title: Using telehealth to augment an intensive case monitoring program in veterans with schizophrenia and suicidal ideation: A pilot trial.
abstract: Veterans with schizophrenia admitted for suicidal ideation were recruited into a post-discharge program consisting of Intensive Case Monitoring (ICM) with daily monitoring with the Health Buddy (HB; experimental group) or ICM alone (control group). This study tested the feasibility of the telehealth monitoring intervention in this population. Secondly, we determined whether augmentation of ICM with our intervention for 3 months would result in a reduction in suicidal ideation. Twenty of 25 telehealth participants could set up the device. Monthly adherence for telehealth participants was > 80%. A qualitative analysis of endpoint surveys revealed that the majority of participants had positive responses. In both groups, there were improvements in Beck Scale for Suicidal Ideation (BSS) scores at endpoint relative to baseline. No group differences were present with survival analysis when using remission (i.e., BSS score = 0) as the outcome; however, in a subgroup with a history of suicide attempt, there was a trend (p = .093) for a higher rate of remission for those in the HB condition. In conclusion, telehealth monitoring for this population appears to be feasible for those who are able to start using the system. The pilot data obtained should help investigators design better telehealth interventions for this population.
authors.affiliation: MIRECC and Behavioral Health, VA Pittsburgh Health Care System, Pittsburgh, PA 15240, United States; Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States; VA Pittsburgh Center for Health and Equity Promotion, Pittsburgh, PA 15240, United States. Electronic address: kasckowjw@upmc.edu.
authors.forename: John
authors.initials: J
authors.lastname: Kasckow
authors.affiliation: VA Pittsburgh Center for Health and Equity Promotion, Pittsburgh, PA 15240, United States; Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States.
authors.forename: Susan
authors.initials: S
authors.lastname: Zickmund
authors.affiliation: MIRECC and Behavioral Health, VA Pittsburgh Health Care System, Pittsburgh, PA 15240, United States.
authors.forename: John
authors.initials: J
authors.lastname: Gurklis
authors.affiliation: MIRECC and Behavioral Health, VA Pittsburgh Health Care System, Pittsburgh, PA 15240, United States.
authors.forename: James
authors.initials: J
authors.lastname: Luther
authors.affiliation: MIRECC and Behavioral Health, VA Pittsburgh Health Care System, Pittsburgh, PA 15240, United States.
authors.forename: Lauren
authors.initials: L
authors.lastname: Fox
authors.affiliation: VA Pittsburgh Patient Care Services, VA Pittsburgh Health Care System, Pittsburgh, PA 15240, United States.
authors.forename: Melissa
authors.initials: M
authors.lastname: Taylor
authors.affiliation: VA Pittsburgh Patient Care Services, VA Pittsburgh Health Care System, Pittsburgh, PA 15240, United States.
authors.forename: Ira
authors.initials: I
authors.lastname: Richmond
authors.affiliation: MIRECC and Behavioral Health, VA Pittsburgh Health Care System, Pittsburgh, PA 15240, United States; Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, United States.
authors.forename: Gretchen L
authors.initials: GL
authors.lastname: Haas
mesh_terms: D000328:Adult; D003422:Critical Care / Q000379:methods / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000706:statistics & numerical data; D010865:Pilot Projects; D012559:Schizophrenia / Q000175:diagnosis* / Q000628:therapy*; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology; D017216:Telemedicine / Q000379:methods / Q000706:statistics & numerical data*; D014728:Veterans / Q000523:psychology*
keywords: Schizophrenia; Suicide; Telehealth