Tag: telemedicine

Reading of the Week: the CANMAT Depression Update – Seven Takeaways & Commentary; Also, Patient Preferences for Televideo Backgrounds

From the Editor

Much has changed in the past eight years. In 2016, singer Olivia Rodrigo was starting high school. Quarterback Tom Brady seemed ageless. And none of us were talking about pandemics. 2016 was also the year when the last Canadian Network for Mood and Anxiety Treatments (CANMAT) depression guidelines were released. Well, it’s 2024 and the update has just been published in The Canadian Journal of Psychiatry

How has depression management changed over these past eight years, and how should you adjust your clinical practice? In the first selection, we look at seven takeaways and a commentary.

Melancholia (from the Wellcome Library)

In this week’s other selection, Dr. Nathan Houchens (of the University of Michigan) and his co-authors consider telemedicine video backgrounds in a new research letter from JAMA Network Open. They asked patients to rate different backgrounds and in various medical circumstances; they report on survey results of more than 1 200 patients. “In this study, two-thirds of participants preferred a traditional health care setting background for video visits with any physician type, with physician office displaying diplomas rated highest.”

DG

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Reading of the Week: Telepsych vs. In-Person Treatment – the new BJP Paper; Also, Rethinking Palliative Care in Psychiatry and Kemp on His Depression

From the Editor

When the pandemic started in 2020, the webcam sitting on my desk had barely been used. Of course, over the following days, it became an indispensable part of my outpatient practice as terms like “lockdown” and “Zoom fatigue” entered the common lexicon. 

As we move past the pandemic, questions arise. Who benefits from telepsychiatry? And who is better served with in-person visits? Katsuhiko Hagi (of the Sumitomo Pharma Co.) and co-authors attempt to answer these questions with a new systematic review and meta-analysis, just published in The British Journal of Psychiatry. They analyzed 32 papers, involving 3 600 people, across 11 mental illnesses. “Telepsychiatry achieved a symptom improvement effect for various psychiatric disorders similar to that of face-to-face treatment. However, some superiorities/inferiorities were seen across a few specific psychiatric disorders, suggesting that its efficacy may vary according to disease type.” We consider the paper and its implications.

In the second selection, Kwok Ying Chan (of Grantham Hospital) and his co-authors discuss palliative care. In a Viewpoint paper for JAMA Psychiatry, they note that some patients with severe mental illness could benefit from palliative care – yet such care is less available to those with mental disorders than the general population. They highlight challenges and then outline “a more sustainable model for the collaboration between palliative care and psychiatric teams.”

And in the third selection, health care executive Joe Kemp writes about his struggles with suicidal thoughts and substance misuse. In a deeply personal essay for the New York Post, he talks about turning around his life. “I can’t deny my drug-addled past, or that I’m a survivor of two suicide attempts. But I can proudly show the man I am today as someone who has dignity and self-respect; I’ve acquired the most important things to live a happy life. I just followed a different path to get here.”

DG

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Reading of the Week: Clozapine Prescribing & Demographics; Also, HBR on Equity in Telemedicine, and Eichler on Her Uncle & His Disappearances

From the Editor

Is clozapine prescribing effected by demographics?

In the first selection, from Psychiatric Services, Natalie Bareis (of Columbia University) and her co-authors consider medication prescriptions for those with psychotic disorders, drawing on US Medicaid data. “Our results indicate significant variation across states and among racial-ethnic groups in prescription patterns of six types of psychotropic medications, even after we had adjusted for multiple patient factors.” Indeed, they find that clozapine is much more commonly prescribed for those who are White. We consider the paper and its implications.

unknownClozapine: a simple molecule but complicated availability in the US?

In the second selection, Dr. Jonathan Rogg (of the University of Texas) and his co-authors consider equity and telemedicine. In a paper for the Harvard Business Review, they describe the services offered in a low-income area of Texas, and the lessons learned. “The Covid-19 pandemic has forced a rapid evolution in technology with the potential to help the most disadvantaged patients. Our experience during the pandemic has demonstrated that telemedicine can overcome access-related challenges faced by indigent populations. By allowing them to access care in their homes or even their jobs, it can help them address health issues expeditiously with minimal disruption to their lives.”

Finally, in the third selection from The Globe and Mail, writer Leah Eichler writes about her uncle, who probably had an undiagnosed mental illness. She writes about his disappearances and erratic behaviour. “We like to believe our relationships are solid, that love is somehow inextricably linked to permanence. Missing our loved ones, if anything, highlights how impermanent even our closest relationships can be.”

Please note that there will be no Reading next week.

DG

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