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Effendi DE, Handayani S, Nugroho AP, Ardani I, Fitrianti Y, Karlina K, Latifah C. The Significance of Physician-Patient Communication on Telemedicine Patients' Health Outcomes: Evidence from Indonesia. HEALTH COMMUNICATION 2024; 39:1932-1941. [PMID: 37580857 DOI: 10.1080/10410236.2023.2247852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
The importance of physician-patient communication on patient health outcomes has been globally known. Poor communication in clinical settings, including in telemedicine visits, has been identified as a key barrier to successful medical consultation. This barrier is even more prevalent among people from linguistically and culturally diverse communities. This study investigated the influence of physician-patient communication on telemedicine patient health outcomes in Indonesia, a developing country with great linguistic and cultural diversity. This study utilized secondary data from a telemedicine utilization survey conducted during the coronavirus disease 2019 (COVID-19) pandemic. Socioeconomic factors and communication features were included as predictors of patients' health improvement. Logistic regressions were utilized to examine the significance of the communication features on patients' health. The analysis results indicated that five communication features including the adequacy of consultation length, a timely physician response, the provision of an explanation of the medication and possible side effects, the patient's ability to utter their physical condition and opinion regarding medication goals, and the patient's ability to comprehend physician explanations and instructions were significantly associated with the patient's health outcomes. Physicians and healthcare providers should focus on the provision of communication features revealed in this study to elevate the likelihood of improved health conditions in telemedicine patients.
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Affiliation(s)
- Diyan Ermawan Effendi
- Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia
| | - Sri Handayani
- Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia
| | - Arief Priyo Nugroho
- Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia
| | - Irfan Ardani
- Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia
| | - Yunita Fitrianti
- Research Center for Public Health and Nutrition, National Research and Innovation Agency Republic of Indonesia
| | - Karlina Karlina
- Health Policy Agency, Ministry of Health Republic of Indonesia
| | - Choirum Latifah
- Health Policy Agency, Ministry of Health Republic of Indonesia
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Gülırmak Güler K, Güleç Keskin S, Terzi M. Transformative impact of positive psychotherapy-based hope placement program on life goals and hope level of individuals with multiple sclerosis. Public Health Nurs 2024. [PMID: 39105489 DOI: 10.1111/phn.13389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 07/17/2024] [Accepted: 07/21/2024] [Indexed: 08/07/2024]
Abstract
AIM This study aimed to assess the impact of a positive psychotherapy-based hope placement program on life goal setting and hope levels in individuals diagnosed with multiple sclerosis (MS). METHOD A Solomon Four-Group experimental design was used, involving 50 individuals diagnosed with MS who sought treatment at a university hospital's neurology outpatient clinic. Experimental (1-2) and control (1-2) groups were randomized, and pretests were administered exclusively to the experimental and control groups. Data were collected using a Personal Information Form, the Herth Hope Scale, and the Scale for Determining Life Goals in the Context of Positive Psychotherapy. A 5-week/10-session Positive Psychotherapy-Based Hope Placement Program was conducted online for the Experimental groups. The research was conducted in the form of group therapy. Post-tests were administered to all groups upon program completion. RESULTS The experimental 1-2 group exhibited statistically significant improvements in the Scale for Identifying Life Goals in the Context of Positive Psychotherapy and Herth Hope Scale scores (p < .05). The Positive Psychotherapy-Based Hope Placement Program effectively enhances hope levels and life goal setting for individuals diagnosed with MS. CONCLUSION The results indicate that the program increased the sense of purpose in life and elevated levels of hope among MS patients. These findings suggest that positive psychotherapy-based interventions significantly improve the quality of life for MS patients. CLINICAL OR METHODOLOGICAL SIGNIFICANCE OF THIS ARTICLE This study examines the impact of a Positive Psychotherapy-based hope placement program on determining hope and life purpose in patients with Multiple Sclerosis (MS). This research shows that HOPP (Hope Placement Program), an intervention based on Positive Psychotherapy, can significantly improve the quality of life of MS patients. These findings support the consideration of Positive Psychotherapy-based approaches as a potential therapeutic option that can positively influence the life experiences of MS patients. Therefore, this article makes an important contribution to researchers interested in using Positive Psychotherapy-based interventions in clinical practice and related research.
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Affiliation(s)
- Kübra Gülırmak Güler
- Faculty of Health Sciences, Department of Psychiatric Nursing, Ondokuz Mayıs University, Samsun, Turkey
| | - Serap Güleç Keskin
- Faculty of Health Sciences, Department of Psychiatric Nursing, Ondokuz Mayıs University, Samsun, Turkey
| | - Murat Terzi
- Faculty of Medicine, Department of Neurology, Ondokuz Mayıs University, Samsun, Turkey
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Galvin E, Desselle S, Gavin B, McNicholas F, Cullinan S, Hayden J. Training Service Users in the Use of Telehealth: Scoping Review. J Med Internet Res 2024; 26:e57586. [PMID: 39083789 PMCID: PMC11325118 DOI: 10.2196/57586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/08/2024] [Accepted: 05/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND The use of telehealth has rapidly increased, yet some populations may be disproportionally excluded from accessing and using this modality of care. Training service users in telehealth may increase accessibility for certain groups. The extent and nature of these training activities have not been explored. OBJECTIVE The objective of this scoping review is to identify and describe activities for training service users in the use of telehealth. METHODS Five databases (MEDLINE [via PubMed], Embase, CINAHL, PsycINFO, and Web of Science) were searched in June 2023. Studies that described activities to train service users in the use of synchronous telehealth consultations were eligible for inclusion. Studies that focused on health care professional education were excluded. Papers were limited to those published in the English language. The review followed the Joanna Briggs Institute guidelines for scoping reviews and was reported in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Titles and abstracts were screened by 1 reviewer (EG). Full texts were screened by 2 reviewers (EG and JH or SC). Data extraction was guided by the research question. RESULTS The search identified 8087 unique publications. In total, 13 studies met the inclusion criteria. Telehealth training was commonly described as once-off preparatory phone calls to service users before a telehealth visit, facilitated primarily by student volunteers, and accompanied by written instructions. The training content included guidance on how to download and install software, troubleshoot technical issues, and adjust device settings. Older adults were the most common target population for the training. All but 1 of the studies were conducted during the COVID-19 pandemic. Overall, training was feasible and well-received by service users, and studies mostly reported increased rates of video visits following training. There was limited and mixed evidence that training improved participants' competency with telehealth. CONCLUSIONS The review mapped the literature on training activities for service users in telehealth. The common features of telehealth training for service users included once-off preparatory phone calls on the technical elements of telehealth, targeted at older adults. Key issues for consideration include the need for co-designed training and improving the broader digital skills of service users. There is a need for further studies to evaluate the outcomes of telehealth training activities in geographically diverse areas.
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Affiliation(s)
- Emer Galvin
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Shane Desselle
- Touro University California, California, CA, United States
| | - Blánaid Gavin
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Fiona McNicholas
- School of Medicine, University College Dublin, Dublin, Ireland
- Children's Health Ireland, Dublin, Ireland
- Lucena Child and Adolescent Mental Health Service (CAMHS), Dublin, Ireland
| | - Shane Cullinan
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - John Hayden
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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de Figueirêdo RC, de Siqueira Silva Í, de Araújo AJ, Silva CRDV, Martiniano CS, Brito EWG, Xavier PB, da Costa Uchôa SA. Preparation and validation of the instrument "QualiAPS digital-Brazil" for assessing digital health care in primary health care: a required tool. Front Public Health 2024; 12:1304148. [PMID: 39081352 PMCID: PMC11286592 DOI: 10.3389/fpubh.2024.1304148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 07/03/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction The use of Information and Communication Technologies in the field of health is increasing across the world, demarcating the field of digital health. The goal of this study is to formulate and validate a matrix of indicators, design assessment scripts and indicate data collection techniques for assessing the quality of digital health care in Brazilian Primary Health Care (PHC). Methodology This is a validation study divided into three phases: preparation of the instrument, analysis of validity and pilot study. The instrument was prepared based on the PHC assessment model from a literature review; the analysis of validity used the Delphi technique associated with the nominal group and the evidence from the literature reference. In the pilot study, audio-recorded interviews were conducted with strategic primary care actors. Results The matrix of indicators "QualiAPS Digital-Brazil" introduces a set of 37 indicators, distributed into three distinct components and their respective dimensions. The component "Structure" includes the dimension "Resources"; the component "Processes" includes the dimensions "Technical," "Organizational" and "Relational"; and the component "Results" includes the dimensions "Short-Term Results" and "Medium-Term Results." The general values obtained for CVI and IRR were 0.89 and 1.00; respectively. Therefore, it was possible to design assessment scripts and indicate qualitative data collection techniques for assessing digital health in Brazilian PHC. Conclusion The instrument presented was validated regarding its relevance, content and theoretical support to evaluate the quality of digital health care, supporting decision-making by managers and health professionals in the search for improving remote primary care provided to the population.
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Affiliation(s)
| | | | | | | | | | | | - Pedro Bezerra Xavier
- Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Brazil
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de Siqueira Silva Í, de Araújo AJ, Lopes RH, Silva CRDV, Xavier PB, de Figueirêdo RC, Brito EWG, Lapão LV, Martiniano CS, de Araújo Nunes VM, da Costa Uchôa SA. Digital home care interventions and quality of primary care for older adults: a scoping review. BMC Geriatr 2024; 24:507. [PMID: 38858634 PMCID: PMC11163791 DOI: 10.1186/s12877-024-05120-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/29/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Population aging is forcing the transformation of health care. Long-term care in the home is complex and involves complex communication with primary care services. In this scenario, the expansion of digital health has the potential to improve access to home-based primary care; however, the use of technologies can increase inequalities in access to health for an important part of the population. The aim of this study was to identify and map the uses and types of digital health interventions and their impacts on the quality of home-based primary care for older adults. METHODS This is a broad and systematized scoping review with rigorous synthesis of knowledge directed by the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The quantitative data were analyzed through descriptive statistics, and the qualitative data were analyzed through basic qualitative content analysis, considering the organizational, relational, interpersonal and technical dimensions of care. The preliminary results were subjected to consultation with stakeholders to identify strengths and limitations, as well as potential forms of socialization. RESULTS The mapping showed the distribution of publications in 18 countries and in the Sub-Saharan Africa region. Older adults have benefited from the use of different digital health strategies; however, this review also addresses limitations and challenges, such as the need for digital literacy and technological infrastructure. In addition to the impacts of technologies on the quality of health care. CONCLUSIONS The review gathered priority themes for the equitable implementation of digital health, such as access to home caregivers and digital tools, importance of digital literacy and involvement of patients and their caregivers in health decisions and design of technologies, which must be prioritized to overcome limitations and challenges, focusing on improving quality of life, shorter hospitalization time and autonomy of older adults.
