ARTICLE: Telemedicine and Office-Based Care for Behavioral and Psychiatric Conditions During the COVID-19 Pandemic in the United States

AUTHORS: Omar Mansour, Matthew Tajanlangit, James Heyward, Ramin Mojtabai, G Caleb Alexander

JOURNAL: Ann Intern Med. 2021 Mar;174(3):428-430. doi: 10.7326/M20-6243. Epub 2020 Nov 17.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has had far-reaching effects on health care delivery in the United States, ranging from postponement of elective care (1) to increases in the use of telemedicine (2). However, little is known about how the pandemic has affected the treatment of behavioral and psychiatric conditions.

Objective: To characterize quarterly telemedicine and office-based visits from the first quarter of 2018 (2018Q1) through the second quarter of 2020 (2020Q2).

Methods and Findings: We used IQVIA's National Disease and Therapeutic Index—a proprietary, 2-stage, stratified (by specialty and geographic area), nationally representative audit of ambulatory care in the United States—to characterize quarterly telemedicine and office-based visits from 2018Q1 through 2020Q2. Telemedicine visits included those taking place by telephone as well as through web-based platforms. The National Disease and Therapeutic Index involves approximately 4800 physicians who use an electronic form to record details of all patient contacts during 2 consecutive workdays per quarter and generates more than 350 000 annual contact records. Reporting days are randomly assigned to ensure that all workdays in a report period are covered; Saturdays, Sundays, and holidays are assigned as reporting days to physicians practicing on those days. We restricted our analyses to primary care and psychiatric visits and focused on care for 6 of the most prevalent behavioral and psychiatric conditions in the United States: anxiety, depression, overactivity, bipolar disorder, insomnia, and opioid use disorder (3).

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