Telepsychiatry: knowledge,effectiveness, and willingness; assessments of psychiatrists in Saudi Arabia |
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| Authors: | Saleh A. Alghamdi Osamah M. Alshahrani Abdulmajeed K. Alharbi Omar A. Alghamdi Reem A. Almohaini Jouf Y. Alsayat |
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| Affiliation: | From the Department of Clinical Neurosciences (Alghamdi), College of Medicine (Alshahrani, Alghamdi, Almohaini, Alsayat), Imam Mohammad Ibn Saud Islamic University, and from College of Medicine (Alharbi), King Saud University, Riyadh, Kingdom of Saudi Arabia. |
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| Abstract: | Objectives:To assess psychiatrists’ knowledge and perception regarding telepsychiatry and evaluate their willingness to adopt telepsychiatry clinical practice in Saudi Arabia.Methods:A cross-sectional study was conducted among psychiatrists working in Saudi Arabia from November 2020 through May 2021. A self-administered questionnaire comprising socio-demographic data, factors related to knowledge, perception, willingness, barriers, and the effectiveness of telepsychiatry, was distributed via. online platform. Data were tabulated and cleaned in MS Excel, and all statistical analyses were performed using SPSS v26.Results:There were 328 psychiatrists enrolled in the group with an average age of 25–35 years (48.8%). The group comprised mainly Saudis (83.5%); male participants outnumbered females (70.4% to 29.6%). Overall, the psychiatrists’ telepsychiatry knowledge level was poor (51.8%), while (48.2%) of the respondents showed good knowledge. However, nearly all respondents exhibited good perception (80.8%), with only 19.2% classified as poor. In addition, older individuals, consultants, clinicians with 11–15 years of experience, clinicians interacting with patients via email, and those who frequently received patient questions regarding online communication indicated increased knowledge.Conclusion:Although perception was positive regarding telepsychiatry, psychiatrists’ knowledge on the subject was deemed insufficient. Psychiatrists’ knowledge depended on their age, position, years of experience, frequent interaction with patients through an online platform, and clients that provided their online contact details. The earliest telemedicine trials were in the 1950s when Norfolk State Hospital and Nebraska Psychiatric Institute used closed-circuit television to provide patient consultations. Telemedicine has various branches; it includes telepsychiatry, which offers psychiatric care through any form of telecommunication, such as video conferencing. 1 Telecommunication provided for both psychiatrists and their patients a convenient, easy, and fast tool to connect both parties for accessible psychiatric evaluations, various forms of therapy such as individual, group, family therapy, medication management, and essential information on their diseases; most importantly it saved both time and effort for both psychiatrists and their patients. 2,3 It can also be utilized for non-clinical applications, such as organizational learning, in addition to infinite services. 4 Telepsychiatry can be applied in situations where patients stay in rural areas or move from distant areas become difficult; also, in follow-ups or medication refills. 5 Many patients reported their satisfaction with telecommunications. 3 Telepsychiatry, similar to any technology, faces barriers or limitations in its use; therefore, considerable research has been conducted to identify these barriers. 2-13 Barriers such as technical, interpersonal challenges hindering their use of Telepsychiatry, lack of cost-effectiveness, the opposing view among psychiatrists; as many psychiatrists find it challenging to accept Telepsychiatry, and they are reluctant to accept the effectiveness of this service delivery and think that system workflow integration should be improved. In addition, psychiatrists dislike their inability to take physical steps to ensure patients’ comfort. 2-7 Furthermore, Telepsychiatry is the most active telemedicine application functioning as a feasible alternative for current mental health services, improved care services, and early treatment. Regardless of the benefits mentioned previously; psychiatrists are less satisfied with it because the quality of audio-visual technology impacts the reliability of teleconsultation. in addition, there were a few limitations when addressing satisfaction, such as the lack of return to clinics (RTCs), small sample sizes, and no apparent difference in satisfaction between Telepsychiatry and face-to-face consultation. For that reason, substantial research has been conducted to identify this satisfaction limitation as it is still unknown whether opposing is due to the program or technology. User acceptance or Patients and cultural factors presented a primary barrier or challenges in implementation, as many Saudi psychiatrists are skeptical of Telepsychiatry’s outcomes, and clinicians are unsatisfied with the service, affecting their willingness to utilize telemedicine. The second barrier is consumer acceptance, impacting patients’ willingness to be treated by telemedicine. Other obstacles are the lack of qualified experts to implement the technology, essential Information and Communications Technology (ICT) infrastructure, and acceptable strategies and plans for implementing telemedicine in Saudi Arabia. In addition, some health providers lack ICT skills and cannot apply the innovation. 