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Affiliation(s)
- Ísis de Siqueira Silva
- Postgraduate in Collective Health, Federal University of Rio Grande Do Norte, Natal, Brazil.
| | | | | | | | - Pedro Bezerra Xavier
- Postgraduate in Health Sciences, Federal University of Rio Grande Do Norte, Natal, Brazil
| | | | | | - Luís Velez Lapão
- WHO Collaborating Center on Health Workforce Policy and Planning, IHMT, Universidade Nova de Lisboa, Lisbon, Portugal
- UNIDEMI, Department of Mechanical and Industrial Engineering, Nova School of Science and Technology, Caparica, Portugal
- Laboratório Associado de Sistemas Inteligentes, Escola de Engenharia Universidade do Minho, Campus Azurém, 4800-058, Guimarães, Portugal
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Boudreau JH, Moo LR, Kennedy MA, Conti J, Anwar C, Pimentel CB, Nearing KA, Hung WW, Dryden EM. Needs for Successful Engagement in Telemedicine Among Rural Older US Veterans and Their Caregivers: Qualitative Study. JMIR Form Res 2024; 8:e50507. [PMID: 38713503 PMCID: PMC11109863 DOI: 10.2196/50507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 02/15/2024] [Accepted: 03/13/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Telemedicine is an important option for rural older adults who often must travel far distances to clinics or forgo essential care. In 2014, the Geriatric Research, Education, and Clinical Centers (GRECC) of the US Veterans Health Administration (VA) established a national telemedicine network called GRECC Connect. This network increased access to geriatric specialty care for the 1.4 million rural VA-enrolled veterans aged 65 years or older. The use of telemedicine skyrocketed during the COVID-19 pandemic, which disproportionately impacted older adults, exacerbating disparities in specialty care access as overburdened systems shut down in-person services. This surge presented a unique opportunity to study the supports necessary for those who would forgo telemedicine if in-person care were available. OBJECTIVE In spring 2021, we interviewed veterans and their informal caregivers to (1) elicit their experiences attempting to prepare for a video visit with a GRECC Connect geriatric specialist and (2) explore facilitators and barriers to successful engagement in a telemedicine visit. METHODS We conducted a cross-sectional qualitative evaluation with patients and their caregivers who agreed to participate in at least 1 GRECC Connect telemedicine visit in the previous 3 months. A total of 30 participants from 6 geographically diverse GRECC Connect hub sites agreed to participate. Semistructured interviews were conducted through telephone or the VA's videoconference platform for home telemedicine visits (VA Video Connect) per participant preference. We observed challenges and, when needed, provided real-time technical support to facilitate VA Video Connect use for interviews. All interviews were recorded with permission and professionally transcribed. A team of 5 researchers experienced in qualitative research analyzed interview transcripts using rapid qualitative analysis. RESULTS From 30 participant interviews, we identified the following 4 categories of supports participants described regarding successful engagement in telemedicine, as defined by visit completion, satisfaction, and willingness to engage in telemedicine in the future: (1) caregiver presence to facilitate technology setup and communication; (2) flexibility in visit modality (eg, video from home or a clinic or telephone); (3) technology support (eg, determining device compatibility or providing instruction and on-demand assistance); and (4) assurance of comfort with web-based communication, including orientation to features like closed captioning. Supports were needed at multiple points before the visit, and participants stressed the importance of eliciting the varying needs and preferences of each patient-caregiver dyad. Though many initially agreed to a telemedicine visit because of pandemic-related clinic closures, participants were satisfied with telemedicine and willing to use it for other types of health care visits. CONCLUSIONS To close gaps in telemedicine use among rural older adults, supports must be tailored to individuals, accounting for technology availability and comfort, as well as availability of and need for caregiver involvement. Comprehensive scaffolding of support starts well before the first telemedicine visit.
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Affiliation(s)
- Jacqueline Hannah Boudreau
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, US Department of Veterans Affairs, Bedford, MA, United States
| | - Lauren R Moo
- New England Geriatric Research, Education, and Clinical Center, VA Bedford Healthcare System, US Department of Veterans Affairs, Bedford, MA, United States
- Department of Neurology, Harvard Medical School, Boston, MA, United States
| | - Meaghan A Kennedy
- New England Geriatric Research, Education, and Clinical Center, VA Bedford Healthcare System, US Department of Veterans Affairs, Bedford, MA, United States
- Department of Family Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Jennifer Conti
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, US Department of Veterans Affairs, Bedford, MA, United States
| | - Chitra Anwar
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, US Department of Veterans Affairs, Bedford, MA, United States
| | - Camilla B Pimentel
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, US Department of Veterans Affairs, Bedford, MA, United States
- New England Geriatric Research, Education, and Clinical Center, VA Bedford Healthcare System, US Department of Veterans Affairs, Bedford, MA, United States
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Kathryn A Nearing
- Eastern Colorado VA Geriatric Research Education and Clinical Center, Aurora, CO, United States
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - William W Hung
- Bronx Geriatric Research Education and Clinical Center, James J Peters VA Medical Center, Bronx, New York, NY, United States
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine, New York, NY, United States
| | - Eileen M Dryden
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, US Department of Veterans Affairs, Bedford, MA, United States
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Hawley CE, Wagner C, Venegas MD, Genovese N, Triantafylidis LK, McCullough MB, Beizer JL, Hung WW, Moo LR. Connecting the disconnected: Leveraging an in-home team member for video visits for older adults. J Am Geriatr Soc 2024; 72:1408-1419. [PMID: 37960887 PMCID: PMC11188997 DOI: 10.1111/jgs.18663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Older adults are interested and able to complete video visits, but often require coaching and practice to succeed. Data show a widening digital divide between older and younger adults using video visits. We conducted a qualitative feasibility study to investigate these gaps via ethnographic methods, including a team member in older participants' homes. METHODS This ethnographic feasibility study included a virtual medication reconciliation visit with a clinical pharmacist for Veterans aged 65 and older taking 5 or more medications. An in-home study team member joined the participant and recorded observations in structured fieldnotes derived from the Updated Consolidated Framework for Implementation Research and Age-Friendly Health Systems. Fieldnotes included behind-the-scenes facilitators, barriers, and solutions to challenges before and during the visits. We conducted a thematic analysis of these observations and matched themes to implementation solutions from the Expert Recommendations for Implementing Change. RESULTS Twenty participants completed a video visit. Participants were 74 years old (range 68-80) taking 12 daily medications (range 7-24). Challenges occurred in half of the visits and took the in-home team member and/or pharmacist an average of 10 minutes to troubleshoot. Challenges included notable new findings, such as that half of the participants required technology assistance for challenges that would not have been able to be solved by the pharmacist virtually. Furthermore, although many participants had a device or had used video visits before, some did not have a single device with video, audio, Internet, and access to their email username and password. CONCLUSIONS Clinicians may apply these evidence-based implementation solutions to their approach to video visits with older adults, including having a team member join the visit before the clinician, involving tech-savvy family members, ensuring the device works with the visit platform ahead of time, and creating a troubleshooting guide from our common challenges.
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Affiliation(s)
- Chelsea E. Hawley
- New England Geriatric Research Education and Clinical Center, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Department of Medicine, Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Caroline Wagner
- New England Geriatric Research Education and Clinical Center, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Pharmacy Department, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Maria D. Venegas
- New England Geriatric Research Education and Clinical Center, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Department of Medicine, Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, Massachusetts, USA
- Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, Bedford, Massachusetts, USA
| | - Nicole Genovese
- Pain Management, Opioid Safety, and Prescription Drug Monitoring Program, Veterans Affairs New Jersey Healthcare System, East Orange, New Jersey, USA
| | | | - Megan B. McCullough
- Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Department of Health Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Judith L. Beizer
- College of Pharmacy and Health Sciences, St. John’s University, New York, New York, USA
| | - William W. Hung
- Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lauren R. Moo
- New England Geriatric Research Education and Clinical Center, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Center for Healthcare Organization and Implementation Research, Bedford VA Medical Center, Bedford, Massachusetts, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Wang QP, Chang WY, Han MM, Hu YX, Lin SS, Gu YC. Application of telemedicine system for older adults postoperative patients in community: a feasibility study. Front Public Health 2024; 12:1291916. [PMID: 38435285 PMCID: PMC10904463 DOI: 10.3389/fpubh.2024.1291916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/06/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose In response to the growing challenges posed by an aging society, a telemedicine system was developed specifically for older adults postoperative patients, and its effectiveness was thoroughly investigated. Methods Between May 2020 and May 2022, a total of 88 older adults postoperative patients were enrolled and randomly allocated into an experimental group and a control group. The experimental group received telemedicine services after discharge, while the control group received conventional medical services following the traditional protocol. One month after discharge, various indicators were evaluated for both groups, including number of visits, medical expenditures, postoperative recovery, anxiety, depression and satisfaction. Results The number of visits and medical expenditures of the experimental group were less than those of the control group [1 (0, 1) vs. 1 (1, 2), Z = -3.977, p < 0.001; 25.25 (0.00, 277.40) yuan vs. 174.65 (49.63, 446.10) yuan, Z = -2.150, p = 0.032]. In both groups, there were 2 cases of incision infection, respectively. No significant difference was observed between the two groups (Fisher χ2, p = 0.259). In both groups, there was no instance of incision bleeding, incision dehiscence, readmission, or reoperation. Additionally, there was no significant difference in physical status between the two groups at discharge and after discharge (66.06 ± 8.92 vs. 65.45 ± 7.39 t = 0.287, p = 0.775; 73.33 ± 9.97 vs. 70.91 ± 7.50, t = 1.202, p = 0.235). And there was no significant difference in the change of physical status between the two groups after discharge [10.00 (0.00, 10.00) vs. 5.00 (0.00, 10.00), Z = -1.077, p = 0.281]. There was no significant difference in body weight change between the two groups after discharge [1.05 (0.38, 1.60) Kg vs. 0.80 (0.50, 1.43) Kg, Z = -0.265, p = 0.791]. There was no significant difference in the levels of anxiety and depression between the two groups at discharge (45.64 ± 8.10 vs. 44.60 ± 8.24, t = 0.520, p = 0.604, 48.33 ± 8.46 vs. 47.50 ± 6.85, t = 0.418, p = 0.677). But the levels of anxiety and depression in the experimental group were lower than those in the control group after discharge (34.92 ± 7.38 vs. 39.03 ± 8.42, t = -2.183, p = 0.032, 37.86 ± 7.29 vs. 41.93 ± 7.13, t = -2.281, p = 0.025); The change of anxiety level and depression level of the experimental group were more than those of the control group [-10.00 (-11.25, -8.75) vs. -5.00 (-7.81, -3.75), Z = -5.277, p < 0.001; -10.00 (-12.50, -7.50) vs. -5.00 (-7.75, -3.44), Z = -4.596, p < 0.001]. The level of satisfaction regarding medical services, daily care, and psychological comfort was higher in the experimental group compared to the control group [3 (3, 3.25) vs. 2 (1, 2), Z = -5.931, p < 0.001; 3 (3, 4) vs. 3 (2, 3), Z = -2.286, p = 0.022; 2 (1, 3) vs. 1 (0.75, 2), Z = -2.081, p = 0.037]. Conclusion In the context of an aging society, telemedicine system can offer improved healthcare to older adults postoperative patients. This includes benefits such as reducing number of visits, saving medical expenditures, enhancing psychological comfort and daily care.
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Affiliation(s)
- Quan-Peng Wang
- General Surgery Department, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, China
| | - Wan-Ying Chang
- Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Man-Man Han
- General Surgery Department, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, China
| | - Ye-Xiao Hu
- General Surgery Department, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, China
| | - Sai-Sai Lin
- General Surgery Department, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, China
| | - Ye-Chun Gu
- General Surgery Department, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, China
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Chen S, Niu M, Ngai CSB. What is the next step of ICT development? The changes of ICT use in promoting elderly healthcare access: A systematic literature review. Heliyon 2024; 10:e25197. [PMID: 38371988 PMCID: PMC10873661 DOI: 10.1016/j.heliyon.2024.e25197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/20/2024] Open
Abstract
The objective of this study was to undertake a comprehensive review of the evidence published, with a focus on understanding the experiences of the elderly in leveraging Information and Communication Technology (ICT) for their healthcare needs during the COVID-19 period. In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this review scrutinized all peer-reviewed articles in English sourced from PubMed, PsycINFO, Scopus, and Web of Science, targeting studies that focused exclusively on the elderly within the COVID-19 timeframe, incorporated ICT-based technology as intervention, and were associated with the assessment of the process of employing ICT for healthcare needs. The search strategy identified 1752 records, of which 34 studies met the inclusion criteria. The functionality of ICT was categorized, types of barriers were identified, and the subsequent changes that the elderly population underwent were synthesized and deliberated. This review offers valuable insights into the elderly's subjective experiences in utilizing ICT, which may offer guidance for future ICT development geared towards enhancing the well-being of the elderly. Future research should incorporate the perspectives of relevant healthcare providers in evaluating the effectiveness of ICT usage. Further studies are also needed on underserved elderly groups to provide a more holistic view.
