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Research Article: Use Case/Pilot/Methodology

Bringing Specialty Telebehavioral Medicine Home: Feasibility of a Quality Improvement Pilot for Medically Complex Patients

By
Lillian M. Christon ,
Lillian M. Christon
Jennifer Correll ,
Jennifer Correll
Wendy Balliet ,
Wendy Balliet
Eva R. Serber ,
Eva R. Serber
Sharlene Wedin ,
Sharlene Wedin
Rebecca Kilpatrick ,
Rebecca Kilpatrick
Lauren Holland-Carter ,
Lauren Holland-Carter
Stacey Maurer ,
Stacey Maurer
Jimmy McElligott ,
Jimmy McElligott
Kelly Barth ,
Kelly Barth
Jeffrey J. Borckardt
Jeffrey J. Borckardt

Abstract

Objectives: The aims of this quality improvement project were twofold: Phase 1: conduct a needs assessment study for home-based telebehavioral medicine (H-TBM) among medically complex patients living in rural areas seeking care at an academic medical center (AMC) in a Behavioral Medicine Clinic, and Phase 2: evaluate the feasibility of a pilot implementation of H-TBM to improve therapy access for these underserved patients.

Results: The needs assessment study supported patient interest and need for H-TBM services. In the pilot, patients and providers were “satisfied to completely satisfied” using H-TBM. Patients engaging in H-TBM (Phase 2) reported significantly lower acute distress after H-TBM sessions than they experienced prior to sessions (t(29)=4.26; p<.001).

Conclusion: Results demonstrated preliminary acceptance by and feasibility for Behavioral Medicine Clinic patients with complex medical conditions to receive psychotherapy via H-TBM (in their homes), reducing their travel burden. H-TBM services offer the following benefits to chronically ill patients: they help to manage psychosocial complications associated with chronic disease and to prepare for intensive medical interventions.

References

1.
Serber ER, Finch NJ, Afrin LB, Greenland WJ. Using a webcast support service: Experiences of in-person attendees of an implantable cardioverter defibrillator support group. Heart &amp; Lung. 2010;39(2):94–104.
2.
Palermo TM, Wilson AC, Peters M, Lewandowski A, Somhegyi H. Randomized controlled trial of an Internet-delivered family cognitive–behavioral therapy intervention for children and adolescents with chronic pain. Pain. 2009;146(1):205–13.
3.
Rini C, Williams DA, Broderick JE, Keefe FJ. Meeting them where they are: Using the Internet to deliver behavioral medicine interventions for pain. Translational Behavioral Medicine. 2012;2(1):82–92.
4.
Ehde DM, Dillworth TM, Turner JA. Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. American Psychologist. 69(2):153–66.
5.
Wetherell JL, Afari N, Rutledge T, Sorrell JT, Stoddard JA, Petkus AJ, et al. A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain. Pain. 2011;152(9):2098–107.
6.
Plack K, Herpertz S, Petrak F. Behavioral medicine interventions in diabetes. Current Opinion in Psychiatry. 2010;23(2):131–8.
7.
DeFife JA, Conklin CZ, Smith JM, Poole J. Psychotherapy appointment no-shows: Rates and reasons. Psychotherapy: Theory, Research, Practice, Training. 47(3):413–7.
8.
Schlomer GL, Bauman S, Card NA. Best practices for missing data management in counseling psychology. Journal of Counseling Psychology. 57(1):1–10.
9.
Rubin DB. Multiple Imputation for Nonresponse in Surveys. Wiley Series in Probability and Statistics. 1987.
10.
Luxton DD, O’Brien K, McCann RA, Mishkind MC. Home-Based Telemental Healthcare Safety Planning: What You Need to Know. Telemedicine and e-Health. 2012;18(8):629–33.
11.
Schwagar HA. 21st century house call home tele-behavioral medicine. European Psychiatry. 2016;33(S1):S66–7.
12.
Fisher EB, Fitzgibbon ML, Glasgow RE, Haire-Joshu D, Hayman LL, Kaplan RM, et al. Behavior Matters. American Journal of Preventive Medicine. 2011;40(5):e15–30.
13.
Herbert MS, Afari N, Liu L, Heppner P, Rutledge T, Williams K, et al. Telehealth Versus In-Person Acceptance and Commitment Therapy for Chronic Pain: A Randomized Noninferiority Trial. The Journal of Pain. 2017;18(2):200–11.
14.
Hilty DM, Ferrer DC, Parish MB, Johnston B, Callahan EJ, Yellowlees PM. The Effectiveness of Telemental Health: A 2013 Review. Telemedicine and e-Health. 2013;19(6):444–54.
15.
Gros DF, Morland LA, Greene CJ, Acierno R, Strachan M, Egede LE, et al. Delivery of Evidence-Based Psychotherapy via Video Telehealth. Journal of Psychopathology and Behavioral Assessment. 2013;35(4):506–21.
16.
Godleski L, Darkins A, Peters J. Outcomes of 98,609 U.S. Department of Veterans Affairs Patients Enrolled in Telemental Health Services, 2006–2010. Psychiatric Services. 2012;63(4):383–5.
17.
Yellowlees P, Shore J, Roberts L. Practice Guidelines for Videoconferencing-Based Telemental Health – October 2009. Telemedicine and e-Health. 2010;16(10):1074–89.
18.
Bashshur RL, Shannon GW, Smith BR, Woodward MA. The Empirical Evidence for the Telemedicine Intervention in Diabetes Management. Telemedicine and e-Health. 2015;21(5):321–54.
19.
Rabinowitz T, Murphy KM, Amour JL, Ricci MA, Caputo MP, Newhouse PA. Benefits of a Telepsychiatry Consultation Service for Rural Nursing Home Residents. Telemedicine and e-Health. 2010;16(1):34–40.
20.
Beck CA, Beran DB, Biglan KM, Boyd CM, Dorsey ER, Schmidt PN, et al. National randomized controlled trial of virtual house calls for Parkinson disease. Neurology. 2017;89(11):1152–61.
21.
DelliFraine JL, Dansky KH. Home-based telehealth: a review and meta-analysis. Journal of Telemedicine and Telecare. 2008;14(2):62–6.
22.
Grady B, Myers KM, Nelson EL, Belz N, Bennett L, Carnahan L, et al. Evidence-Based Practice for Telemental Health. Telemedicine and e-Health. 2011;17(2):131–48.

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