Weekly Mind Reader: Telehealth and Collaborative Care

The Journal of Clinical Psychiatry has published a case study that takes a look at the benefits of telehealth on collaborative care programs.

Pharmacist-Led Telehealth for People With Psychosis or Bipolar Disorder

The study investigates the impact of a telehealth, collaborative care program managed by psychiatric clinical pharmacists on the health care quality for adults with severe and persistent mental illness (SPMI) in a large California health system. Officials implemented the program, named SPMI Population Care, to address the multifaceted health needs of individuals with schizophrenia, schizoaffective disorder, and bipolar disorder.

The retrospective cohort study compared 968 program enrollees at six demonstration sites (Population Care) to 8,339 contemporaneous patients with SPMI at six non-program sites (Usual Care). The primary outcomes assessed were optimal psychotropic medication adherence, guideline-recommended glycemic screening, annual psychiatrist visits, and emergency department use. The analysis utilized a difference-in-difference approach, comparing changes in outcomes from 12 months pre-enrollment to 12 months post-enrollment.

Results showed that SPMI Population Care was associated with improved psychotropic medication adherence and glycemic screening, but unexpectedly led to a decrease in annual psychiatrist visits. However, there was no significant change in emergency department use. The study also highlighted high levels of engagement in the program, with more than 75% of participants attending an intake and at least one follow-up visit.

The findings suggest that clinical pharmacist-led telehealth collaborative care has the potential to enhance psychopharmacologic treatment adherence and recommended disease-preventive screening for individuals with psychosis or bipolar disorder. Despite the decrease in annual psychiatrist visits, the program demonstrated positive impacts on overall healthcare quality. Further research is needed to explore long-term associations and outcomes in this vulnerable population. The study contributes valuable insights into the role of telehealth and collaborative care models, particularly in addressing mental health clinician shortages and improving the quality of care for individuals with severe and persistent mental illnesses.

IN OTHER PSYCHIATRY AND NEUROLOGY NEWS

• In a bid to “reprioritize” its resources for treating Alzheimer’s disease, drug maker Biogen announced that it will end its licensing agreement to produce the drug, Aduhelm, and shut down its related clinical study.
• New evidence reinforces the well-recognized benefits of physical exercise while highlighting the lesser-known negative health outcomes associated with sedentary behaviors.
• The Psychiatric Consultation Service at Massachusetts General Hospital, through rounds reports and a case vignette, highlights the recognition, diagnostic workup, and collaborative management of somatic symptom disorder (SSD), emphasizing the importance of early intervention and a partnership between primary care and behavioral health.
• A woman with a 28-year history of continuous use of risperidone and trihexyphenidyl (THP) for undifferentiated schizophrenia successfully gave birth to five healthy children who reached adolescence or adulthood, with no adverse gestational or neurodevelopmental outcomes reported, presenting a unique case in the literature, highlighting the potential safety and positive real-world outcomes of antipsychotic exposure during pregnancy and breastfeeding.
• New research shows that writing by hand –  instead of relying on a keyboard – helps boost learning and memory.

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