EP-105 - Psychiatric Mental Health Advanced Practices Nurses Using Synchronous Telepsychiatry: A Systematic Review
Monday, April 30
4:05 PM - 4:20 PM
Location: Education Zone, Booth 2416, Screen 1
Background/Significance: Estimates suggest that one in five Americans ages 12 and older are suffering from mental illness, yet less than half receive treatment (1,2). One modality to increase mental health care access and treatment is via telepsychiatry, which has demonstrated clinical effectiveness and satisfaction among providers and patients (3). Among psychiatric mental health advanced practice nurses (PMH APRNs; defined as graduate-prepared, licensed providers who may diagnose, provide psychotherapy, and prescribe medication for mental illness), telepsychiatry use does not have systematic exploration. Thus, this study is the first to systematically review PMH APRN's role and usage of synchronous telepsychiatry.
Methods: The systematic review followed PRISMA guidelines and was registered through Prospero International prospective register of systematic reviews (4). Searched databases included Medline, Embase, Google Scholar, PsychInfo, OpenGrey, and Scopus. Article inclusion criteria comprised the following: PMH APRNs must be represented among telepsychiatry service providers, written in English, telepsychiatry services must be synchronous, real-time, one-on-one treatment, and provide mental health services using visual and auditory teleconferencing technology. Exclusion criteria included the following: Not providing mental health services, not written in English, services provided by registered nurses not holding a graduate degree and/or psychiatric mental health advanced practice license, including only physician providers, non-individual (i.e., group) treatment, and telepsychiatry services that were asynchronous, and did not include both visual and auditory technology. There was no restriction on publication year. The search included syntactic variations and combinations of the following MeSH and commonly used terms: 1) 'advanced practice nursing'/exp OR 'nurse practitioner'/exp OR 'nurse practitioner' OR 'nurse clinician' OR 'advanced practice nurse' OR 'advanced practice nursing' OR aprn OR pmhnp; 2) 'mental health care'/exp OR 'mental disease'/exp OR 'mental patient'/exp OR 'substance abuse'/exp OR 'psychiatric treatment'/exp OR 'mental health'/exp OR stress OR anxiety OR psychosis OR psychotic OR suicide OR suicidal OR 'mental health'; and 3)
'telemedicine'/exp OR 'videoconferencing'/exp OR 'e-counseling'/exp OR 'telenursing'/exp OR 'telehealth'/de OR telepsychiatr* OR telemedicine OR 'tele-mental' OR telesupport OR 'tele-support' OR telemonitoring OR 'tele-monitoring' OR 'tele psych*' OR telepsych* OR 'tele-medicine'. The search was conducted by an associate medical librarian, yielding 277 articles, which were screened by the three nursing researcher authors according to PRISMA guidelines, yielding 100% interrater agreement for inclusion.
Results/Discussion: Only 12 articles met criteria. After, articles were analyzed using The Grades of Recommendation Assessment, Development, and Evaluation (GRADE) Working Group method that holistically evaluates evidence quality and recommendation grading based on risk/benefit ratio (5). Next, results were synthesized using PRISMA guidelines, including narrative descriptions of key features like study characteristics, bias, results, overall integrating findings and summarizing evidence (4). Overall, the vast paucity of the literature andly low methodological quality warrants more telepsychiatry clinical utilization and original scholarly contributions from PMH APRNs, especially across diverse psychiatric clinical settings and geographical locations.
- Participants will understand that there are currently no systematic reviews of psychiatric mental health advanced practice nurses' role using synchronous telepsychiatry.
- Participants will understand the method used for this systematic review, including PRISMA guidelines and GRADE quality assessment.
- Participants will understand the current utilization and recognize future opportunities for psychiatric mental health advanced practice nurses using synchronous telepsychiatry.