Authors (including presenting author) :
Leung PYK(1), So WKA(1), Chan YHM(1), Lai SKE(1)
Affiliation :
(1) Occupational Therapy Department, Castle Peak Hospital
Keyword 1: :
Mental disorder
Keyword 4: :
Rehabilitation
Keyword 5: :
Occupational Therapy
Introduction :
Despite computer-assisted cognitive remediation(CR) was proven effective in enhancing cognitive functioning of people with mental disorders, it is mostly arranged as onsite training in Hong Kong. Out-patients with mental disorders often have impaired motivation to attend onsite training regularly, including avolition in schizophrenia and anhedonia in depression. While some hesitate to attend due to full-time work or study, training cost and traveling time. For those required escort, like elderly and hostel residents, attendance to onsite training is restricted by availability of carer or escort. Telehealth is defined as delivery of health-related services via telecommunications or technology-based virtual platforms. Implementation of telehealth in this study involved CR using online platform HappyNeuron Pro and HA Go app, which allows occupational therapists to prescribe personalized training via digital platforms and remotely monitor training progress.
Objectives :
(1) Shorten waiting time before CR can be arranged (2) Evaluate effectiveness of hybrid mode of telehealth and onsite CR in improving cognitive functioning
Methodology :
This study adopted single group pre-post design. Participants were recruited from out-patients of occupational therapy service of Castle Peak Hospital, between 18-64 years old; without diagnosis of organic brain disorder or intellectual disability. After pre-assessment, patient chose either telehealth CR, onsite training or both. Waiting time before commencement of CR was captured. Upon completion of 20 training sessions (45-60 minutes each), post assessment was completed. Effectiveness was evaluated by improvement in T-scores of MATRICS™ Consensus Cognitive Battery (MCCB™) as primary outcome, a measure of global cognitive functioning assessing speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning & problem solving and neurocognitive composite; pre- and post- T-scores of MCCB™ was compared by paired t-test, p value< 0.05 was adopted for statistical significance.
Result & Outcome :
(1) Waiting time before commencement of CR (2) T-scores of MATRICS™ Consensus Cognitive Battery (MCCB™) A total of 22 participants were recruited, 54.5% selected telehealth CR. Unlike onsite training which cannot be arranged before training vacancy is available, telehealth CR can be readily prescribed after assessment with no waiting time, the average waiting time dropped from 8 weeks to 3.8 weeks. Statistically significant improvement was showed in neurocognitive composite T-score of MCCB™ with mean paired difference=+9.50 (t(22)=8.152, p=0.000); statistically significant improvements were shown in T-scores of all cognitive domains except working memory, ranged from +5.45 to +11.59.