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Affiliation(s)
- Sihui Chen
- The Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hong Kong
| | - Mengyuan Niu
- Division of Public Policy, The Hong Kong University of Science and Technology, Hong Kong
| | - Cindy Sing Bik Ngai
- The Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hong Kong
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Pimentel CB, Dryden EM, Nearing KA, Kernan LM, Kennedy MA, Hung WW, Riley J, Moo LR. The role of Department of Veterans Affairs community-based outpatient clinics in enhancing rural access to geriatrics telemedicine specialty care. J Am Geriatr Soc 2024; 72:520-528. [PMID: 38032320 DOI: 10.1111/jgs.18703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/16/2023] [Accepted: 10/28/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Half of the 4.7 M veterans who reside in rural communities and rely on U.S. Department of Veterans Affairs (VA) health care are older (≥65). Their rurality presents unique challenges, including a shortage of clinicians skilled in geriatric medicine. Community-based outpatient clinics (CBOCs) help extend VA's geographic reach but are typically located in under-resourced settings. Telemedicine may increase access to care, but little is known about CBOCs' capacity to leverage telemedicine to meet older patients' needs. We identified organizational barriers and facilitators to the use of geriatric telemedicine specialty care from the perspective of rural clinicians and staff. METHODS From February-April 2020, we interviewed CBOC clinicians and staff (N = 50) from 13 rural CBOCs affiliated with four VA Geriatric Research Education and Clinical Centers. Semi-structured interviews addressed patient population characteristics; CBOC location, staffing, and in-house resources; use of VA specialty care services; and telemedicine use. We developed a codebook using an iterative process and Gale's Framework Method thematically organize and analyze data. RESULTS Respondents perceived that their CBOCs serve a predominantly older patient population. Four characteristics enabled CBOCs to offer geriatric telemedicine specialty care: partnerships with larger VA Medical Center teams; social worker/telehealth clinical technician knowledge of geriatrics and telehealth resources; periodic outreach/education from geriatric specialists; and routine use of other telehealth services. Barriers included: constraints on clinic space and unstable internet for telemedicine visits; staffing challenges leading to limited familiarity with telemedicine resources; and clinician and staff perceptions of older veterans' preference for in-person visits. CONCLUSIONS Telemedicine is an important modality to enhance access to care for an increasingly older and medically complex patient population. Although rural CBOCs provide a large portion of care to VA's growing geriatric population, staff are insufficiently trained in geriatrics, work in resource-poor settings, and are largely unaware of VA telemedicine programs designed to support them.
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Affiliation(s)
- Camilla B Pimentel
- New England Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts, USA
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA
- Department of Public Health, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Eileen M Dryden
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA
| | - Kathryn A Nearing
- Eastern Colorado VA Geriatric Research Education and Clinical Center, Aurora, Colorado, USA
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Laura M Kernan
- Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Meaghan A Kennedy
- New England Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts, USA
- Department of Family Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - William W Hung
- Bronx Geriatric Research Education and Clinical Center, James J. Peters VA Medical Center, Bronx, New York, USA
- Icahn School of Medicine, Mount Sinai, New York, USA
| | - Jessica Riley
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA
| | - Lauren R Moo
- New England Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs (VA) Bedford Healthcare System, Bedford, Massachusetts, USA
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, Massachusetts, USA
- Harvard Medicine School, Boston, Massachusetts, USA
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Roper A, Brooks D, Mitchell LK, Pachana NA, Au TR, Byrne GJ, O'Sullivan JD, Dissanayaka NN. Feasibility and Acceptability of a Videoconferencing CBT Intervention for Anxiety in People with Parkinson's Disease. Clin Gerontol 2024:1-16. [PMID: 38277135 DOI: 10.1080/07317115.2024.2306861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVES In people with Parkinson's disease (PwPD), non-motor symptoms such as anxiety are common and have negative impacts on their quality of life. There are currently few interventions that address anxiety in PwPD, and access to diagnosis and treatment is often limited for those living in rural areas. The aim of this study was to evaluate the feasibility and acceptability of a telehealth videoconferencing CBT intervention for anxiety in PwPD. METHODS A pre- and post-test feasibility study (N = 10) was conducted and evaluated utilizing the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance). RESULTS Lack of access to the internet and videoconferencing technology were identified as barriers to participation. Physical health issues also impacted recruitment and retention. Non-completers were significantly older and less likely to have a carer involved in the intervention. Clinician adoption of the intervention was low while participant acceptability of videoconferencing technology varied and required carer support. CONCLUSIONS Providing access to technology and support to overcome technological issues, as well as telehealth training for clinicians, are recommended in future studies to improve recruitment, retention, and implementation. CLINICAL IMPLICATIONS Identification of barriers and facilitators provides future studies with the knowledge to tailorize their program to better suit PwPD.
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Affiliation(s)
- Amy Roper
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Deborah Brooks
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | | | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Tiffany R Au
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Gerard J Byrne
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Mental Health Service, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - John D O'Sullivan
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Neurology, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - Nadeeka N Dissanayaka
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
- Department of Neurology, Royal Brisbane & Women's Hospital, Brisbane, Australia
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Jagielo AD, Chieng A, Tran C, Pirkl A, Cao-Nasalga A, Bragg A, Mirkin R, Prochaska JJ. Predictors of Patient Engagement in Telehealth-Delivered Tobacco Cessation Treatment during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:131. [PMID: 38397622 PMCID: PMC10887648 DOI: 10.3390/ijerph21020131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024]
Abstract
Smoking causes one in three cancer deaths and may worsen COVID-19 outcomes. Telehealth tobacco cessation treatment is offered as a covered benefit for patients at the Stanford Cancer Center. We examined predictors of engagement during the COVID-19 pandemic. Data were abstracted from the Electronic Health Record between 3/17/20 (start of pandemic shelter-in-place) and 9/20/22, including patient tobacco use, demographics, and engagement in cessation treatment. Importance of quitting tobacco was obtained for a subset (53%). During the first 2.5 years of the pandemic, 2595 patients were identified as recently using tobacco, and 1571 patients were contacted (61%). Of the 1313 patients still using tobacco (40% women, mean age 59, 66% White, 13% Hispanic), 448 (34%) enrolled in treatment. Patient engagement was greater in pandemic year 1 (42%) than in year 2 (28%) and year 3 (19%). Women (41%) engaged more than men (30%). Patients aged 36-45 (39%), 46-55 (43%), 56-65 (37%), and 66-75 (33%) engaged more than patients aged 18-35 (18%) and >75 (21%). Hispanic/Latinx patients (42%) engaged more than non-Hispanic/Latinx patients (33%). Engagement was not statistically significantly related to patient race. Perceived importance of quitting tobacco was significantly lower in pandemic year 1 than year 2 or 3. Nearly one in three cancer patients engaged in telehealth cessation treatment during the COVID-19 pandemic. Engagement was greater earlier in the pandemic, among women, Hispanic/Latinx individuals, and patients aged 36 to 75. Sheltering-in-place, rather than greater perceived risk, may have facilitated patient engagement in tobacco cessation treatment.
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Affiliation(s)
- Annemarie D. Jagielo
- PGSP-Stanford PsyD Consortium, Palo Alto University, Palo Alto, CA 94304, USA;
- Department of Psychiatry & Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Amy Chieng
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, USA;
| | - Cindy Tran
- Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA; (C.T.); (A.P.); (A.C.-N.); (A.B.); (R.M.)
| | - Amy Pirkl
- Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA; (C.T.); (A.P.); (A.C.-N.); (A.B.); (R.M.)
| | - Ann Cao-Nasalga
- Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA; (C.T.); (A.P.); (A.C.-N.); (A.B.); (R.M.)
| | - Ashley Bragg
- Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA; (C.T.); (A.P.); (A.C.-N.); (A.B.); (R.M.)
| | - Rachelle Mirkin
- Health Education, Engagement and Promotion, Stanford Healthcare, Menlo Park, CA 94025, USA; (C.T.); (A.P.); (A.C.-N.); (A.B.); (R.M.)
| | - Judith J. Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Palo Alto, CA 94304, USA;
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Martinson A, Johanson K, Wong S. Examining the Efficacy of a Brief Cognitive-Behavioral Therapy for Chronic Pain (Brief CBT-CP) Group Delivered via VA Video Connect (VVC) Among Older Adult Veterans. Clin Gerontol 2024; 47:122-135. [PMID: 36880605 DOI: 10.1080/07317115.2023.2186303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of a Brief CBT-CP Group delivered via VA Video Connect (VVC) among different age groups of Veterans with chronic noncancer pain being seen in primary care. A secondary aim was to evaluate participant characteristics of patients who completed vs. did not complete the group. METHODS Single-arm treatment study in which outcomes were evaluated by comparing self-reported symptom levels pre- and post-treatment. Dependent variables included generalized anxiety, quality of life, disability, physical health, and pain outcomes. RESULTS Following a 2 × 3 mixed-model ANCOVA, a main effect of time was found for all outcome variables, demonstrating significant improvements in disability rating, physical health, quality of life, generalized anxiety, and pain outcomes from pre- to post-treatment. There were no significant main effects for age group for any outcome variable, suggesting that patients of all ages reported improvements. CONCLUSIONS Accommodations and adaptations to telehealth treatment for older adults are proposed and discussed. CLINICAL IMPLICATIONS The Brief CBT-CP Group via VVC is an effective and accessible treatment for older adults with chronic noncancer pain who are being managed in the primary care setting. Certain Veterans are less likely to complete the Brief CBT-CP Group via VVC.
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Affiliation(s)
- Amber Martinson
- Mental Health, VA Salt Lake City Health Care System, Salt Lake, Utah, USA
- Department of Psychiatry, University of Utah, Salt Lake, Utah, USA
| | - Katherine Johanson
- Mental Health, VA Salt Lake City Health Care System, Salt Lake, Utah, USA
| | - Shan Wong
- Mental Health, West Palm Beach VA Medical Center, Riviera Beach, Florida, USA
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Manes MR, Burnfield JM, Boersma K, Peoples J, Davis A, Beneciuk JM, Bialosky J, Jordan K, Osborne R. Virtual Rehabilitation and COVID-19: Varied Adoption and Satisfaction Among Patients and Providers Participating in a Multi-Site Survey Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580231222334. [PMID: 38166514 PMCID: PMC10768633 DOI: 10.1177/00469580231222334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 01/04/2024]
Abstract
The COVID-19 pandemic compelled rapid healthcare adaptations including increased use of telehealth (TH) and virtual care (VC) to provide rehabilitation services. This multi-site cross-sectional survey study examined rehabilitation patients' and providers' experiences with service delivery during the COVID-19 pandemic, including the use of TH/VC. Patients and providers who received or provided rehabilitation services were recruited from 1 of 3 large, post-acute rehabilitation systems located in the Southeastern and Midwestern United States during the COVID-19 pandemic. Participants rated personal satisfaction with rehabilitation services received or rendered during the pandemic and willingness to use TH/VC in the future. Questions also addressed accessibility, ease of use, and perceived barriers to TH/VC use. The adoption and personal satisfaction of TH/VC for rehabilitation care varied between patients and providers. Patients reported higher levels of satisfaction compared to providers (P < .001). Patients who did not use TH/VC had higher satisfaction than those who did (P < .05). Patients were less willing than providers to use TH/VC (P < .001). Those who used TH/VC prior to the pandemic were more willing to use post-pandemic (P < .001). Patients reported TH/VC was useful in increasing health services accessibility yet were neutral as to the ability of TH/VC to improve outcomes. Patients and providers agreed that TH/VC was easy to learn and use. Medical providers found TH/VC more useful than therapy providers. Participants who used TH/VC during the pandemic are more willing to use the service again in the future. Understanding patient and provider preferences and perspectives is key to the continued use of TH/VC in rehabilitation care.
