title: Videoconferencing in a mental health service in The Netherlands: A randomized controlled trial on patient satisfaction and clinical outcomes for outpatients with severe mental illness.
abstract: Introduction The goal of the study was to determinate if there was added value in the use of videoconferencing (VCF) in outpatient care for people with severe mental illness (SMI). Methods A VCF-group was compared to a control group (care as usual) over a period of 18 months. Block randomization was used to assign patients to one of the two groups. The video communication was available to the patients on a 24/7 basis, so that emergency calls could also be made via VCF. The primary outcome was patient satisfaction, other outcomes were: quality of life, loneliness, daily functioning (psychologically and socially), and the fulfilment of needs of care. Eventually, 93 patients signed their informed consent and participated. Results For the primary outcome a statistically significant time by treatment interaction effect was found, where higher degree of satisfaction was associated with the patients in the VCF-group. The secondary outcomes revealed no differences between the two groups. Despite the participants not using the VCF units extensively during the project, they were reasonably satisfied with VCF; on average, they rated the service with a 7.5 grade (on a scale from 1-10). Discussion Although the study showed a positive result for patient satisfaction, overall the VCF seemed to have limited impact. So VCF might not offer much added value to care as usual. However, statistical power in this study dropped somewhat due to dropout. Furthermore, VCF usage was lower than expected. Assuming that VCF will be most effective if it is actually used, it seems likely that the actual effect-size reached in this study has been significantly lower than the anticipated effect-size. Finally, this study shows that VCF is a tool that can be used in the care for people with severe mental illness.
authors.affiliation: 1 Department of Community Care and Reintegration, Netherlands Institute of Mental Health and Addiction, The Netherlands.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Hulsbosch
authors.affiliation: 2 GGZ Noord-Holland Noord, The Netherlands.
authors.forename: M Annet
authors.initials: MA
authors.lastname: Nugter
authors.affiliation: 3 Amici Zorgt, The Netherlands.
authors.forename: Petra
authors.initials: P
authors.lastname: Tamis
authors.affiliation: 1 Department of Community Care and Reintegration, Netherlands Institute of Mental Health and Addiction, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Kroon
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008132:Loneliness; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D009426:Netherlands; D010045:Outpatients; D017060:Patient Satisfaction; D011788:Quality of Life; D049269:Videoconferencing / Q000458:organization & administration*
keywords: Telepsychiatry; care needs; loneliness; outpatient care; patient satisfaction; psychosis; quality of life; randomized controlled trial; schizophrenia; severe mental illness; videoconferencing