Use of Direct-to-Consumer Telemedicine for Attention-Deficit Hyperactivity Disorder

Hohman, Jessica; Martinez, Kathryn A.; Anand, Amit; Martyn, Trejeeve; Rood, Mark; Rothberg, Michael B.

doi:10.1007/s11606-020-05891-2

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…These health platforms connect patients with healthcare professionals online, allowing for increased access to care by removing physical barriers in seeking treatment. One retrospective cross-sectional study on encounters for ADHD via direct-to-consumer telemedicine found that from 2016 to 2018, ADHD visits increased 500%, with 43% of ADHD-related encounters resulting in prescription of non-controlled medications (Hohman et al, 2020). These findings coincide with data from the National Mental Health Services Survey showing that mental health facilities increased telemedicine services from 22.2% in 2015 to 68.7% in 2020.…”

Section: Discussionmentioning

confidence: 99%

Regional Disparities in Prescription Methamphetamine and Amphetamine Distribution Across the United States

et al. 2023

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Objective: The objectives of this report were to characterize the regional and state differences in prescription methamphetamine and amphetamine distribution in the US. Methods: Prescription methamphetamine and amphetamine distribution was obtained from the Drug Enforcement Administration for 2019. Results: Total per capita drug weight distribution of amphetamine was 4,000 times higher than methamphetamine. Regionally, total per capita drug weight for methamphetamine was highest in the West (32.2% of total distribution) and lowest in the Northeast (17.4%). The total per capita drug weight for amphetamine was highest in the South (37.0% of total distribution) and lowest in the Northeast (19.4%). Distribution of methamphetamine was 16.1% while amphetamine was 54.0% of its production quota. Conclusion: Overall, prescription amphetamine distribution was common while prescription methamphetamine distribution was rare. The patterns observed in distribution are likely the result of stigmatization, differences in accessibility, and the efforts of initiatives such as the Montana Meth Project.

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Section: Discussionmentioning

confidence: 99%

Regional Disparities in Prescription Methamphetamine and Amphetamine Distribution Across the United States

et al. 2023

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“…37 Recent studies highlight telemedicine's potential to improve access across medical conditions. 16,29,[38][39][40] For mental healthcare, specifically, DTC telemedicine may enhance access in several ways. First, it extends the current supply of both mental health professionals and generalists comfortable treating psychiatric disorders into geographically underserved areas.…”

Section: Discussionmentioning

confidence: 99%

Use of Direct-to-Consumer Telemedicine to Access Mental Health Services

et al. 2022

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Background The coronavirus disease 2019 pandemic has contributed to growing demand for mental health services, but patients face significant barriers to accessing care. Direct-to-consumer(DTC) telemedicine has been proposed as one way to increase access, yet little is known about its pre-pandemic use for mental healthcare. Objective To characterize patients, providers, and their use of a large nationwide DTC telemedicine platform for mental healthcare. Design Retrospective cross-sectional study. Setting Mental health encounters conducted on the American Well DTC telemedicine platform from 2016 to 2018. Participants Patients and physicians. Main Measures Patient measures included demographics, insurance report, and number of visits. Provider characteristics included specialty, region, and number of encounters. Encounter measures included wait time, visit length and timing, out-of-pocket payment, coupon use, prescription outcome, referral receipt, where care otherwise would have been sought, and patient satisfaction. Factors associated with five-star physician ratings and prescription receipt were assessed using logistic regression. Key Results We analyzed 19,270 mental health encounters between 6708 patients and 1045 providers. Visits were most frequently for anxiety (39.1%) or depression (32.5%), with high satisfaction (4.9/5) across conditions. Patients had a median 2.0 visits for psychiatry (IQR 1.0–3.0) and therapy (IQR 1.0–5.0), compared to 1.0 visit (IQR 1.0–1.0) for urgent care. High satisfaction was positively correlated with prescription receipt (OR 1.89, 95% CI 1.54–2.32) and after-hours timing (aOR 1.18, 95% CI 1.02–1.36). Prescription rates ranged from 79.6% for depression to 32.2% for substance use disorders. Prescription receipt was associated with increased visit frequency (aOR 1.95, 95% CI 1.57–2.42 for ≥ 3 visits). Conclusions As the burden of psychiatric disease grows, DTC telemedicine offers one solution for extending access to mental healthcare. While most encounters were one-off, evidence of some continuity in psychiatry and therapy visits—as well as overall high patient satisfaction—suggests potential for broader DTC telemental health use. Supplementary Information The online version contains supplementary material available at 10.1007/s11606-021-07326-y.