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Affiliation(s)
- Mindi R. Manes
- Brooks Rehabilitation, Brooks Center for Research Analytics and Outcomes, Jacksonville, FL, USA
| | - Judith M. Burnfield
- Madonna Rehabilitation Hospitals, Institute for Rehabilitation Science and Engineering, Lincoln, NE, USA
| | - Kelsey Boersma
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Jason Peoples
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Anita Davis
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
| | - Jason M. Beneciuk
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
- University of Florida, Department of Physical Therapy, Gainesville, FL, USA
| | - Joel Bialosky
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
- University of Florida, Department of Physical Therapy, Gainesville, FL, USA
| | - Katelyn Jordan
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
| | - Raine Osborne
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
- University of North Florida, Department of Physical Therapy, Jacksonville, FL, USA
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15
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Choi SL, Hites L, Bolland AC, Lee J, Payne-Foster P, Bissell K. Telehealth uptake among middle-aged and older Americans during COVID-19: chronic conditions, social media communication, and race/ethnicity. Aging Ment Health 2024; 28:160-168. [PMID: 36450359 DOI: 10.1080/13607863.2022.2149696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVES This study investigated whether and to what extent constructs of the protection motivation theory of health (PMT)-threat appraisal (perceived vulnerability/severity) and coping appraisal (response efficacy and self-efficacy)-are related to telehealth engagement during the COVID-19 pandemic, and how these associations differ by race/ethnicity among middle-aged and older Americans. METHODS Data were from the 2020 Health and Retirement Study. Multivariable ordinary least-squares regression analyses were computed adjusting for health and sociodemographic factors. RESULTS Some PMT constructs are useful in understanding telehealth uptake. Perceived vulnerability/severity, particularly comorbidity (b = 0.13, 95% confidence interval (CI) [0.11, 0.15], p < 0.001), and response efficacy, particularly participation in communication via social media (b = 0.24, 95% CI [0.21, 0.27], p < 0.001), were significantly and positively associated with higher telehealth uptake during the COVID-19 pandemic among middle-aged and older Americans. Non-Hispanic Black adults were more likely to engage in telehealth during the pandemic than their non-Hispanic White counterparts (b = 0.20, 95% CI [0.12, 0.28], p < 0.001). Multiple moderation analyses revealed the significant association between comorbidity and telehealth uptake was similar across racial/ethnic groups, whereas the significant association between social media communication and telehealth uptake varied by race/ethnicity. Specifically, the association was significantly less pronounced for Hispanic adults (b = -0.11, 95% CI [-0.19, -0.04], p < 0.01) and non-Hispanic Asian/other races adults (b = -0.13, 95% CI [-0.26, -0.01], p < 0.05) than it was for their non-Hispanic White counterparts. CONCLUSION Results suggest the potential of using social media and telehealth to narrow health disparities, particularly serving as a bridge for members of underserved communities to telehealth uptake.
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Affiliation(s)
- Shinae L Choi
- Department of Consumer Sciences, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL, USA
- Center for Innovation in Social Science, College of Arts and Sciences, Boston University, Boston, MA, USA
| | - Lisle Hites
- Department of Community Medicine and Population Health, College of Community Health Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Anneliese C Bolland
- Department of Communication Studies, College of Communication and Information Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Jiyoung Lee
- Department of Journalism and Creative Media, College of Communication and Information Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Pamela Payne-Foster
- Department of Community Medicine and Population Health, College of Community Health Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Kimberly Bissell
- Department of Journalism and Creative Media, College of Communication and Information Sciences, The University of Alabama, Tuscaloosa, AL, USA
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Loewenthal J, Berning MJ, Wayne PM, Eckstrom E, Orkaby AR. Holistic frailty prevention: The promise of movement-based mind-body therapies. Aging Cell 2024; 23:e13986. [PMID: 37698149 PMCID: PMC10776124 DOI: 10.1111/acel.13986] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023] Open
Abstract
Aging is characterized by fundamental cellular and molecular hallmarks that result in physiologic decline of most body systems. This may culminate in frailty, a state of decreased reserve. Because frailty is a state of multisystem dysregulation, multimodal interventions may be necessary to mitigate and prevent progression rather than interventions targeting a single system. Movement-based mind-body therapies, such as tai chi and yoga, are promising multimodal strategies for frailty prevention and treatment given their inherent multicomponent nature. In this review, we summarize the links between hallmarks of aging and frailty and how tai chi and yoga may impact these hallmarks. We review trial evidence for the impact of tai chi and yoga on frailty in older populations and discuss opportunities for future research.
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Affiliation(s)
- Julia Loewenthal
- Division of Aging, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | | | - Peter M. Wayne
- Division of Preventive MedicineBrigham and Women's HospitalBostonMassachusettsUSA
- Osher Center for Integrative Medicine, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Elizabeth Eckstrom
- Division of General Internal Medicine & GeriatricsOregon Health & Science UniversityPortlandOregonUSA
| | - Ariela R. Orkaby
- Division of Aging, Brigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- New England Geriatric Research, Education, and Clinical Center (GRECC)VA Boston Healthcare SystemBostonMassachusettsUSA
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El-Sherif DM, Ahmed AA, Sharif AF, Elzarif MT, Abouzid M. Greenway of Digital Health Technology During COVID-19 Crisis: Bibliometric Analysis, Challenges, and Future Perspective. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1458:315-334. [PMID: 39102206 DOI: 10.1007/978-3-031-61943-4_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Digital health has transformed the healthcare landscape by leveraging technology to improve patient outcomes and access to medical services. The COVID-19 pandemic has highlighted the urgent need for digital healthcare solutions that can mitigate the impact of the outbreak while ensuring patient safety. In this chapter, we delve into how digital health technologies such as telemedicine, mobile apps, and wearable devices can provide personalized care, reduce healthcare provider burden, and lower healthcare costs. We also explore the creation of a greenway of digital healthcare that safeguards patient confidentiality, enables efficient communication, and ensures cost-effective payment systems. This chapter showcases the potential of digital health to revolutionize healthcare delivery while ensuring patient well-being and medical staff satisfaction.
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Affiliation(s)
- Dina M El-Sherif
- Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province, School of Food Science and Technology, Jiangnan University, Wuxi, 214122, China.
- National Institute of Oceanography and Fisheries (NIOF), Cairo, Egypt.
| | - Alhassan Ali Ahmed
- Department of Bioinformatics and Computational Biology, Poznan University of Medical Sciences, 60-781, Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, 60-812, Poznan, Poland
| | - Asmaa Fady Sharif
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt
- Clinical Medical Sciences Department, College of Medicine, Dar Al-Uloom University, Riyadh, Saudi Arabia
| | | | - Mohamed Abouzid
- Doctoral School, Poznan University of Medical Sciences, 60-812, Poznan, Poland
- Department of Physical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3 St., 60-806, Poznan, Poland
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Gately ME, Trudeau SA. An Online Learning Experience Simulating Video Telehealth with Older Adults: Student Perceptions. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2023; 9:154-163. [PMID: 38586236 PMCID: PMC10996448 DOI: 10.1007/s41347-023-00363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 04/09/2024]
Abstract
Older adults are an underserved population with a broad-spectrum of care needs due to multi-morbidity, including increasing rates of mental health conditions. Though a prime target for tele-behavioral health due to access barriers, older adults face a persistent digital divide that necessitates clinician training and education to ensure interprofessional tele-behavioral health is tailored to their needs. This paper presents findings from a simulation learning program designed to teach students about the role of video telehealth with populations with diverse needs. Occupational therapy (OT) students enrolled in a Master's program between 2017 and 2018 conducted a simulated video telehealth session geared for an older adult. Sessions were recorded and annotated by students, who then provided feedback on their experience of the simulation via reflective essays (N = 27). Essays were analyzed using conventional content analysis with themes revealing the benefits of simulation in providing students with an opportunity to experience the often unpredictable nature of video telehealth. Themes also revealed perceived limitations of video and the negative impact of age-related conditions and age itself on older adults' ability to engage in video, reflecting ageist stereotyping and bias as potential barriers to novice practitioners' integration of video telehealth with older adults. Simulation provides students an opportunity to engage in active learning and problem-solving in the moment, fostering students' development of clinical reasoning while promoting reflective practice. Findings reveal the importance of supporting students' recognition of biased attitudes to ensure equitable application of tele-behavioral health care, especially to populations with complex needs.
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Affiliation(s)
- Megan E. Gately
- Geriatric Research Education and Clinical Center, VA; Bedford Health Care System, Bedford, MA, USA
- Department of Occupational Therapy, Tufts University, Medford, MA, USA
| | - Scott A. Trudeau
- Geriatric Research Education and Clinical Center, VA; Bedford Health Care System, Bedford, MA, USA
- Department of Occupational Therapy, Tufts University, Medford, MA, USA
- American Occupational Therapy Association, Bethesda, MD, USA
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Neumann AV, Gonzalez A, Walter LC, Rivera J. Improving older adults' telehealth through a novel community-academic partnership: Preliminary data. J Am Geriatr Soc 2023; 71:3886-3895. [PMID: 37607098 DOI: 10.1111/jgs.18556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/28/2023] [Accepted: 07/13/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND The COVID-19 pandemic increased the use of telehealth, which posed unique challenges for the provision of care to older adults who face numerous barriers to accessing and using technology. To improve older adults' online health-related abilities, the UCSF Geriatrics Workforce Enhancement Program (UCSF-GWEP) partnered with Little Brothers Friends of the Elderly-San Francisco (LBFE-SF) to develop a model telehealth training intervention. METHODS LBFE-SF recruited older adults from their members with wi-fi and paired each one with a new device and volunteer trainer to cover seven lessons and four key tasks (emailing providers, video visits, accessing health information, and using patient portals). Older adults completed surveys to self-assess their skill level after training, and their confidence before, immediately after, and 3 months post training. A subset of trainees were also interviewed about their program goals and experiences. UCSF-GWEP conducted statistical analyses of survey data, and coded interview transcripts to identify aspects of the model supportive to learning and success. RESULTS Of 43 participants, 31 completed training. Their median age was 75; 48% were non-white; 45% had no more than a high school education; and 63% reported yearly income below U.S. $20,000. Three months after completing the program, more than 50% of trainees reported that they needed little or no help performing all four key tasks, and confidence with video visits, online searches, and patient portals showed significant improvement. Additionally, in interviews participants reported improved health, social benefits, and explained that learning was facilitated by self-pacing, repetition, and longitudinal support from volunteer trainers. CONCLUSIONS Older adults with various barriers to learning technology showed online independence and increased confidence with some telehealth tasks after a novel training intervention. Key characteristics of the model included a tablet device, one-on-one longitudinal support from volunteers, comprehensive learning materials, and community-academic partnership.
