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      Treatment satisfaction of home-based telehealth versus in-person delivery of prolonged exposure for combat-related PTSD in veterans

      1 , 2 , 1 , 2 , 3 , 1 , 3

      Journal of Telemedicine and Telecare

      SAGE Publications

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          Abstract

          Introduction Although there is growing support that evidence-based psychotherapies (EBPs) delivered in-person and through telehealth are equivalent in terms of symptom reduction for posttraumatic stress disorder (PTSD), there has been far less investigation comparing these treatment modalities in terms of patient satisfaction. The present study investigated participant satisfaction and perception of the quality of service delivery within a clinical trial comparing the delivery of an EBP, Prolonged Exposure (PE) for PTSD, through home-based telehealth and in-person services. Methods Veterans ( N = 67) with PTSD were randomized to receive PE via video telehealth technology ( n = 27) or via in-person delivery ( n = 40). Participants completed service demographic questions, PTSD symptom assessments, and satisfaction and service delivery perception questionnaires. Results Analyses of covariance were used to investigate the influence of treatment modality on patient satisfaction and perceived quality of service delivery, while controlling for demographics and PTSD symptoms. No differences were observed on the majority of measures, with the exception of participants in the telehealth condition endorsing willingness to drive further for telehealth services as compared with participants in the in-person condition. Discussion Findings illustrate participant satisfaction and acceptance of EBPs delivered via telehealth at a level consistent with that of in-person services. Preliminary findings suggest that the experience of receiving telehealth services may be associated with increased willingness to participate in telehealth services again. Together, these findings of patient satisfaction and acceptance of telehealth services support the ongoing delivery of EBPs via telehealth as well as their future expansion.

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          Most cited references 18

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          The drug abuse screening test

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            Prolonged Exposure Therapy for PTSD: Therapist Guide

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              Limitations of patient satisfaction studies in telehealthcare: a systematic review of the literature.

              The objective of this study is to provide a systematic review of studies on patient satisfaction with telemedicine. The review included empirical studies that investigated patient satisfaction with that telemedicine service. The search strategy involved matching at least one of 11 'telemedicine' terms with one of 5 'satisfaction' terms. The following databases were searched: Telemedicine Information Exchange (TIE) database, MEDLINE, Science Citation Index (SCI), Social Science Citation Index (SSCI), Psycinfo, and Citation Index of Nursing and Allied Health (CINAHL). A highly structured instrument was used for data extraction. The review included 93 studies. Telepsychiatry represents the largest portion of these studies (25%), followed by multispecialty care (14%), nursing (11%), and dermatology (8%). Real-time videoconferencing was used in 88% of these studies. Only 19 (20%) included an independent control group, including 9 (10%) randomized control trial (RCT) studies. One third of studies were based on samples of less than 20 patients, and only 21% had samples of over 100 patients. Aspects of patient satisfaction most commonly assessed were: professional-patient interaction, the patient's feeling about the consultation, and technical aspects of the consultation. Only 33% of the studies included a measure of preference between telemedicine and face-to-face consultation. Almost half the studies measured only 1 or 2 dimensions of satisfaction. Reported levels of satisfaction with telemedicine are consistently greater than 80%, and frequently reported at 100%. Progression of telemedicine services from "trial" status to routine health service must be supported by improved research into patients' satisfaction with telemedicine. Further investigation of factors that influence patient acceptance of telemedicine is indicated.
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                Author and article information

                Journal
                Journal of Telemedicine and Telecare
                J Telemed Telecare
                SAGE Publications
                1357-633X
                1758-1109
                September 20 2016
                January 2018
                September 26 2016
                January 2018
                : 24
                : 1
                : 51-55
                Affiliations
                [1 ]Mental Health Service, Ralph H. Johnson Veterans Affairs Medical Center, USA
                [2 ]Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, USA
                [3 ]College of Nursing, Medical University of South Carolina, USA
                Article
                10.1177/1357633X16671096
                27672059
                © 2018

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