Health-care–Related Practices in Virtual Behavioral Health Treatment for Major Depression Before and During the Covid-19 Pandemic

Bibliographic Data

ID9101655
AuthorsNancy S Weinfield (0000-0002-1417-2271, Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, corresponding author), Heather M Tavel (Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO), Glenn K Goodrich (0000-0002-0487-0682, Kaiser Permanente), Glenn Goodrich (Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO), Courtney E McCracken (0000-0001-7941-1256, Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA), Sundeep Basra (0000-0003-0040-9896, Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, corresponding author), Jennifer C Gander (0000-0002-4798-0750, Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA), Teaniese L Davis (0000-0001-7408-0291, Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA), Debra P Ritzwoller (0000-0001-7116-8458, Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO), Douglas W Roblin (Kaiser Permanente Mid-Atlantic Permanente Research Institute, Rockville, MD, corresponding author)
Year2023
Volume61
IssueSuppl 1
PagesS47-S53
Publication date2023-04-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001815
PMID36893418
OpenAlexW4323656875
LanguageEN
Citations received2
References cited21

BACKGROUND: The abrupt shift to virtual care at the onset of the COVID-19 pandemic had the potential to disrupt care practices in virtual behavioral health encounters. We examined changes over time in virtual behavioral health-care-related practices for patient encounters with diagnoses of major depression. METHODS: This retrospective cohort study utilized electronic health record data from 3 integrated health care systems. Inverse probability of treatment weighting was used to adjust for covariates across 3 time periods, prepandemic (January 2019-March 2020), peak-pandemic shift to virtual care (April 2020-June 2020), and recovery of health care operations (July 2020-June 2021). First virtual follow-up behavioral health department encounters after an incident diagnostic encounter were examined for differences across the time periods in rates of antidepressant medication orders and fulfillments, and completion of patient-reported symptoms screeners in service of measurement-based care. RESULTS: Antidepressant medication orders declined modestly but significantly in 2 of the 3 systems during the peak-pandemic period but rebounded during the recovery period. There were no significant changes in patient fulfillment of ordered antidepressant medications. Completion of symptom screeners increased significantly in all 3 systems during the peak-pandemic period and continued to increase significantly in the subsequent period. CONCLUSIONS: A rapid shift to virtual behavioral health care was possible without compromising health-care-related practices. The transition and subsequent adjustment period have instead been marked by improved adherence to measurement-based care practices in virtual visits, signaling a potential new capacity for virtual health care delivery

Cohort · Coronavirus disease 2019 (COVID-19) · Depression (economics) · Family medicine · Health care · MEDLINE · Pandemic · Psychiatry · Retrospective cohort study · Telemedicine · Digital Mental Health Interventions · Emergency Medicine · Medicine · Mental Health Treatment and Access · Telemedicine and Telehealth Implementation

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