907. The Use of Home-Based Telepsychiatry for Mild to Moderate Major Depression in HIV-Positive Adults 50 Years and Older Living in San Francisco
Session: Poster Abstract Session: Clinical Trials
Friday, October 9, 2015
Room: Poster Hall

Background: The HIV population is aging. Depression is increased in HIV-positives and with increasing age. More efficient strategies like telemedicine are needed to address depression in this population given increasingly scarce resources. Studies have shown comparable results between telepsychiatry and in-person treatment.

Methods: This study evaluates provision of home-based telepsychiatry in an urban setting to HIV-positives aged ≥ 50 with mild-moderate depression based on Patient Health Questionnaire. There were 2 phases:

(i)                Subjects reviewed informational material to establish a baseline understanding of telemedicine. A questionnaire assessed subject perception of and amenability towards telemedicine before engaging in any treatment.

(ii)              Amenable subjects engaged in a telepsychiatry session with a study physician using encrypted laptops, secure WiFi, and two-way video. The physician conducted surveys to assess subject depressive state, quality of life, readiness to change, cognitive function, comorbidities, and drug and alcohol use. Both subject and physician completed surveys evaluating the session.

Results: 41 subjects completed Phase I and 25 completed Phase II. Pre- and post-intervention data among those who completed both phases were analyzed using paired t-tests and chi-squared tests. All tests were 2-sided and p < 0.05 was the criterion for statistical significance. Analysis suggested a significantly improved outlook towards telemedicine (p = 0.004), including sense of privacy (p = 0.001), overall satisfaction (p < 0.001), and preference for telemedicine over in-person consultation (p < 0.001). Those who were not amenable to scheduling a telemedicine session were more likely to be unsure about the privacy of such sessions (44% vs. 8%, p = 0.011). Provider questionnaires further supported the efficacy of telemedicine.

Conclusion: Telemedicine with use of standardized assessments is a clinically viable means to evaluate depression in HIV-positives aged ≥ 50 with mild-moderate depression. Systems of care with HIV psychiatry may consider use of telemedicine in this fashion when expanding clinical services for this growing population, particularly those with barriers to participate in usual in-person clinical care.

Jessica Rhee, BA1, Eric Chan, MD2, Paul Elizondo III, DO2, James Bourgeois, OD, MD2, Cameron Foreman, BA1, Lisa Dazols, LCSW1, Jorien Breur, MD2, Joseph Shemuel, BA1, Amanda Martin, MSW1, Sharonya Shrivastava, BA1 and Malcolm John, MD, MPH3, (1)360: The Positive Care Center, UC San Francisco, San Francisco, CA, (2)Psychiatry, Langley Porter Psychiatric Institute, UC San Francisco, San Francisco, CA, (3)Medicine, 360: The Positive Care Center, UC San Francisco, San Francisco, CA

Disclosures:

J. Rhee, None

E. Chan, None

P. Elizondo III, None

J. Bourgeois, None

C. Foreman, None

L. Dazols, None

J. Breur, None

J. Shemuel, None

A. Martin, None

S. Shrivastava, None

M. John, None

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