6-13 Thus, there are scattered current data investigating psychiatrists’ satisfaction with Telepsychiatry in Saudi Arabia. Therefore, this study aims to fill the research gap in this area.The earliest telemedicine trials were in the 1950s when Norfolk State Hospital and Nebraska Psychiatric Institute used closed-circuit television to provide patient consultations. Telemedicine has various branches; it includes Telepsychiatry, which offers psychiatric care through any form of telecommunication, such as video conferencing. 1 Telecommunication provided for both psychiatrists and their patients a convenient, easy, and fast tool to connect both parties for accessible psychiatric evaluations, various forms of therapy such as individual, group, family therapy, medication management, and essential information on their diseases; most importantly it saved both time and effort for both psychiatrists and their patients. 2,3 It can also be utilized for non-clinical applications, such as organizational learning, in addition to infinite services. 4 Telepsychiatry can be applied in situations where patients stay in rural areas or move from distant areas become difficult; also, in follow-ups or medication refills. 5 Many patients reported their satisfaction with telecommunications. 3 Telepsychiatry, similar to any technology, faces barriers or limitations in its use; therefore, considerable research has been conducted to identify these barriers. 2-13 Barriers such as technical, interpersonal challenges hindering their use of Telepsychiatry, lack of cost-effectiveness, the opposing view among psychiatrists; as many psychiatrists find it challenging to accept Telepsychiatry, and they are reluctant to accept the effectiveness of this service delivery and think that system workflow integration should be improved. In addition, psychiatrists dislike their inability to take physical steps to ensure patients’ comfort. 2-7 Furthermore, Telepsychiatry is the most active telemedicine application functioning as a feasible alternative for current mental health services, improved care services, and early treatment. Regardless of the benefits mentioned previously; psychiatrists are less satisfied with it because the quality of audio-visual technology impacts the reliability of teleconsultation. in addition, there were a few limitations when addressing satisfaction, such as the lack of return to clinics (RTCs), small sample sizes, and no apparent difference in satisfaction between Telepsychiatry and face-to-face consultation. For that reason, substantial research has been conducted to identify this satisfaction limitation as it is still unknown whether opposing is due to the program or technology. User acceptance or patients and cultural factors presented a primary barrier or challenges in implementation, as many Saudi psychiatrists are skeptical of Telepsychiatry’s outcomes, and clinicians are unsatisfied with the service, affecting their willingness to utilize telemedicine. The second barrier is consumer acceptance, impacting patients’ willingness to be treated by telemedicine. Other obstacles are the lack of qualified experts to implement the technology, essential Information and Communications Technology (ICT) infrastructure, and acceptable strategies and plans for implementing telemedicine in Saudi Arabia. In addition, some health providers lack ICT skills and cannot apply the innovation. 6-13 Thus, there are scattered current data investigating psychiatrists’ satisfaction with Telepsychiatry in Saudi Arabia. Therefore, this study aims to fill the research gap in this area.Table 1- The psychiatrists’ socio-demographic characteristics. n=328| Study data | n (%) |
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| Age group | | 25–35 years | 160 (48.8) | | 36–45 years | 95 (29.0) | | 46–55 years | 49 (14.9) | | 56–65 years | 19 (05.8) | | >65 years | 05 (01.5) | | Gender | | Male | 231 (70.4) | | Female | 97 (29.6) | | Nationality | | Saudi | 274 (83.5) | | Non-Saudi | 54 (16.5) | | Position | | Resident | 140 (42.7) | | Specialist | 79 (23.8) | | Consultant | 110 (33.5) | | Years of experience in psychiatry | | 1–5 years | 129 (39.3) | | 6–10 years | 66 (20.1) | | 11–15 years | 57 (17.4) | | 16–20 years | 39 (11.9) | | >20 years | 37 (11.3) |
Open in a separate windowTable 2- Factors related to telepsychiatry knowledge. (n=328)| Statements | Low | Average | High |
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| n (%) | n (%) | n (%) |
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| Are you familiar with telepsychiatry technology? | 98 (29.9) | 171 (52.1) | 59 (18.0) | | Are you familiar with the medical applications of telepsychiatry technology? | 121 (36.9) | 156 (47.6) | 51 (15.5) | | How often are conferences, speeches, or meetings held in your workplace regarding telepsychiatry technology? | 180 (54.9) | 109 (33.2) | 39 (11.9) | | Are you familiar with telepsychiatry tools? | 131 (39.9) | 145 (44.2) | 52 (15.9) | | Are you familiar with telepsychiatry guidelines? | 177 (54.0) | 109 (33.2) | 42 (12.8) | | Are you familiar with the use of telepsychiatry in other countries? | 163 (49.7) | 137 (41.8) | 28 (08.5) | | Is continuous training in the use of telepsychiatry necessary for doctors? | 62 (18.9) | 157 (47.9) | 109 (33.2) | | Total score (mean±SD) | 12.3±3.45 | -- | -- | | Level of knowledge | | Poor (≤12 score) | 170 (51.8) | -- | -- | | Good (>12 score) | 158 (48.2) | -- | -- |
Open in a separate windowThe assessment of psychiatrists’ knowledge toward telepsychiatry is described in | |
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