Is There a Role for Digital Psychiatry in Older Adults Mental Health Services in the Post Pandemic World?

Abstract

Aims

1. 1. To evaluate the clinical practice and documentation of remote patient consultations in memory assessment service during COVID-19 pandemic

2. 2. To gather the views of clinicians and patients on the benefits and challenges of remote patient consultations 3.To understand the role of digital psychiatry in our services after the pandemic

Methods

An audit tool and feedback questionnaires for patients and clinicians were completed through discussions and consensus with multidisciplinary team. RCPsych guidance for cognitive assessments was also considered.

A random sample of 20 patients was identified who had virtual consultations. Rio clinical records were used for data collection using audit tool.

Patients and clinicians were sent questionnaires

Results

Evaluation of clinical practice

The audit demonstrated that all the relevant documentation was completed in vast majority of cases and the clinical practice was not significantly affected by the consultations being carried out virtually. Mental state examination was identified as one aspect which got partially completed in 4 out of 20 assessments during the remote consultations

Patient survey

Patient survey showed that the purpose of the consultation was mostly served by remote appointments. Almost 90% fedback that the communication was clear and they were able to engage freely and effectively with the clinicians. 55% reported preference for face to face meetings in future. 28% preferred remote consultations citing not having to travel as the main reason for their choice. Another benefit identified was relatives who don't live locally could also attend the virtual meetings to support the patients and to offer useful information

Clinicians’ survey

From clinicians’ perspective, the main advantages were reduced travel time, improved time efficiency, and reduced risk of infection. The main disadvantages were inability to get the full clinical picture compared to face-to-face appointments, technological challenges, and lack of personal touch.43% reported that the job satisfaction has improved from hybrid working

Conclusion

There are certainly benefits and advantages for remote consultations from the perspective of both patients and clinicians. While majority of clinicians prefer a combination of remote working and face-to-face consultations, more than half of patients expressed preference for face-to-face appointments. This audit demonstrates that, although remote consultation is not the gold standard method in assessing cognitive functions and dementia diagnosis, it was useful for obtaining most of the relevant information to enable diagnosis and initiating treatment in timely manner. We also found that approximately 437 miles of travelling was prevented because of the possibility of virtual meetings