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Randomized Controlled Trial
. 2024 Apr;30(4):e1049-e1063.
doi: 10.1089/tmj.2023.0238. Epub 2023 Nov 22.

Patient and Provider Satisfaction with Asynchronous Versus Synchronous Telepsychiatry in Primary Care: A Secondary Mixed-Methods Analysis of a Randomized Controlled Trial

Peter M Yellowlees  1 , Michelle M Burke  1 , Alvaro D Gonzalez  1 , Alice Fisher  2 , Steven R Chan  3   4 , Donald M Hilty  5 , Robert M McCarron  6 , Lorin M Scher  1 , Andres F Sciolla  1 , Jay Shore  7 , Glen Xiong  1 , Jeffrey Fine  2 , Jennifer Bannister  1 , Ana-Maria Iosif  2
Affiliations
Randomized Controlled Trial

Patient and Provider Satisfaction with Asynchronous Versus Synchronous Telepsychiatry in Primary Care: A Secondary Mixed-Methods Analysis of a Randomized Controlled Trial

Peter M Yellowlees et al. Telemed J E Health. 2024 Apr.

Abstract

Background: Asynchronous telepsychiatry (ATP) consultations are a novel form of psychiatric consultation. Studies comparing patient and provider satisfaction for ATP with that for synchronous telepsychiatry (STP) do not exist. Methods: This mixed-methods study is a secondary analysis of patients' and primary care providers' (PCPs) satisfaction from a randomized clinical trial of ATP compared with STP. Patients and their PCPs completed satisfaction surveys, and provided unstructured feedback about their experiences with either ATP or STP. Differences in patient satisfaction were assessed using mixed-effects logistic regression models, and the qualitative data were analyzed using thematic analysis with an inductive coding framework. Results: Patient satisfaction overall was high with 84% and 97% of respondents at 6 months reported being somewhat or completely satisfied with ATP and STP, respectively. Patients in the STP group were more likely to report being completely satisfied, to recommend the program to a friend, and to report being comfortable with their care compared with ATP (all p < 0.05). However, there was no difference between the patients in ATP and STP in perceived change in clinical outcomes (p = 0.51). The PCP quantitative data were small, and thus only summarized descriptively. Conclusions: Patients expressed their overall satisfaction with both STP and ATP. Patients in ATP reported more concerns about the process, likely because feedback after ATP was slower than that after STP consultations. PCPs had no apparent preference for STP or ATP, and reported implementing the psychiatrists' recommendations for both groups when such recommendations were made, which supports our previous findings. Trial Registration: ClinicalTrials.gov NCT02084979; https://clinicaltrials.gov/ct2/show/NCT02084979.

Keywords: mental health; telehealth; telemedicine; telepsychiatry.

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Conflict of interest statement

The authors report no conflicting financial relationships with commercial interests except P.M.Y., who received royalties from the American Psychiatric Association Press and multiple academic and conference speaking engagements. P.M.Y., M.M.B., and S.R.C. are cofounders of AsyncHealth. J.S. has received royalties from the American Psychiatric Association Press and Springer Press. A.-M.I. has received honoraria for reviewing activities from Elsevier. S.R.C. provided consultation services for Advanced Clinical, University of Wisconsin, Madison, and Orbit Health Telepsychiatry.

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