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“…These health platforms connect patients with healthcare professionals online allowing for increased access to care by removing physical barriers in seeking treatment. One retrospective cross-sectional study on encounters for ADHD via Direct-to-consumer telemedicine found that from 2016 to 2018, ADHD visits increased 500%, with 43% of ADHD related encounters resulting in prescription of non-controlled medications [26]. Similar telemedicine platforms such as Cerebral Inc. offer online prescriptions to controlled medications such as amphetamine-based stimulants and benzodiazepams, which has led to US federal investigation on prescribing practices [27].…”

Section: Discussionmentioning

confidence: 99%

Regional disparities in prescription methamphetamine and amphetamine distribution across the United States in 2019

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O'Kane

Goldhirsh

et al. 2022

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Introduction: Methamphetamine is a highly addictive psychostimulant and controlled substance that has detrimental health consequences for chronic users. Amphetamine is a structurally-related stimulant commonly used to treat ADHD, however, it also has a high risk for substance misuse. The objectives of this report were to characterize the regional differences in prescription methamphetamine and amphetamine distribution in the US, and examine potential reasons for variations in distribution. Methods: Data for prescription methamphetamine and amphetamine distribution was obtained from the US Drug Enforcement Administrations Automation of Reports and Consolidated Orders System (ARCOS) Retail Drug Summary Report for 2019. Quarterly, state, and regional differences in distributions of the two controlled substances were analyzed and. Results: The preponderance (97%) of retail drug distribution for both drugs in 2019 were made through pharmacies. In the same year, prescription methamphetamine (+6.8%) and amphetamine (+5.8%) saw increases in drug distribution from Quarter 1 to Quarter 4.. Across the entire US, total per capita drug weight distribution of amphetamine was exactly 4,000 times higher than methamphetamine. Regionally, total per capita drug weight for methamphetamine was highest in the West (32.2% of total distribution) and lowest in the Northeast (17.4%). The total per capita drug weight for amphetamine was highest in the South (37.0% of total distribution) and lowest in the Northeast (19.4%). The ratio between the 90th and 10th percentiles of per capita drug weight by state was 4.39 for methamphetamine and 2.45 for amphetamine. Distribution of methamphetamine only measured 16.1% of its production quota, while distribution of amphetamine measured 54.0% of its production quota. Discussion: Overall, prescription amphetamine distribution was common while prescription methamphetamine distribution was rare. Regional disparities were also present with lowest distribution of both substances in the Northeast region. The patterns observed in distribution are likely the result of stigmatization, differences in accessibility, and the efforts of initiatives such as the Montana Meth Project. This cycle will likely also change in response to physician recommendation and public opinions surrounding issues for pharmacotherapies for ADHD management.

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Use of Direct-to-Consumer Telemedicine for Attention-Deficit Hyperactivity Disorder

Cited by 7 publications

References 5 publications

Regional Disparities in Prescription Methamphetamine and Amphetamine Distribution Across the United States

Regional Disparities in Prescription Methamphetamine and Amphetamine Distribution Across the United States

Use of Direct-to-Consumer Telemedicine to Access Mental Health Services

Regional disparities in prescription methamphetamine and amphetamine distribution across the United States in 2019

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