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Affiliation(s)
- Alicia V Neumann
- School of Medicine, Division of Geriatrics, University of California San Francisco, San Francisco, California, USA
| | - Andrea Gonzalez
- School of Medicine, Division of Geriatrics, University of California San Francisco, San Francisco, California, USA
| | - Louise C Walter
- School of Medicine, Division of Geriatrics, University of California San Francisco, San Francisco, California, USA
- San Francisco VA Medical Center, San Francisco, California, USA
| | - Josette Rivera
- School of Medicine, Division of Geriatrics, University of California San Francisco, San Francisco, California, USA
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Choi SL, Carr D, Namkung EH. Telehealth Use Among Older Adults With Sensory, Cognitive, and Physical Impairments: A Substitute or Supplement to Traditional Care? J Gerontol B Psychol Sci Soc Sci 2023; 78:1735-1746. [PMID: 37422799 DOI: 10.1093/geronb/gbad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVES Telehealth use flourished during the COVID-19 pandemic, as older patients faced obstacles to seeking in-person care. Heavy reliance on telehealth may continue postpandemic, due to increased Medicare investments in its use. However, it is unclear if older adults with disabilities face obstacles to effective telehealth use. We evaluate (a) how sensory, physical, and cognitive impairments affect older adults' use of telehealth only, traditional in-person care only, neither, or both (i.e., combined care); and (b) whether these patterns differ on the basis of socioeconomic and social resources that may facilitate telehealth use. METHOD Data are from the Self-Administered Questionnaire in the 2020 wave of the Health and Retirement Study (n = 4,453). We estimated multinomial logistic regression models to evaluate associations between impairments and health care service use and tested 2-way interaction terms to evaluate moderation effects. RESULTS Persons without impairments were most likely to use combined care, considered the optimal form of care. Persons with vision or cognitive impairment were more likely to use telehealth or traditional care only, whereas persons with 3 or more physical limitations were least likely to use telehealth alone, relative to combined care. Patterns did not differ significantly on the basis of any of the potential moderators. DISCUSSION We discuss implications for health care policy and practice, in light of reimbursement changes proposed by the Centers for Medicare and Medicaid Services for telehealth services. These proposals include the elimination of voice-only services which may be particularly beneficial to vision-impaired older adults.
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Affiliation(s)
- Shinae L Choi
- Department of Consumer Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Deborah Carr
- Department of Sociology and Center for Innovation in Social Science, Boston University, Boston, Massachusetts, USA
| | - Eun Ha Namkung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
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21
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Hunsbedt Fjellså HM, Husebø AML, Braut H, Mikkelsen A, Storm M. Older Adults' Experiences With Participation and eHealth in Care Coordination: Qualitative Interview Study in a Primary Care Setting. J Particip Med 2023; 15:e47550. [PMID: 37782538 PMCID: PMC10580142 DOI: 10.2196/47550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/06/2023] [Accepted: 07/27/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Owing to the demographic changes in the elderly population worldwide, delivering coordinated care at home to multimorbid older adults is of great importance. Older adults living with multiple chronic conditions need information to manage and coordinate their care. eHealth can be effective for gaining sufficient information, communicating, and self-managing chronic conditions. However, incorporating older adults' health preferences and ensuring active involvement remain challenging. More knowledge is needed to ensure successful participation and eHealth use in care coordination. OBJECTIVE This study aimed to explore multimorbid older adults' experiences with participation and eHealth in care coordination with general practitioners (GPs) and district nurses (DNs). METHODS The study had a qualitative explorative approach. Data collection included semistructured interviews with 20 older adults with multimorbidity receiving primary care services from their GPs and DNs. The participants were included by their GPs or nurses at a local intermunicipal acute inpatient care unit. The data analysis was guided by systematic text condensation. RESULTS We identified 2 categories: (1) older adults in charge of and using eHealth in care coordination, and (2) older adults with a loss of control in care coordination. The first category describes how communication with GPs and DNs can facilitate participation, the importance of managing own medication, and how eHealth can support older adults' information needs. The second category focuses on older adults who depend on guidance and help from their GPs and DNs to manage their health, describing how a lack of capacity and system support to be involved makes these adults lose control of their care coordination. CONCLUSIONS Being in charge of care coordination is important for older multimorbid adults. The results show that older adults are willing to use eHealth to be informed and to seek information, which ensures high levels of participation in care coordination. Future research should investigate how older adults can be involved in electronic information sharing with health care providers.
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Affiliation(s)
| | - Anne Marie Lunde Husebø
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Research Group of Nursing and Health Sciences, Stavanger University Hospital, Stavanger, Norway
| | - Harald Braut
- Department of Innovation, Leadership, and Marketing, Business School, University of Stavanger, Stavanger, Norway
| | - Aslaug Mikkelsen
- Department of Innovation, Leadership, and Marketing, Business School, University of Stavanger, Stavanger, Norway
- Stavanger University Hospital, Stavanger, Norway
| | - Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
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22
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Loizos M, Baim-Lance A, Ornstein KA, Lubetsky S, Salas-Belkin L, Chavez S, Zhang M, DeCherrie LV, Gliatto PM. If You Give Them Away, It Still May Not Work: Challenges to Video Telehealth Device Use Among the Urban Homebound. J Appl Gerontol 2023; 42:1896-1902. [PMID: 37070328 PMCID: PMC10524114 DOI: 10.1177/07334648231170144] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
The growing homebound population may particularly benefit from video telehealth. However, some patients do not have the ability or resources to successfully use this modality. This report presents the experience of a large urban home-based primary care program disseminating cellular-enabled tablets with basic instruction to a subset of its patients who would not otherwise have had the ability to engage in video telehealth. Program goals included: increasing the number of patients able to engage in video encounters and leveraging technology to help achieve greater equity. While 123 homebound patients received devices for telehealth, only one-third successfully utilized them. We identified multiple barriers to telehealth utilization beyond physical access to a device, including a lack of skill. Efforts to increase video encounters among patient groups who are less experienced with technology cannot simply rely on device provision or basic instruction but must include reinforced learning strategies combined with ongoing technical assistance.
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Affiliation(s)
- Maria Loizos
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Abigail Baim-Lance
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | | | - Sara Lubetsky
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Silvia Chavez
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Meng Zhang
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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23
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Sabo K, Wong J, Lopez RP. Loneliness and Unmet Needs of Older Adults Living in Publicly Supported Housing. Res Gerontol Nurs 2023; 16:217-223. [PMID: 37335895 DOI: 10.3928/19404921-20230606-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Guided by the RE-AIM framework, the current study sought to examine the relationship between perceived needs of older adults living in publicly supported housing and loneliness. Participants were males and females aged 70 to 83 years who identified as White or Chinese. Using the Camberwell Assessment of Need Short Appraisal Schedule and UCLA Loneliness Scale, the relationship between residents' needs and loneliness was assessed to guide the development of interventions. Results revealed residents self-reported 54% of their needs were met and rated their loneliness at a score of 36.5 (moderate level). Furthermore, there was a medium positive correlation between unmet needs and loneliness whereby high unmet needs were associated with higher loneliness scores. Findings suggest that these older adults living in publicly supported housing are vulnerable to the negative consequences of loneliness. Implementing equitable and inclusive interventions to address the impact of loneliness in the context of social determinants of health is warranted. [Research in Gerontological Nursing, 16(5), 217-223.].
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24
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Ricks D, Brannon GE. "It's real. It's a thing:" Mental health counselors' listening exhaustion during COVID-19. QUALITATIVE RESEARCH IN MEDICINE & HEALTHCARE 2023; 7:11261. [PMID: 37692451 PMCID: PMC10483483 DOI: 10.4081/qrmh.2023.11261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 05/24/2023] [Indexed: 09/12/2023] Open
Abstract
Mental health counselors regularly use active listening skills to be present with each client; however, active listening may cause burnout due to high emotional labor, inadequate staffing, excessive workload, and many other issues, each of which contributes to career exits. COVID-19 exacerbated all of these factors, and-adding to already stressful conditions-most mental health professionals were forced to conduct therapy sessions via telehealth. For this study, twenty licensed mental health counselors at various stages of their careers were interviewed during the height of the pandemic to understand their experiences with the technology and other factors related to their workload during that time. Thematic qualitative analysis was used to explore effects of active listening-including requisite adjustments made for virtual therapy sessions-on counselors' emotional exhaustion and burnout levels. Results show how back-to-back, daily therapy sessions increased listening exhaustion levels and that counselors experienced both long-term and short-term listening exhaustion when utilizing telehealth due to lack of nonverbal cues and other related factors pertaining to online delivery. Implications for counselors, social workers, and other mental health professionals are discussed.
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Affiliation(s)
| | - Grace Ellen Brannon
- Department of Communication, College of Liberal Arts, University of Texas at Arlington, Arlington, TX, USA
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25
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Taylor S, Souza S, Little L, Odiaga J. Enhancing Telehealth Competency: Development and Evaluation of Education Modules for Older Adults. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:478-486. [PMID: 36757088 PMCID: PMC10333962 DOI: 10.1177/15394492231153115] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Despite a rapid increase in telehealth utilization, older adults disproportionately experience disparities to services. To promote telehealth accessibility among this population, there is a need for specific training to increase user perceived competency. For this sequential mixed-methods study, we designed telehealth education modules through consultation with older adults. We then evaluated their impact on older adults' perceived telehealth competency. To solicit feedback on preliminary modules, we administered a semi-structured interview to a sample (n = 5) of older adults; then, we assessed the revised modules' impact on perceived competency among a sample of older adults (n = 53). Participants critiqued the preliminary training materials as having limited information on telehealth privacy and advised increasing the accessibility of design. Those that completed the revised modules demonstrated significant improvements in perceived telehealth competence. Telehealth training modules may be a promising method to increase perceived telehealth competency among older adults.
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Blanco-Aparicio M, Almonacid C, Calvín Lamas M, Delgado J, Gandolfo-Cano M, López-Carrasco V, Vega JM, Díaz-Pérez D, Villamañán E. [Telemedicine and severe asthma in our environment: Views on the experience of professionals and suggestions to make it a reality]. OPEN RESPIRATORY ARCHIVES 2023; 5:100239. [PMID: 37810420 PMCID: PMC10556775 DOI: 10.1016/j.opresp.2023.100239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/02/2023] [Indexed: 03/19/2023] Open
Abstract
This paper aims to examine the recent experience in telemedicine (TM) management of patients with severe asthma (SA). A committee of health professionals involved in asthma management (pulmonology, allergology, respiratory nursing, and hospital pharmacy) held discussion meetings on the practical experience of TM for the management of SA and the means available complemented with a bibliographic search to know the current status of TM in SA. The main barriers detected for the implementation of TM in SA have been the lack of technological training, the lack of registration of TM in the clinical history, the care overload, or the connectivity problems at the administration level. The practical solutions are provided such as the selection of the patient suitable for TM, the registration of TM in the medical record, its inclusion in the care objectives or the increase of funding for systems. Moreover, the main App and Webapp for use by patients are provided, and the portable equipment for remote functional respiratory tests. In conclusion, it is necessary that the teleconsultation has the same entity as the face-to-face visit with a schedule in the appointment's agenda and a structure of both the medical interview and the tests to be performed in each consultation. Additionally, should be promoted the implementation of a video call system, tools that allow the monitoring of both therapeutic adherence and inhalation technique, as well as the patient's lung function.
