Wednesday, October 27, 2010

Telepsychiatry to Treat Youths

An initial pilot study sponsored by Oregon Health and Science University will examine how best to use telepsychiatry (TP) to treat rural youths 6 to 17 years old. The study will explore how offering telepsychiatry care to kids who live in rural areas will help them.

The problem our country faces is that it is difficult to provide kids who live in rural areas good psychiatric care. There are only about 7000 pediatric psychiatrists in the entire country. Even when adding nurse practitioners who specialize in mental healthcare for children there still isn’t enough help available for everyone that needs care.

The pilot specifically addresses children and adolescents with Attention Deficit/Hyperactivity Disorder (ADHD) and especially children and adolescents with co-occurring psychiatric conditions because of high co-morbidity rates in ADHD. Co-morbidity is present in as many as two-thirds of children with ADHD including up to 50 percent for other disruptive disorders, 15 to 20 percent for mood disorders, 20 to 25 percent for anxiety disorders, and 15 to 20 percent for learning disorders.

The researchers will find study subjects when parents seek care at clinics in rural Oregon. The physicians will be aware of the study and will refer the children to the study when they think a child or youth needs care from a specialized mental health professional that is either a pediatric psychiatrist or a nurse practitioner with extensive experience in pediatric mental health.

At the first visit, the mental health profession will determine if the diagnosis is correct and if so, the parent and child will then be given an exam to confirm the ADHD diagnosis. If accepted into the study, the youth will then be assigned to the mental health professional.

The subjects will be split into two study groups. As subjects are identified, they will be assigned a screening number according to a randomization table. The study will then use TP for one group and face-to-face (F2F) care for the other group.

Since this is an initial pilot study, the information collected will mainly offer a better understanding of whether or not a larger study is possible or needed. The researchers will look at how many of the youths stayed in the study or dropped out. The plan is to also study whether those subjects part of the TP group did as well or nearly as well, as those in the F2F group.

The study with an estimated enrollment of 50 to start in 2010 and be completed in 2011 was first received March 2010 but was updated in October 2010. The contact for the clinical trial identified as (NCT02096953) is Eric D. Colling at