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Mental health specialist video consultations for patients with depression or anxiety disorders in primary care: protocol for a randomised controlled feasibility trial
  1. Justus Tönnies1,
  2. Mechthild Hartmann1,
  3. Michel Wensing2,
  4. Joachim Szecsenyi2,
  5. Andrea Icks3,4,
  6. Hans-Christoph Friederich1,
  7. Markus W Haun1
  1. 1 Department of General Internal Medicine and Psychosomatics, Heidelberg University, Heidelberg, Germany
  2. 2 Department of General Practice and Health Services Research, Heidelberg University, Heidelberg, Germany
  3. 3 Institute of Health Services Research and Health Economics, Heinrich Heine University, Düsseldorf, Germany
  4. 4 Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
  1. Correspondence to Mr Markus W Haun; markus.haun{at}med.uni-heidelberg.de

Abstract

Introduction Most people suffering from depression and anxiety disorders are entirely treated in primary care. Due to growing challenges in ageing societies, for example, patients’ immobility and multimorbidity, the transition to specialised care becomes increasingly difficult. Although the co-location of general practitioners and mental health specialists improves the access to psychosocial care, integrated in-person approaches are not practical for rural and single-doctor practices with limited personnel and financial resources. Treating primary care patients via internet-based video consultations by remotely located mental health specialists bears the potential to overcome structural barriers and provide low-threshold care. The aim of this randomised controlled feasibility trial is to investigate the feasibility of implementing of mental health specialist video consultations in primary care practices.

Methods and analysis Fifty primary care patients with significant depression and/or anxiety symptomatology will be randomised in two groups receiving either the treatment as usual as provided by their general practitioner or up to five video consultations conducted by a mental health specialist. The video consultations focus on (1) systematic diagnosis plus proactive monitoring using validated clinical rating scales, (2) the establishment of an effective working alliance and (3) a stepped-care algorithm within integrated care adjusting treatments based on clinical outcomes. We will investigate the following outcomes: effectiveness of the recruitment strategies, patient acceptance of randomisation, practicability of the technical and logistical processes related to implementing video consultations in the practices’ workflows, feasibility of the data collection and clinical parameters.

Ethics and dissemination This trial has undergone ethical scrutiny and has been approved by the Medical Faculty of the University of Heidelberg Ethics Committee (S-634/2018). The findings will be disseminated to the research community through presentations at conferences and publications in scientific journals. This feasibility trial will prepare the ground for a large-scale, fully powered randomised controlled trial.

Trial registration number DRKS00015812.

  • primary care
  • mental health
  • telemedicine
  • video consultations
  • feasibility

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Footnotes

  • Contributors All authors contributed substantially to the conception and the design of the study. JT, MH, MW, JS, AI, and MWH contributed to data analysis plan. JT, MH, HC-F, and MWH drafted the manuscript. All authors including MW, AI, and HC-F revised the manuscript critically for important intellectual content. All authors approved the version of the manuscript to be published and have agreed to be accountable for all aspects of the work.

  • Funding This work was supported entirely by the German Federal Ministry of Education and Research (BMBF) (grant no. 01GY16129). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing and publishing the report.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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