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Affiliation(s)
| | - Carlos Almonacid
- Servicio de Neumología, Hospital Universitario de Toledo, Toledo, España
| | - Marta Calvín Lamas
- Servicio de Farmacia, Complexo Hospitalario Universitario A Coruña, A Coruña, España
| | - Julio Delgado
- Unidad de Gestión Clínica Alergología, Hospital Virgen Macarena, Sevilla, España
| | - Mar Gandolfo-Cano
- Servicio de Alergología, Hospital Universitario de Fuenlabrada, Madrid, España
| | | | - José María Vega
- Servicio de Alergología, Hospital Regional Universitario de Málaga, Málaga, España
| | - David Díaz-Pérez
- Servicio de Neumología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - Elena Villamañán
- Servicio de Farmacia, Hospital Universitario La Paz, Madrid, España
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Ryan M, Gibbs LM, Sehgal SR. Health Support for At-Risk Older Adults during COVID-19. Healthcare (Basel) 2023; 11:1856. [PMID: 37444693 DOI: 10.3390/healthcare11131856] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Older adults are highly susceptible to COVID-19 infection and at the highest risk for severe disease and death. Yet, older adults lacked access to accurate and easy-to-use COVID-19 information and support early in the pandemic. This prospective, experimental cohort study sought to examine whether older adults could be engaged during the pandemic through a community partner and if a low-touch intervention, designed with health literacy best practices, could positively impact COVID-19 knowledge, mitigation behaviors, telehealth/doctor visits, exercise, and loneliness. A senior resource kit was distributed to older adults sheltering at home through food assistance program agents from October 2020 to February 2021; the kit was developed using health literacy best practices. Simple random assignment was used to divide program participants into treatment and control groups. Both groups received senior kits, but the treatment group also received telephonic health coaching. The primary outcome was COVID-19 knowledge and mitigation behaviors as derived from self-reported surveys at baseline and after four months. Secondary outcomes included a telehealth or doctor visit, exercise frequency, and a loneliness score (3-Item Loneliness Scale). Health literacy was assessed using the BRIEF screening tool. Ninety-eight older adults consented to participate in the study and 87 completed the study (88.7% completion rate). Participants had moderate clinical risk, one-third preferred the Spanish language, and 52% were categorized as having inadequate or marginal health literacy. Significant changes were found for increasing COVID-19 mitigation behaviors and the frequency of exercise across the cohort, but not for COVID-19 knowledge, telehealth visits, or decreasing loneliness. Conclusions: Partnering with a trusted entity in the community is a feasible and important strategy to reach older adults during a lockdown and provide them with easy-to-read health information and resources. If the time horizon had been longer, improvements in other outcome variables may have been achieved.
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Affiliation(s)
- Marian Ryan
- Institute for Healthcare Advancement, La Habra, CA 90631, USA
| | - Lisa M Gibbs
- Division of Geriatric Medicine and Gerontology, Department of Family Medicine, University of California, Irvine (UCI), Irvine, CA 92697, USA
| | - Sonia R Sehgal
- Division of Geriatric Medicine and Gerontology, Department of Family Medicine, University of California, Irvine (UCI), Irvine, CA 92697, USA
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28
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Louissaint J, Wilder JM, Tapper EB, Rodriguez JA, Rosenblatt R, Verna EC. Confronting Disparities in Telehepatology Research. Clin Gastroenterol Hepatol 2023; 21:1385-1389. [PMID: 36563767 DOI: 10.1016/j.cgh.2022.11.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/09/2022] [Accepted: 11/17/2022] [Indexed: 12/25/2022]
Affiliation(s)
- Jeremy Louissaint
- Center for Liver Disease and Transplantation, Columbia University, New York, New York
| | - Julius M Wilder
- Division of Gastroenterology, Duke University, Durham, North Carolina; Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Elliot B Tapper
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan
| | - Jorge A Rodriguez
- Division of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Russell Rosenblatt
- Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, New York
| | - Elizabeth C Verna
- Center for Liver Disease and Transplantation, Columbia University, New York, New York
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29
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Haimi M. The tragic paradoxical effect of telemedicine on healthcare disparities- a time for redemption: a narrative review. BMC Med Inform Decis Mak 2023; 23:95. [PMID: 37193960 DOI: 10.1186/s12911-023-02194-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 05/09/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Telemedicine has become more convenient and advantageous due to the rapid development of the internet and telecommunications. A growing number of patients are turning to telemedicine for health consultations and health-related information. Telemedicine can increase access to medical care by removing geographical and other barriers. In most nations, the COVID-19 pandemic imposed social isolation. This has accelerated the transition to telemedicine, which has become the most commonly utilized method of outpatient care in many places. Telehealth can assist resolve gaps in access to healthcare services and health outcomes, in addition to its primary function of boosting accessibility to remote health services. However, as the benefits of telemedicine become more apparent, so do the limitations of serving vulnerable groups. Some populations may lack digital literacy or internet access. Homeless persons, the elderly, and people with inadequate language skills are also affected. In such circumstances, telemedicine has the potential to exacerbate health inequities. AIM AND METHODS In this narrative review (using the PubMed and Google scholar database), the different benefits and drawbacks of telemedicine are discussed, both globally and in Israel, with particular focus paid to special populations and to the telehealth usage during the Covid-19 period. FINDINGS The contradiction and paradox of using telemedicine to address health inequities yet sometimes making them worse is highlighted. The effectiveness of telemedicine in bridging access to healthcare inequities is explored along with a number of potential solutions. CONCLUSIONS Policy makers should identify barriers among special populations to using telemedicine. They should initiate interventions to overcome these barriers, while adapting them to the needs of these groups.
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Affiliation(s)
- Motti Haimi
- Clalit Health Services, Tel Aviv, Israel.
- Rappaport Faculty of Medicine, Technion, Haifa, Israel.
- School of Public Health, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.
- Health Disparities Working Group, International Society for Telemedicine and E-Health (ISfTeH), Basel, Switzerland.
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30
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Cunha AS, Pedro AR, Cordeiro JV. Facilitators and barriers to access hospital medical specialty telemedicine consultations during the COVID-19 pandemic: Systematic Review. J Med Internet Res 2023. [PMID: 37262124 DOI: 10.2196/44188] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND COVID-19 pandemic accelerated the digital transition in healthcare, which required a rapid adaptation of stakeholders. Telemedicine has emerged as an ideal tool to ensure continuity of care by allowing remote access to specialized medical services. However, its rapid implementation has exacerbated disparities in healthcare access, especially for the most vulnerable populations. OBJECTIVE To characterize the determinants factors (facilitators and barriers) of access to hospital medical specialty telemedicine consultations during the COVID-19 pandemic; to identify the main opportunities and challenges (technological, ethical, legal and/or social) generated by the use of telemedicine in the context of the COVID-19 pandemic. METHODS A systematic review was conducted according to PRISMA guidelines. Four databases (Scopus, Web of Science, PubMed and Cochrane COVID-19 Study Register) were searched for empirical studies published between January 3rd, 2020, and December 31st, 2021, using established criteria. The protocol of this review was registered and published in PROSPERO (CRD42022302825). A methodological quality assessment was performed, and results were integrated into a thematic synthesis. The identification of main opportunities and challenges was done by interpreting and aggregating the thematic synthesis results. RESULTS Of the 106 studies identified, 9 met the inclusion criteria and the intended quality characteristics. All studies were originally from the United States of America (USA). The following facilitating factors of telemedicine use were identified: health insurance coverage; prevention of SARS-CoV-2 infection; access to Internet services; access to technological devices; better management of work-life balance; and savings in travel costs. We identified the following barriers to telemedicine use: lack of access to Internet services; lack of access to technological devices; racial and ethnic disparities; low digital literacy; low income; age; language barriers; health insurance coverage; concerns about data privacy and confidentiality; geographic disparities; and need for complementary diagnostic tests or for the delivery of test results. CONCLUSIONS The facilitating factors and barriers identified in this systematic review present different opportunities and challenges, including those of technological nature (access to technological devices and internet services, level of digital literacy), sociocultural and demographic nature (ethnic and racial disparities, geographical disparities, language barriers, age), socioeconomic nature (income level and health insurance coverage), and ethical and legal nature (data privacy and confidentiality). To expand telemedicine access to hospital-based specialty medical consultations and provide high-quality care to all, including the most vulnerable communities, the challenges identified must be thoroughly researched and addressed with informed and dedicated responses. CLINICALTRIAL
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Affiliation(s)
- Ana Soraia Cunha
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal, Avenida Padre Cruz, Lisbon, PT
| | - Ana Rita Pedro
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal, Lisbon, PT
| | - João Valente Cordeiro
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal, Lisbon, PT
- Interdisciplinary Centre of Social Sciences (CICS.NOVA), Universidade NOVA de Lisboa, Lisbon, Portugal, Lisbon, PT
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Dryden EM, Kennedy MA, Conti J, Boudreau JH, Anwar CP, Nearing K, Pimentel CB, Hung WW, Moo LR. Perceived benefits of geriatric specialty telemedicine among rural patients and caregivers. Health Serv Res 2023; 58 Suppl 1:26-35. [PMID: 36054487 PMCID: PMC9843069 DOI: 10.1111/1475-6773.14055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Explore the perceived benefits of a Veterans Health Administration (VHA) geriatric specialty telemedicine service (GRECC Connect) among rural, older patients and caregivers to contribute to an assessment of its quality and value. DATA SOURCES In Spring 2021, we interviewed a geographically diverse sample of rural, older patients and their caregivers who participated in GRECC Connect telemedicine visits. STUDY DESIGN A cross-sectional qualitative study focused on patient and caregiver experiences with telemedicine, including perceived benefits and challenges. DATA COLLECTION We conducted 30 semi-structured qualitative interviews with rural, older (≥65) patients enrolled in the VHA and their caregivers via videoconference or phone. Interviews were recorded, transcribed, and analyzed using a rapid qualitative analysis approach. PRINCIPAL FINDINGS Participants described geriatric specialty telemedicine visits focused on cognitive assessments, tailored physical therapy, medication management, education on disease progression, support for managing multiple comorbidities, and suggestions to improve physical functioning. Participants reported that, in addition to prescribing medications and ordering tests, clinicians expedited referrals, coordinated care, and listened to and validated both patient and caregiver concerns. Perceived benefits included improved patient health; increased patient and caregiver understanding and confidence around symptom management; and greater feelings of empowerment, hopefulness, and support. Challenges included difficulty accessing some recommended programs and services, uncertainty related to instructions or follow-up, and not receiving as much information or treatment as desired. The content of visits was well aligned with the domains of the Age-Friendly Health Systems and Geriatric 5Ms frameworks (Medication, Mentation, Mobility, what Matters most, and Multi-complexity). CONCLUSIONS Alignment of patient and caregiver experiences with widely-used models of comprehensive geriatric care indicates that high-quality geriatric care can be provided through virtual modalities. Additional work is needed to develop strategies to address challenges and optimize and expand access to geriatric specialty telemedicine.
