Mental health specialist video consultations versus treatment-as-usual for patients with depression or anxiety disorders in primary care: randomized controlled feasibility trial.
Open accessPublished version of a preprint
Abstract
BACKGROUND: Most people affected by depression or anxiety disorders are treated solely by their primary care physician. Access to specialized mental health care is impeded by patients' comorbidity and immobility in aging societies and long waiting times at the providers' end. Video-based integrated care models may leverage limited resources more efficiently and provide timely specialized care in primary care settings. OBJECTIVE: The study aims to evaluate the feasibility of mental health specialist video consultations with primary care patients with depression or anxiety disorders. METHODS: Participants were recruited by their primary care physicians during regular practice visits. Patients who had experienced at least moderate symptoms of depression and/or anxiety disorders were considered eligible for the study. Patients were randomized into 2 groups receiving either treatment-as-usual as provided by their general practitioner or up to 5 video consultations conducted by a mental health specialist. Video consultations focused on systematic diagnosis and proactive monitoring using validated clinical rating scales, the establishment of an effective working alliance, and a stepped-care algorithm within integrated care adjusting treatments based on clinical outcomes. Feasibility outcomes were recruitment, rate of loss to follow-up, acceptability of treatment, and attendance at sessions. Effectiveness outcomes included depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), burden of specific somatic complaints (Somatic Symptom Disorder-B Criteria Scale-12), recovery (Recovery Assessment Scale-German [RAS-G]), and perception of chronic illness care (Patient Assessment of Chronic Illness Care), which were measured at baseline and 16 weeks postallocation by assessors blinded to the group allocation. RESULTS: A total of 50 patients with depression and/or anxiety disorders were randomized, 23 in the intervention group and 27 in the treatment-as-usual group. The recruitment yield (number randomized per number screened) and the consent rate (number randomized per number eligible) were 69% (50/73) and 86% (50/58), respectively. Regarding acceptability, 87% (20/23) of the participants in the intervention group completed the intervention. Of the 108 planned video consultations, 102 (94.4%) were delivered. Follow-up rates were 96% (22/23) and 85% (23/27) for the intervention and control groups, respectively. The change from baseline scores at postmeasurement for the No Domination by Symptoms domain of recovery (RAS-G) was somewhat higher in the intervention group than in the control group (Mann-Whitney U test: rank-biserial r=0.19; 95% CI -0.09 to 0.46; P=.18). We did not detect any notable differences between the intervention and control groups in terms of other effectiveness outcomes. We did not observe any serious adverse events related to the trial. CONCLUSIONS: The intervention and study procedures were found to be feasible for patients, primary care practice staff, and mental health specialists. A sufficiently powered pragmatic trial on mental health specialist video consultations should be conducted to investigate their effectiveness in routine care. TRIAL REGISTRATION: German Clinical Trials Register DRKS00015812; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00015812.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Internet-based treatments are feasible and gained importance during the SARS-CoV-2 pandemic.
“Furthermore, they are feasible and gained in importance during the SARS-CoV-2 pandemic (31, 32).”
From Metacognitive Short-Term Intervention in Patients With Mental Disorders Following Cardiovascular Events (2022) · cites this paper as [31]
The Discussion > Conclusions section says that mental health specialist video consultations for primary-care patients with depression or anxiety are feasible. The paper does not say that internet-based treatments gained importance during the SARS-CoV-2 pandemic; searches for SARS-CoV-2, COVID-19, and pandemic did not find support for that part. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 72 · Cited by 40
Research works printed but not linked: 1
- [67]Kringos DS Boerma WGW Hutchinson A Saltman RB Building primary care in a changing Europe case studies 2015 2021-02-26 http://www.euro.who.int/en/about-us/partners/observatory/publications/studies/building-primary-care-in-a-changing-europe-case-studiesISBN:978-92-890-5033-3 29064645
- Authors
- Tönnies, J., Hartmann, M., Wensing, M., Szecsenyi, J., Peters-Klimm, F., Brinster, R., Weber, D., Vomhof, M., Icks, A., Friederich, H.-C., & Haun, M. W.
- Affiliations
- Heidelberg University (DE)
- Heinrich Heine University Düsseldorf (DE)
- Corresponding author
- Haun, Markus W
- ORCID
- Venue
- JMIR Mental Health
- Publisher
- JMIR Publications Inc.
- Published
- 2021-03-12
- Volume
- 8
- Issue
- 3
- Pages
- e22569
- ISSN
- 2368-7959 (ISSN-L)
- PMC
- PMC7998325
- OpenAlex
- W3126728785
- Cited by
- 40
- References
- 72
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 6 · 2023: 12 · 2022: 7 · 2021: 5
- FWCI
- 6.50
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- depression, anxiety disorders, video consultation, telemedicine, primary care, integrated care, feasibility, recovery, somatic symptoms, chronic care, therapeutic relationship, treatment acceptability, waiting time, access to mental health care, older adults, comorbidities, PHQ-9, Generalized Anxiety Disorder-7
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
