June 7, 2012

Telephone Therapy Increases Patient Retention

(Ivanhoe Newswire) — In the first large trial to compare the benefits of face-to face and telephone therapy in patients, it is revealed that patients participating in phone therapy were more likely to finish 18 weeks of treatment compared with those who had face-to-face interaction.

Phone therapy is a rapidly growing trend among psychologists, and 85% of therapists now deliver their services over the phone in response to competing demands, transportation issues and other problems that prevent patients from visiting their offices.

"Our study found psychotherapy conveniently provided by telephone to patients wherever they are is effective and reduces dropout. This suggests these services now should be covered by insurance,” David Mohr, the lead author and a professor of preventive medicine at Northwestern University Feinberg School of Medicine, was quoted as saying.
The randomized control trial included 325 primary care patients with major depressive disorder. 20.9 percent of patients who had cognitive behavioral therapy over the phone dropped out compared to 32.7 percent for face-to-face therapy. In both therapies, patients showed equal improvement in their depression after treatment ended. Six months after the treatment, all patients remained much improved, though patients who had the telephone therapy scored three points higher on a depression scale than those who had face-to-face sessions.

"The three point difference is of questionable clinical significance but it raises the question whether some individuals are at risk of worsening after treatment with telephone therapy compared to face-to-face," Mohr was quoted as saying.

The worsening in telephone therapy post-treatment could be attributed to patients who had more mental health difficulties and who would have dropped out of face-to-face sessions were retained in telephone therapy.

"But we can't rule out the possibility that it may be true and there is something about face-to-face treatment that creates better results for some people," Mohr was quoted as saying. "The physical presence of the therapist may be therapeutic in a way that helps some patients maintain their improvement in mood. There may be a unique quality about the human contact that increases resilience and maintains the skills learned to manage depression after treatment has ended."

It is hoped that this study´s results will encourage insurance providers like Medicare to reimburse telephone therapy sessions that aren´t currently covered by many companies.

"There is good reason to reimburse these sessions," Mohr was quoted as saying. "Many people can't get to a therapist's office, but they want to talk to someone. Telephone therapy is highly effective and offers a solution to people with depression who otherwise would be left out." Examples of such people include those with disabilities or those who live where care is unavailable, such as in rural areas.

Current research shows that patients prefer talk therapy over antidepressant medication, but many quickly drop out of treatment or don´t follow up on physician referrals, most likely due to various inabilities to get to the therapist´s office.

Source: Journal of American Medical Association, June 2012