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Affiliation(s)
- Eileen M. Dryden
- Center for Healthcare Organization and Implementation ResearchDepartment of Veterans Affairs (VA) Bedford Healthcare SystemBedfordMassachusettsUSA
| | - Meaghan A. Kennedy
- New England Geriatric Research, Education, and Clinical CenterVA Bedford Healthcare SystemBedfordMassachusettsUSA,Department of Family MedicineBoston University School of MedicineBostonMassachusettsUSA
| | - Jennifer Conti
- Center for Healthcare Organization and Implementation ResearchDepartment of Veterans Affairs (VA) Bedford Healthcare SystemBedfordMassachusettsUSA
| | - Jacqueline H. Boudreau
- Center for Healthcare Organization and Implementation ResearchDepartment of Veterans Affairs (VA) Bedford Healthcare SystemBedfordMassachusettsUSA
| | - Chitra P. Anwar
- Center for Healthcare Organization and Implementation ResearchDepartment of Veterans Affairs (VA) Bedford Healthcare SystemBedfordMassachusettsUSA
| | - Kathryn Nearing
- Eastern Colorado VA Geriatric Research Education and Clinical CenterAuroraColoradoUSA,Division of Geriatric MedicineUniversity of Colorado Anschutz Medical CampusAuroraColoradoUSA
| | - Camilla B. Pimentel
- Center for Healthcare Organization and Implementation ResearchDepartment of Veterans Affairs (VA) Bedford Healthcare SystemBedfordMassachusettsUSA,New England Geriatric Research, Education, and Clinical CenterVA Bedford Healthcare SystemBedfordMassachusettsUSA,Department of Public Health, Zuckerberg College of Health SciencesUniversity of Massachusetts LowellLowellMassachusettsUSA
| | - William W. Hung
- Bronx Geriatric Research Education and Clinical CenterJames J. Peters VA Medical CenterBronxNew YorkUSA,Department of Geriatrics and Palliative MedicineIcahn School of MedicineNew York CityNew YorkUSA
| | - Lauren R. Moo
- New England Geriatric Research, Education, and Clinical CenterVA Bedford Healthcare SystemBedfordMassachusettsUSA,Department of NeurologyHarvard Medical SchoolBostonMassachusettsUSA
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Connolly SL, Charness ME, Miller CJ. To increase patient use of video telehealth, look to clinicians. Health Serv Res 2023; 58:5-8. [PMID: 35904201 PMCID: PMC9836957 DOI: 10.1111/1475-6773.14041] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Samantha L. Connolly
- Center for Healthcare Organization and Implementation ResearchVA Boston Healthcare SystemBostonMassachusettsUSA
- Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
| | - Michael E. Charness
- Chief of Staff of the VA Boston Healthcare SystemBostonMassachusettsUSA
- Department of NeurologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Christopher J. Miller
- Center for Healthcare Organization and Implementation ResearchVA Boston Healthcare SystemBostonMassachusettsUSA
- Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
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Wardlow L, Leff B, Biese K, Roberts C, Archbald-Pannone L, Ritchie C, DeCherrie LV, Sikka N, Gillespie SM. Development of telehealth principles and guidelines for older adults: A modified Delphi approach. J Am Geriatr Soc 2023; 71:371-382. [PMID: 36534900 DOI: 10.1111/jgs.18123] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic elevated telehealth as a prevalent care delivery modality for older adults. However, guidelines and best practices for the provision of healthcare via telehealth are lacking. Principles and guidelines are needed to ensure that telehealth is safe, effective, and equitable for older adults. The Collaborative for Telehealth and Aging (C4TA) composed of providers, experts in geriatrics, telehealth, and advocacy, developed principles and guidelines for delivering telehealth to older adults. Using a modified Delphi process, C4TA members identified three principles and 18 guidelines. First, care should be person-centered; telehealth programs should be designed to meet the needs and preferences of older adults by considering their goals, family and caregivers, linguistic characteristics, and readiness and ability to use technology. Second, care should be equitable and accessible; telehealth programs should address individual and systemic barriers to care for older adults by considering issues of equity and access. Third, care should be integrated and coordinated across systems and people; telehealth should limit fragmentation, improve data sharing, increase communication across stakeholders, and address both workforce and financial sustainability. C4TA members have diverse perspectives and expertise but a shared commitment to improving older adults' lives. C4TA's recommendations highlight older adults' needs and create a roadmap for providers and health systems to take actionable steps to reach them. The next steps include developing implementation strategies, documenting current telehealth practices with older adults, and creating a community to support the dissemination, implementation, and evaluation of the recommendations.
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Affiliation(s)
- Liane Wardlow
- Clinical Research, West Health Institute, La Jolla, CA, USA
| | - Bruce Leff
- The Center for Transformative Geriatric Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kevin Biese
- Emergency and Geriatric Medicine, University of North Carolina Health, Chapel Hill, NC, USA
| | - Carly Roberts
- Clinical Research, West Health Institute, La Jolla, CA, USA
| | | | - Christine Ritchie
- Palliative Care and Geriatric Medicine, Massachusetts General Hospital and Harvard University, Boston, MA, USA
| | - Linda V DeCherrie
- Clinical Strategy and Implementation, Medically Home, New York, New York, USA
| | - Neal Sikka
- Emergency Medicine, The George Washington University, Washington, DC, USA
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Lindenfeld Z, Berry C, Albert S, Massar R, Shelley D, Kwok L, Fennelly K, Chang JE. Synchronous Home-Based Telemedicine for Primary Care: A Review. Med Care Res Rev 2023; 80:3-15. [PMID: 35510736 DOI: 10.1177/10775587221093043] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Synchronous home-based telemedicine for primary care experienced growth during the coronavirus disease 2019 pandemic. A review was conducted on the evidence reporting on the feasibility of synchronous telemedicine implementation within primary care, barriers and facilitators to implementation and use, patient characteristics associated with use or nonuse, and quality and cost/revenue-related outcomes. Initial database searches yielded 1,527 articles, of which 22 studies fulfilled the inclusion criteria. Synchronous telemedicine was considered appropriate for visits not requiring a physical examination. Benefits included decreased travel and wait times, and improved access to care. For certain services, visit quality was comparable to in-person care, and patient and provider satisfaction was high. Facilitators included proper technology, training, and reimbursement policies that created payment parity between telemedicine and in-person care. Barriers included technological issues, such as low technical literacy and poor internet connectivity among certain patient populations, and communication barriers for patients requiring translators or additional resources to communicate.
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Affiliation(s)
- Zoe Lindenfeld
- New York University School of Global Public Health, New York City, USA
| | | | | | | | - Donna Shelley
- New York University School of Global Public Health, New York City, USA
| | | | | | - Ji Eun Chang
- New York University School of Global Public Health, New York City, USA
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Zou C, Harvard A, Qian J, Fox BI. A systematic review of digital health technologies for the care of older adults during COVID-19 pandemic. Digit Health 2023; 9:20552076231191050. [PMID: 37529545 PMCID: PMC10388634 DOI: 10.1177/20552076231191050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/13/2023] [Indexed: 08/03/2023] Open
Abstract
Objective During the Coronavirus Disease 2019 (COVID-19) pandemic, digital health technologies (DHTs) became increasingly important, especially for older adults. The objective of this systematic review was to synthesize evidence on the rapid implementation and use of DHTs among older adults during the COVID-19 pandemic. Methods A structured, electronic search was conducted on 9 November 2021, and updated on 5 January 2023, among five databases to select DHT interventional studies conducted among older adults during the pandemic. The bias of studies was assessed using Version 2 of the Cochrane Risk-of-Bias Tool for randomized trials (RoB 2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I). Results Among 20 articles included in the review, 14 (70%) focused on older adults with chronic diseases or symptoms, such as dementia or cognitive impairment, type 2 diabetes, and obesity. DHTs included traditional telehealth interventions via telephone, video, and social media, as well as emerging technologies such as Humanoid Robot and Laser acupuncture teletherapy. Using RoB 2 and ROBINS-I, four studies (20%) were evaluated as high or serious overall risk of bias. DHTs have shown to be effective, feasible, acceptable, and satisfactory for older adults during the COVID-19 pandemic compared to usual care. In addition, some studies also highlighted challenges with technology, hearing difficulties, and communication barriers within the vulnerable population. Conclusions During the COVID-19 pandemic, DHTs had the potential to improve various health outcomes and showed benefits for older adults' access to health care services.
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Affiliation(s)
- Chenyu Zou
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
| | - Abbey Harvard
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
| | - Jingjing Qian
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
| | - Brent I Fox
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
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Karlin NJ, Weil J. Need and Potential Use of Telemedicine in Two Rural Areas. ACTIVITIES, ADAPTATION & AGING 2022. [DOI: 10.1080/01924788.2022.2160689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Nancy J. Karlin
- School of Psychological Sciences, University of Northern Colorado, Greeley, Colorado, USA
| | - Joyce Weil
- Gerontology, Towson University, Towson, Maryland, USA
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Korkmaz Yaylagul N, Kirisik H, Bernardo J, Dantas C, van Staalduinen W, Illario M, De Luca V, Apóstolo J, Silva R. Trends in Telecare Use among Community-Dwelling Older Adults: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416672. [PMID: 36554553 PMCID: PMC9779196 DOI: 10.3390/ijerph192416672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 06/08/2023]
Abstract
A scoping review was conducted to map and analyze the concept of telecare services and the trends in telecare use. This scoping review was conducted according to Arksey and O'Malley's framework. A search was conducted in CINAHL (via EBSCO), ERIC, Academic Search Ultimate, and MEDLINE/PubMed databases. This scoping review considered quantitative (e.g., analytical observational studies, including prospective and retrospective cohort studies, case-control, analytical cross-sectional, and descriptive-observational studies), qualitative (e.g., phenomenology, grounded theory, ethnography, and action research), and mixed-method primary studies. Forty research articles published from 1 January 2012, to 1 January 2022 were included in this review, these studies met the eligibility criteria as all were focused on telecare and targeting older adults over 65 living at home. The reviewers coded the data in an Excel spreadsheet, including the articles' title, year, author, journal information and subject, research methods, sample size, location, and summary. Then, the researchers analyzed the conceptual definitions, measurement techniques, and findings in detail and the findings were grouped into categories. The trends around the concept of telecare are independent living, remote care, aging in place, and safety. Telecare research focuses mainly on service use, chronic illness, ethics, and cost-effectiveness. Technology acceptance among older individuals is a critical factor for telecare use. The results found in the literature about the cost-effectiveness of telecare are inconsistent.
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Affiliation(s)
- Nilufer Korkmaz Yaylagul
- Department of Gerontology, Faculty of Health Sciences, University of Akdeniz, Antalya 07070, Turkey
| | - Hande Kirisik
- Elderly Care Program, Vocational School of Haymana, University of Ankara, Ankara 06860, Turkey
| | - Joana Bernardo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-076 Coimbra, Portugal
| | | | | | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - João Apóstolo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-076 Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence (PCEBP), 3000-232 Coimbra, Portugal
| | - Rosa Silva
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000-076 Coimbra, Portugal
- Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence (PCEBP), 3000-232 Coimbra, Portugal
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Ely-Ledesma E, Champagne-Langabeer T. Advancing Access to Healthcare through Telehealth: A Brownsville Community Assessment. Healthcare (Basel) 2022; 10:healthcare10122509. [PMID: 36554033 PMCID: PMC9778105 DOI: 10.3390/healthcare10122509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
(1) Background: This paper focuses on the development of a community assessment for telehealth using an interprofessional lens, which sits at the intersection of public health and urban planning using multistakeholder input. The paper analyzes the process of designing and implementing a telemedicine plan for the City of Brownsville and its surrounding metros. (2) Methods: We employed an interprofessional approach to CBPR which assumed all stakeholders as equal partners alongside the researchers to uncover the most relevant and useful knowledge to inform the development of telehealth community assessment. (3) Results: Key findings include that: physicians do not have the technology, financial means, or staff to provide a comprehensive system for telemedicine; and due to language and literacy barriers, many patients are not able to use a web-based system of telemedicine. We also found that all stakeholders believe that telehealth is a convenient tool that has the capacity to increase patient access and care. (4) Conclusions: Ultimately, the use of an interprofessional community-based participatory research (CBPR) design allowed our team to bring together local knowledge with that of trained experts to advance the research efforts.
