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AKDN Digital Health Resource Centre
Impact evaluation: Assessing the effectiveness of telepsychiatry consultations in Pakistan

The AKDN Digital Health Programme offers telepsychiatry services at AKDN health facilities in Gilgit-Baltistan and Chitral districts of Pakistan. Patients at these facilities can avail live teleconsultations in psychiatry from specialists at the Aga Khan Medical Centre, Gilgit and Aga Khan University Hospital, Karachi.

The Aga Khan Health Service, Pakistan; Aga Khan University (AKU); AKDN dHRC and faculty from Dalhousie University, Canada undertook a research study to evaluate the effectiveness of telepsychiatry services offered at the Aga Khan Medical Centre, Booni, Chitral, Aga Khan Medical Centre, Gilgit and other health centres in Gilgit-Baltistan and Chitral.

The study aimed to capture the patient experiences and perceptions of telepsychiatry services in terms of access, quality and cost of health care services. During 2015, equipment was procured; data collection tools were developed and validated; a mobile application to assist with data collection was developed and tested; and data collectors were recruited and trained.

In 2016, quantitative and qualitative data was gathered by data collectors. The study adopted a mixed-methods design. Qualitative data collection included an exploratory descriptive research wherein patient experiences and perceptions of telepsychiatry services were evaluated through interviews. The mobile app developed by AKDN dHRC, Telepsychiatry Survey Application, assisted in obtaining patient feedback. Quantitative data was gathered through paper-based questionnaires, measuring access, quality and cost of health care services. Quantitative data was also collected by the psychiatrist’s appraisal of the patients’ Mental Status Examination (MSE).  

The results of the study suggested that overall patients were satisfied to receive psychiatric consultation at facilities near their homes. Almost all the participants agreed that telepsychiatry services led them to significant cost reduction in terms of travel expenditure, time and lodging expenses. Out of the 214 patients interviewed, 41% reported acquiring appointment in a week; 18% reported reaching the health centres within an hour; and 67% reported reduction in cost of treatment. 34% consulted a psychiatrist for the first time whereas 76% stated their overall service experience was excellent; 98% were comfortable with interacting with the psychiatrist via teleconsultations; and 99% reported they would use the services again and recommend it to others in need as well.

During 2017, research findings were disseminated at various national and international conferences and awareness sessions at the local community level. Presentations were made at the Seventh FMIC Annual International Scientific Conference at the French Medical Institute for Mothers and Children in Kabul, Afghanistan; at the Canadian Conference on Global Health in Ottawa, Canada; and at the Central Asia Health Systems Strengthening Workshop in Bishkek, Kyrgyz Republic. Similarly, awareness sessions were conducted at the professional and community level in Gilgit-Baltistan and Chitral in Pakistan, where the services are offered.

The study initiated in April 2015 and concluded in 2017 and was funded by Global Affairs Canada and the Aga Khan Foundation Canada.

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