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远程医疗与药物治疗:同步及新型异步数字健康工具在精神病学中的作用。

Telehealth and Pharmacotherapy: The Role of Synchronous and Novel Asynchronous Digital Health Tools in Psychiatry.

作者信息

Choudhary Soumya, Nelson Benjamin, Jones Nev, Mehta Urvakhsh Meherwan, Torous John

机构信息

Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.

Department of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, 20 Overland St, Boston, MA, 02215, USA.

出版信息

Pharmaceut Med. 2025 Aug 25. doi: 10.1007/s40290-025-00579-6.

Abstract

Digital psychiatry tools are increasingly woven into routine care, not only to support pharmacotherapy but also to deliver psychotherapy, sustain engagement and redesign clinical workflows. This narrative review synthesises synchronous (e.g. telepsychiatry and live chat) and asynchronous (e.g. apps, remote monitoring and digital therapeutics/software as a medical device ["SaMD"]) approaches that initiate, monitor or augment medication treatment and commonly paired psychosocial interventions. We outline how these tools can improve adherence, side-effect surveillance, psychoeducation and therapy access while highlighting persistent challenges around evidence strength, workflow integration, equity, reimbursement and regulation. Drawing on emerging hybrid models, such as digital navigators and the digital clinic model, we present pragmatic pathways for safe adoption, data triage and sustained use in real-world settings. We also discuss opportunities for artificial intelligence (AI)-driven personalisation and responsive monitoring, alongside the ethical and implementation considerations they raise. By broadening the lens beyond pharmacotherapy alone, this review provides clinicians and health systems with actionable guidance on selecting, integrating and evaluating digital tools to deliver patient-centred, scalable psychiatric care.

摘要

数字精神病学工具越来越多地融入日常护理中,不仅用于支持药物治疗,还用于提供心理治疗、维持患者参与度以及重新设计临床工作流程。这篇叙述性综述综合了同步(如远程精神病学和实时聊天)和异步(如应用程序、远程监测以及数字疗法/作为医疗设备的软件 ["SaMD"])方法,这些方法启动、监测或增强药物治疗以及通常与之配套的心理社会干预措施。我们概述了这些工具如何提高依从性、副作用监测、心理教育以及治疗可及性,同时强调在证据强度、工作流程整合、公平性、报销和监管方面持续存在的挑战。借鉴数字导航员和数字诊所模式等新兴混合模式,我们提出在现实环境中安全采用、数据分类和持续使用的实用途径。我们还讨论了人工智能(AI)驱动的个性化和响应式监测的机会,以及它们引发的伦理和实施方面的考虑因素。通过拓宽仅关注药物治疗的视野,本综述为临床医生和卫生系统提供了关于选择、整合和评估数字工具以提供以患者为中心、可扩展的精神科护理的可操作指导。

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