No abstract

Internet-delivered interventions can be effective in treating mental disorders. However, their rate of use in German psychiatric inpatient routine care is low. The current study aimed to investigate the attitude of mental health care professionals working in inpatient care regarding internet-delivered interventions, including presumed benefits, barriers and facilitators. In total, 176 health professionals from ten inpatient psychiatric hospitals throughout Germany were surveyed on site. The professionals’ attitude towards internet-delivered interventions in inpatient care was assessed by an adapted version of the ‘Attitude toward Telemedicine in Psychiatry and Psychotherapy’ (ATTiP) questionnaire. To identify benefits, barriers and facilitators, we developed open-response questions that were based on the ‘Unified Theory of Acceptance and Use of Technology’ (UTAUT) and analyzed by a qualitative content analysis. Professionals reported little experience or knowledge about internet-delivered interventions. Their attitude towards internet-delivered interventions in psychiatric inpatient care was rather indifferent. The most frequently mentioned potential benefits were an optimised treatment structure and patient empowerment; the most frequently anticipated barriers were too severe symptoms of patients, the feared neglect of face-to-face contacts and insufficient technical equipment; and the most frequently mentioned facilitators were high usability of the internet-based intervention, a sufficient functional level of the patient and further education of staff. For successful implementation in the inpatient sector, internet-delivered interventions must be adapted to the special needs of severely mentally ill patients and to the hospital management systems and workflow. In addition, technical preconditions (internet access, devices) must be met. Last, further education of mental health care professionals is needed. Supplementary Information The online version contains supplementary material available at 10.1007/s00406-021-01251-1.

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ogy of this study included review of the relevant literature, assessing the possible implementation of the decision rules in the Hungarian context and an overview of the applications submitted to the Hungarian HTA office which fell into the third quadrant. Results: Three main decision rules of the cost-effectiveness can be used in the third quadrant. We came to the conclusion that using the same threshold value requires no additional methodological analysis and it is a decision rule which is consistent in every case, but using the other two methods can be justified as well if the various stakeholders can reach an agreement on the methodological and ethical issues. ConClusions: In our conclusion we suggested using the same threshold value as in the first quadrant, although sometimes using the other two decision rules can also be justified.

Zusammenfassung Hintergrund Die Psychotherapie-Richtlinie (PT-RL) gestaltet die Rahmenbedingungen der Psychotherapie in der vertragsärztlichen Versorgung in Deutschland. Aufgrund der Diskussion um Wartezeiten und inadäquate Versorgung von Betroffenen trat 2017 eine Reform in Kraft, um den Zugang zur Psychotherapie sowie den gesamten Versorgungs- und Behandlungsverlauf zu verbessern. Ziel des Projektes ist die Evaluation der neu eingeführten Versorgungselemente in der PT-RL sowie die Identifikation möglicher Implementierungsschwierigkeiten. Methoden Zur Evaluation der Reform der PT-RL finden sowohl quantitative als auch qualitative Methoden Anwendung. Um einen Vergleich der Versorgungssituation vor und nach der Reform durchzuführen, wird eine vergleichende retrospektive, kohortenbasierte Analyse auf Basis anonymisierter Routinedaten der BARMER und der AOK durchgeführt. Zusätzlich wird mit Hilfe einer Querschnittsanalyse erfasst, wie die neuen Versorgungselemente in der Praxis umgesetzt werden. Dazu erfolgt eine Befragung von Psychotherapeut*innen, Hausärzt*innen und Patient*innen. Fokusgruppen mit relevanten Interessensgruppen stellen zusammen mit einer Literaturrecherche die Basis für die Befragung dar. Zusammen mit den Routinedaten zur Versorgungssituation nach Reform der PT-RL und aggregierten, anonymisierten Daten der KBV zur vertragsärztlichen Versorgung sowie zur Inanspruchnahme der Terminservicestellen ergeben die Befragungsergebnisse die Datenbasis für die Querschnittsanalyse. Schlussfolgerung Durch die Verbindung von quantitativen und qualitativen Daten können die Auswirkungen der Strukturreform der PT-RL von 2016 auf individueller und struktureller Ebene sowie in Bezug auf den gesamten Versorgungs- und Behandlungsprozess analysiert werden. Darauf aufbauend werden Vorschläge für eine bedarfsgerechte Weiterentwicklung der PT-RL unter Berücksichtigung der Perspektiven verschiedener Interessensgruppen ausgearbeitet.