TMS THERAPY
FDA-cleared, non-medication depression treatment
How TMS Providers Are Supporting Patients in a Changing Digital World
Mary El Grammer
Today's digital world is altering how many people prefer to access health care, and TMS providers are adapting to fit patients' needs and expectations.
Recognizing that young people often seek information in the same places they look for news and entertainment—Google and social media, for instance—industrial sectors from retail sales to financial planning have readily adopted smart technology to meet them. As the largest living adult population , millennials are driving trends , and many professional interactions are shifting from in person and over the phone to online.
Still, the health care industry has yet to fully incorporate technology solutions to maximize care delivery outside of traditional environments. While some patients may feel frustrated with the apparent lag in adaptation, others, such as seniors, may require special consideration to change their expectations of managing their health care with technology.
Greenbrook TMS is working to ensure that its patients are cared for in whatever way is most convenient and comfortable for them, and its TMS providers remain flexible in meeting their patients' needs.
Digital Technology and the Future of Health Care
Advances in digital technology will play an important role in the future of health care by connecting devices and embedding them with software and sensors to collect and exchange data, not only in doctors' offices and hospitals but in the places where people live, work, and play.
Accelerated by the COVID-19 pandemic , telehealth is the most notable technology being implemented today by health care providers. Some advantages of telehealth include expanded options for patients and providers for outreach, treatment delivery, and compliance monitoring—and, as a consequence, potentially improved clinical outcomes.
However, there are both pros and cons of telehealth. One disadvantage is that video telehealth services depend on both internet bandwidth and in-home computer equipment. Many people lack reliable broadband internet access or the equipment necessary to have an online appointment. For those who do have a workable setup, technology issues can still arise with sound delays, lighting issues, and audio glitches.
Telehealth and Psychiatry
Telehealth poses some unique challenges for psychiatry. One example is misdiagnosis. While patients often seek mental health care for what they believe is depression, a medical examination may determine that they are suffering from a neurological condition that has a secondary symptom of depression. Without an in-person assessment, the root problem would be missed, and the patient would be misdiagnosed.
Furthermore, developing face-to-face rapport is important in establishing a trusting, open relationship between patient and provider. With telehealth, your provider may have a harder time interpreting all the nuances of tone, body language, and facial expression than they would during an in-person visit.
TMS and Telehealth
While the pros and cons of telehealth may be weighted toward the pros for some patients, others might be more concerned about online health care and feel that it's neither convenient nor appropriate for them.
Greenbrook TMS offers telehealth appointments based on clinical suitability and patient preference. If you want to take advantage of telehealth and it is clinically appropriate, Greenbrook providers will offer it to accommodate your needs. If it's not clinically appropriate or you don't have the resources or preference for that mode of therapy, you have the option of an in-person examination.
Greenbrook TMS has always promoted patient convenience and choice. Unlike other depression treatments, however, TMS treatment has to be calibrated by a psychiatrist and administered by a technician, which requires an in-person visit. In other words, because TMS is a hands-on procedure, you will need to come in for a visit eventually . With this in mind, all Greenbrook centers are based on geographic proximity to people's homes and workplaces in appealing office spaces that are safe and spa-like, with treatments taking place in private rooms.
If you are considering TMS therapy, contact Greenbrook for a free consultation and see if a telehealth appointment is right for you.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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