JMIR Publications

ABSTRACT

Background:

Depression and anxiety are common comorbidities in outpatients of cardiovascular clinics. Timely identification and intervention of these mental and psychological disorders can contribute to correct diagnosis, better prognosis, less medical expenses, and improvement of quality of life. The online doctor-patient communication platform has attracted more and more patients for online consultation due to its convenience. However, online and offline healthcare are very different. There is no research on how to identify psychological disorders in patients who have online cardiology consultation.

Objective:

The purpose of this study was to explore the feasibility of using a self-rating scale to assess mental illness among patients who consult with cardiologist online, and to compare the differences in anxiety and depression between online and offline patients.

Methods:

From June 2022 to July 2022, we conducted follow-up visits in 10173 patients who had consulted with the same cardiologist on the Haodf APP platform during the past three years. We conducted detailed consultations on 286 patients who visited the same cardiologist in the outpatient department from June 2022 to July 2022. We used the Generalized Anxiety Disorder (GAD-7) and the Patient Health Questionnaire (PHQ-9) Self-Rating Scale to assess anxiety and depression, respectively. We analyze the influencing factors related to the degree of coordination of online patients. We also compared the incidence of anxiety or depression between online and offline patients, and analyzed the factors related to anxiety or depression using multiple regression methods.

Results:

Of the 10173 online consultation patients, only 186 responded effectively, with an effective response rate of only 1.8%, while the response rate of offline consultation patients was 96.5%. Frequent online communication and watching live video broadcasts are significantly related to effective responses from online patients(P<0.001). The incidence of anxiety (43.75% vs 25.84%, P<0.001) or depression(48.75% vs 27.72%, P<0.001) in online consultation patients is significantly higher than that in offline patients, with suspicious, mild anxiety or depression being the main symptoms. The independent risk factor related to anxiety is women(OR=0.458, 95%CI: 0.286～0.735, P=0.001), while women(OR=0.534, 95%CI:0.355～0.805, P=0.003) and online consultation patients(OR=0.385, 95%CI:0.189～0.784, P=0.009) are more likely to have depression.

Conclusions:

Online patients have more anxiety or depression than offline patients. Women are more likely to experience anxiety and depression, and online consultations patients are more likely to have depression. The self- rating mental state scale can help cardiologist to identify anxiety and depression in patients undergoing online consultation, but the patient's coordination is poor. Increasing the frequency of doctor-patient communication and watching live video broadcasts can improve patient cooperation.