - Suttha Supanya
- Somdet Chaopraya Institute of Psychiatry, Department of Mental Health, Bangkok, Thailand
| | - Napat Sittanomai
- Division of Child and Adolescent Psychiatry, Department of Paediatrics, Faculty of Medicine, Siriraj Hospital, Bangkok, Thailand
| | - Hervita Diatri
- Department of Psychiatry, Faculty Medicine Universitas Indonesia and Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | | | - Afzal Javed
- Pakistan Psychiatric Research Centre, Fountain House, Lahore, Pakistan
| | - Prabha Chandra
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christina W. Hoven
- Department of Psychiatry, College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, United States of America
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes (AMH), Geneva, Switzerland
| |
Collapse
|
4
|
Figge CJ, Kane JC, Skavenski S, Haroz E, Mwenge M, Mulemba S, Aldridge LR, Vinikoor MJ, Sharma A, Inoue S, Paul R, Simenda F, Metz K, Bolton C, Kemp C, Bosomprah S, Sikazwe I, Murray LK. Comparative effectiveness of in-person vs. remote delivery of the Common Elements Treatment Approach for addressing mental and behavioral health problems among adolescents and young adults in Zambia: protocol of a three-arm randomized controlled trial. Trials 2022; 23:417. [PMID: 35590348 PMCID: PMC9117594 DOI: 10.1186/s13063-022-06319-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/19/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND In low- and middle-income countries (LMIC), there is a substantial gap in the treatment of mental and behavioral health problems, which is particularly detrimental to adolescents and young adults (AYA). The Common Elements Treatment Approach (CETA) is an evidence-based, flexible, transdiagnostic intervention delivered by lay counselors to address comorbid mental and behavioral health conditions, though its effectiveness has not yet been tested among AYA. This paper describes the protocol for a randomized controlled trial that will test the effectiveness of traditional in-person delivered CETA and a telehealth-adapted version of CETA (T-CETA) in reducing mental and behavioral health problems among AYA in Zambia. Non-inferiority of T-CETA will also be assessed. METHODS This study is a hybrid type 1 three-arm randomized trial to be conducted in Lusaka, Zambia. Following an apprenticeship model, experienced non-professional counselors in Zambia will be trained as CETA trainers using a remote, technology-delivered training method. The new CETA trainers will subsequently facilitate technology-delivered trainings for a new cohort of counselors recruited from community-based partner organizations throughout Lusaka. AYA with mental and behavioral health problems seeking services at these same organizations will then be identified and randomized to (1) in-person CETA delivery, (2) telehealth-delivered CETA (T-CETA), or (3) treatment as usual (TAU). In the superiority design, CETA and T-CETA will be compared to TAU, and using a non-inferiority design, T-CETA will be compared to CETA, which is already evidence-based in other populations. At baseline, post-treatment (approximately 3-4 months post-baseline), and 6 months post-treatment (approximately 9 months post-baseline), we will assess the primary outcomes such as client trauma symptoms, internalizing symptoms, and externalizing behaviors and secondary outcomes such as client substance use, aggression, violence, and health utility. CETA trainer and counselor competency and cost-effectiveness will also be measured as secondary outcomes. Mixed methods interviews will be conducted with trainers, counselors, and AYA participants to explore the feasibility, acceptability, and sustainability of technology-delivered training and T-CETA provision in the Zambian context. DISCUSSION Adolescents and young adults in LMIC are a priority population for the treatment of mental and behavioral health problems. Technology-delivered approaches to training and intervention delivery can expand the reach of evidence-based interventions. If found effective, CETA and T-CETA would help address a major barrier to the scale-up and sustainability of mental and behavioral treatments among AYA in LMIC. TRIAL REGISTRATION ClinicalTrials.gov NCT03458039 . Prospectively registered on May 10, 2021.
Collapse
Affiliation(s)
- Caleb J. Figge
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Jeremy C. Kane
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W 168th St., New York City, NY 10032 USA
| | - Stephanie Skavenski
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Emily Haroz
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Mwamba Mwenge
- The Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia
| | - Saphira Mulemba
- The Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia
| | - Luke R. Aldridge
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Michael J. Vinikoor
- The Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia
- Department of Medicine, University of Alabama at Birmingham, 845 19th Street South, Birmingham, AL 35294 USA
- Department of Medicine, University of Zambia, PO Box 50110, Lusaka, Zambia
| | - Anjali Sharma
- The Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia
| | - Sachi Inoue
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115 USA
| | - Ravi Paul
- Department of Psychiatry, University of Zambia, PO Box 50110, Lusaka, Zambia
| | - Francis Simenda
- Ministry of Health Zambia, Haille Selassie Avenue, Ndeke House, P.O. Box 30205, Lusaka, Zambia
| | - Kristina Metz
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| | - Carolyn Bolton
- The Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia
| | - Christopher Kemp
- Department of Global Health, Hans Rosling Center, University of Washington School of Public Health, 3980 15th Ave. NE, Seattle, WA 98105 USA
| | - Samuel Bosomprah
- The Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia
| | - Izukanji Sikazwe
- The Centre for Infectious Disease Research (CIDRZ) Zambia, Plot 34620, Lusaka, Zambia
| | - Laura K. Murray
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, 615 N. Wolfe Street, Baltimore, MD 21205 USA
| |
Collapse
|
5
|
Singh GP. Telepsychiatry: A game-changer during Covid-19 pandemic and a wave of future psychiatry in India. Asian J Psychiatr 2021; 64:102795. [PMID: 34329841 PMCID: PMC8419214 DOI: 10.1016/j.ajp.2021.102795] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Gurvinder Pal Singh
- Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India.
| |
Collapse
|