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Sunday, April 12, 2015

Can Telemedicine Help Kids with ADD?

From MedCity News
By Dan Verel
March 24, 2015

The uses of telemedicine seem to be growing by the day, with the latest application coming in the form of treating children with ADD or ADHD in under-served areas, according to a recent study from the American Academy of Child and Adolescent Psychiatry.

The study, first reported in Medscape (subscription) found that telehealth, or more specifically in this instance telepsychiatry, can help bridge significant access gaps in remote communities, particularly amid provider shortages coupled with increasingly hard-to-access mental health services, Medscape Medical News noted.

“Telehealth services bring new resources to treat major psychiatric disorders, such as ADHD in children,” lead study author Kathleen Meyers told Medscape.

“It improves collaboration with primary care physicians, and, importantly, it is a way to redistribute the specialty mental health work force.”

Meyers, M.D., MPH is associate professor of psychiatry and behavioral sciences at University of Washington School of Medicine, and director of Telemental Health Services at Seattle Children’s Hospital.

Several telehealth startups have begun to tap into the mental health space, notably Teladoc and Doctor on Demand, both of which have launched networks of psychologists via telemedicine platforms. Both companies have noted that the improved access to mental health services has the chance to improve overall physical health.

This recent study examined 223 children in a randomized trial who had been referred by 88 primary care providers across seven remote areas, Medscape reports. The children assigned to a randomized telehealth group received six video sessions of pharmacotherapy from psychiatrists, while therapists provided remote behavior training.

In the control group, children were treated by primary care providers, coupled with a telepsychiatry visit.

Both groups benefited, but children in the randomized group “improved significantly more than those in the augmented primary care arm,” for a host of outcomes.

The improvements were in diagnostic criteria for ADHD and oppositional defiant disorder, role performance on the Vanderbilt ADHD Rating Scale, completed by caregivers and teachers; and impairment on the Columbia Impairment Scale–Parent Version.

Researchers said the results underscore the great potential of telehealth and psychiatry.

“This study has very significant implications for the practice of psychiatry in general, child psychiatry, rural and primary mental health service delivery, and all of us in this era of increasingly integrated care,” Donald Hilty, M.D., of USC Medical Center and the Keck School of Medicine, and Peter M. Yellowlees, M.D., of the UC Davis Health System, wrote in an accompanying editorial.

“The findings could lead to better dissemination of existing evidence-based treatments and new modalities of treatment for some psychiatric disorders delivered at a distance, even if the patient is not particularly geographically isolated.”

1 comment:

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