Impact of the COVID-19 pandemic on remote mental healthcare and prescribing in psychiatry: an electronic health record study.
BMJ Open
; 11(3): e046365, 2021 03 30.
Article
in English
| MEDLINE | ID: covidwho-1160430
ABSTRACT
OBJECTIVES:
The recent COVID-19 pandemic has disrupted mental healthcare delivery, with many services shifting from in-person to remote patient contact. We investigated the impact of the pandemic on the use of remote consultation and on the prescribing of psychiatric medications. DESIGN ANDSETTING:
The Clinical Record Interactive Search tool was used to examine deidentified electronic health records of people receiving mental healthcare from the South London and Maudsley (SLaM) NHS Foundation Trust. Data from the period before and after the onset of the pandemic were analysed using linear regression, and visualised using locally estimated scatterplot smoothing.PARTICIPANTS:
All patients receiving care from SLaM between 7 January 2019 and 20 September 2020 (around 37 500 patients per week). OUTCOMEMEASURES:
(i) The number of clinical contacts (in-person, remote or non-attended) with mental healthcare professionals per week.(ii) Prescribing of antipsychotic and mood stabiliser medications per week.RESULTS:
Following the onset of the pandemic, the frequency of in-person contacts was significantly reduced compared with that in the previous year (ß coefficient -5829.6 contacts, 95% CI -6919.5 to -4739.6, p<0.001), while the frequency of remote contacts significantly increased (ß coefficient 3338.5 contacts, 95% CI 3074.4 to 3602.7, p<0.001). Rates of remote consultation were lower in older adults than in working age adults, children and adolescents. Despite this change in the type of patient contact, antipsychotic and mood stabiliser prescribing remained at similar levels.CONCLUSIONS:
The COVID-19 pandemic has been associated with a marked increase in remote consultation, particularly among younger patients. However, there was no evidence that this has led to changes in psychiatric prescribing. Nevertheless, further work is needed to ensure that older patients are able to access mental healthcare remotely.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Drug Prescriptions
/
Practice Patterns, Physicians'
/
Telemedicine
/
COVID-19
/
Mental Health Services
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Adolescent
/
Aged
/
Child
/
Humans
Country/Region as subject:
Europa
Language:
English
Journal:
BMJ Open
Year:
2021
Document Type:
Article
Affiliation country:
Bmjopen-2020-046365
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