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Affiliation(s)
- Edna Ely-Ledesma
- Department of Planning and Landscape Architecture, University of Wisconsin-Madison, Madison, WI 53706, USA
- Correspondence:
| | - Tiffany Champagne-Langabeer
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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Donnelly C, Mills C, Gill S, Mehta K, Ashcroft R. The experience of primary care teams during the early phase of COVID-19: A qualitative study of primary care practice leaders in Ontario, Canada. BMC PRIMARY CARE 2022; 23:294. [PMID: 36418972 PMCID: PMC9682712 DOI: 10.1186/s12875-022-01907-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 08/22/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic has caused a rapid shift to virtual care in primary care practices around the globe. There has been little focus on the experiences of interprofessional teams through the lens of primary care practice leaders. The objective of this study was to examine the experience of primary care teams during the first wave of the COVID-19 pandemic from the perspective of primary care leadership. METHODS Qualitative study using qualitative description methods. Executive Directors of interprofessional primary care teams belonging to the Association of Family Health Teams of Ontario (AFHTO) were invited to participate. Executive Directors were interviewed and the interview transcripts were analyzed using thematic analysis. RESULTS Seventy-one Executive Directors from across all regions of Ontario were interviewed for the study, representing 37% of the AFHTO member clinics. Four themes were identified in the data: i) Complexities of Virtual Care, ii) Continuation of In-person Care, iii) Supporting Patients at Risk, and iv) Stepping up and into New Roles. CONCLUSIONS Primary care teams rapidly mobilized to deliver the majority of their care virtually, while continuing to provide in-person and home care as required. Major challenges to virtual care included technological infrastructure and unfamiliarity with virtual platforms. Advantages to virtual care included convenience and time savings. Virtual care will likely continue to be an important mode of primary care delivery moving forward.
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Affiliation(s)
- Catherine Donnelly
- grid.410356.50000 0004 1936 8331Queen’s University, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Christine Mills
- grid.410356.50000 0004 1936 8331Queen’s University, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Sandeep Gill
- Association of Family Health Teams of Ontario, 400 University Avenue, Suite 2100, Toronto, Ontario M5G 1S5 Canada
| | - Kavita Mehta
- Association of Family Health Teams of Ontario, 400 University Avenue, Suite 2100, Toronto, Ontario M5G 1S5 Canada
| | - Rachelle Ashcroft
- grid.17063.330000 0001 2157 2938University of Toronto, 246 Bloor Street, Toronto, Ontario M5S 1V4 Canada
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Ribaya DNF, Cunningham A, Hersh LR, Salzman B, Parks SM. Acceptability of Telemedicine in a Geriatric Outpatient Practice During the COVID-19 Pandemic. Telemed J E Health 2022. [DOI: 10.1089/tmj.2022.0318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- David Nathan F. Ribaya
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Amy Cunningham
- Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Lauren R. Hersh
- Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Brooke Salzman
- Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Susan M. Parks
- Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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41
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Digitally enabled cardiac rehabilitation following coronary revascularization: results from a single centre feasibility study. Eur Heart J Suppl 2022; 24:H25-H31. [DOI: 10.1093/eurheartjsupp/suac054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Wearable activity monitors, together with smartphone-based health and fitness applications (apps), are becoming more accessible and their widespread use provides an additional opportunity for the recording of cardiovascular metrics in patients with cardiovascular disease. The use of selected metrics by cardiac rehabilitation (CR) programmes allows the facilitation of individualized and tailored positive lifestyle changes to patients and places the patient at the centre of their recovery programme. To investigate the role of such devices on outcomes with patients on a CR programme, a cohort/case–control study was conducted. Patients post-myocardial infarction who were treated with either percutaneous coronary intervention or surgical coronary revascularisation at a single centre were invited to use a physical activity monitor linked to a customized app at their initial assessment for the rehabilitation programme. Those who accepted were allocated to the treatment group. The control group was selected from a larger pool of 400 historical and concurrent patients. Propensity matching was used to associate each case with their closest control. The changes in self-reported physical activity were similar for both groups at the end of the CR programme (EOP). The digitally monitored group tended to achieve greater METS (metabolic equivalent of task - a measure of exercise intensity) at 12 weeks (P < 0.059); however, no difference was observed in the overall change in METS at EOP (P < 0.333). Although no difference was noted in diastolic blood pressure, a statistically significant drop in the systolic blood pressure in the digitally monitored group (P < 0.004) was detected. In this study, the innovative combination of technology and face-to-face CR showed promising results and assisted the individualization of delivered content. This intervention could easily be replicated and expanded. Challenges are the recruitment of the elderly population, those who may be less engaged with or have less access to technology, and the underrepresentation of women in the study sample.
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42
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Chen K, Davoodi NM, Strauss DH, Li M, Jiménez FN, Guthrie KM, Goldberg EM. Strategies to Ensure Continuity of Care Using Telemedicine with Older Adults during COVID-19: A Qualitative Study of Physicians in Primary Care and Geriatrics. J Appl Gerontol 2022; 41:2282-2295. [PMID: 35711106 PMCID: PMC9207584 DOI: 10.1177/07334648221109728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/24/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives: Our objective was to interview primary care physicians (PCPs) and geriatricians on their experiences using telemedicine during the COVID-19 pandemic to examine strategies used to maintain continuity of care with their patients, ages 65 and older. Methods: Using purposive sampling, we selected physicians based on community size (metro/suburban/rural) and practice setting (academic/community) and conducted semi-structured interviews via Zoom (mean: 30 minutes). Interviews were recorded, transcribed, coded, and analyzed using framework analysis. Results: We enrolled 33 physicians (15 PCPs and 18 geriatricians) from July to November 2020. Findings indicate that many physicians successfully bridged the digital divide by: assessing patients' technological readiness in advance, being flexible with telehealth modes, using available home or facility-based staff, educating patients on telehealth privacy and usefulness, making accommodations for disabilities, and involving caregivers. Discussion: These findings can inform future policy and practice and assist physicians in resolving addressable barriers to telehealth use among older patients.
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Affiliation(s)
- Kevin Chen
- The Warren Alpert Medical School of
Brown University, Providence, RI, USA
| | - Natalie M. Davoodi
- Department of Emergency Medicine, The Warren Alpert Medical School of
Brown University, Providence, RI, USA
| | - Daniel H. Strauss
- The Warren Alpert Medical School of
Brown University, Providence, RI, USA
| | | | | | - Kate M. Guthrie
- Department of Psychiatry and Human
Behavior, The Warren Alpert Medical School of
Brown University, Providence, RI, USA
| | - Elizabeth M. Goldberg
- Department of Emergency Medicine, The Warren Alpert Medical School of
Brown University, Providence, RI, USA
- Department of Health Services,
Policy and Practice, Brown University School of Public
Health, Providence, RI, USA
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Galvin E, Desselle S, Gavin B, Quigley E, Flear M, Kilbride K, McNicholas F, Cullinan S, Hayden J. Implementation of telemedicine consultations for people with mental health conditions in the community: a protocol for a systematic review. HRB Open Res 2022; 4:125. [PMID: 36348659 PMCID: PMC9627101 DOI: 10.12688/hrbopenres.13435.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
Abstract
Background: The COVID-19 pandemic response has led to an exponential increase in the use and spread of telemedicine internationally. In community mental health care settings, telemedicine services were implemented within a few weeks, with little time for rigorous planning. Despite the reported acceptability of telemedicine by patients and clinicians, barriers to its implementation have come to light. There is now a need to investigate these barriers, and facilitators, as telemedicine begins to show potential promise beyond the pandemic. We propose a review that aims to identify the factors affecting the implementation of telemedicine consultations for patients with mental health conditions in the community. Methods: A systematic review will be conducted and reported according to the PRISMA guidelines. Five electronic databases will be searched using a pre-defined search strategy from 2016 to 2021. Only studies of synchronous, interactive telemedicine consultations conducted via video, phone or live messaging between patients and providers will be included. Quantitative, qualitative and mixed methods studies will be eligible for inclusion. Only studies published in the English language will be included. Titles and abstracts will be screened by two reviewers. Full text articles will be screened by two reviewers. The methodological quality of studies will be assessed using the Mixed Method Appraisal Tool (MMAT) by two reviewers. Data will be extracted and tabulated to address the aims of the review. A narrative synthesis will be conducted and reported factors will be mapped to the domains of the Consolidated Framework for Implementation Research (CFIR). Conclusion: By identifying the factors that influence the implementation of telemedicine consultations for patients with mental conditions in the community, consideration can be given to both barriers and facilitators that could be addressed in future mental health services planning. PROSPERO registration:CRD42021273422 (04/10/2021)
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Affiliation(s)
- Emer Galvin
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Blánaid Gavin
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Etain Quigley
- National University of Ireland, Maynooth, Maynooth, Ireland
| | | | | | | | - Shane Cullinan
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - John Hayden
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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Jezewski E, Miller A, Eusebio M, Potter J. Targeted Telehealth Education Increases Interest in Using Telehealth among a Diverse Group of Low-Income Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13349. [PMID: 36293929 PMCID: PMC9602760 DOI: 10.3390/ijerph192013349] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/12/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
Telehealth allows older adults to take control over their health and preventive care; however, they are less likely to use telehealth. Minority older adults use telehealth services less than their White counterparts. During COVID-19, the U.S. Medicare system allowed for telehealth delivery of Annual Wellness Visits, which are known to improve use of preventive services. To increase telehealth use, we targeted vulnerable, low-income, minority older adults and provided education to improve knowledge of and identify barriers to telehealth use. Ultimately, this could serve as a means of improving health and preventive care services. Participants resided at independent living facilities, low-income housing, and elders of the Native American coalition; N = 257. Participants received written education materials; a subset attended a 20-min presentation. In this quasi-experimental study, participants completed a pre-post survey. Results were analyzed using Chi-Squared and Fisher's Exact tests. Participants included 54 'in-person' and 203 'at-home' learners. Most were female (79%), single/widowed (51%), and white (65%). At baseline, 39% were familiar with telehealth; following education 73% stated understanding on accessing telehealth. Nearly 40% of participants said they would use telehealth in the future; a larger proportion of "in-person" (73%) learners were willing to use telehealth than "at-home" learners (41%) (p = 0.001). Divorced older adults and Blacks voiced greater likelihoods of using telehealth than their married/widowed and White counterparts, respectively (Χ2(3, N = 195) = 9.693, p = 0.02), (p = 0.01). This education program demonstrates an increase likelihood in health promotion among older adults by increasing confidence in accessing and future use of telehealth; therefore, we achieved our aim of promoting telehealth use and improving health promotion.
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Affiliation(s)
- Emily Jezewski
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Abigale Miller
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | | | - Jane Potter
- Division of Geriatrics, Gerontology, and Palliative Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
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DuMontier C, Jaung T, Bahl NE, Manor B, Testa M, Dieli-Conwright CM, Kim D, Hshieh T, Driver JA, Abel GA. Virtual frailty assessment for older adults with hematologic malignancies. Blood Adv 2022; 6:5360-5363. [PMID: 35616435 PMCID: PMC9631705 DOI: 10.1182/bloodadvances.2022007188] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/15/2022] [Indexed: 11/20/2022] Open
Affiliation(s)
- Clark DuMontier
- New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Brigham and Women’s Hospital, Boston, MA
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA
| | - Tim Jaung
- Dana-Farber Cancer Institute, Boston, MA
| | | | - Brad Manor
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA
| | - Marcia Testa
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA; and
| | - Christina M. Dieli-Conwright
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA
- Dana-Farber Cancer Institute, Boston, MA
| | - Dae Kim
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA
| | - Tammy Hshieh
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA
- Dana-Farber Cancer Institute, and
| | - Jane A. Driver
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA
- Geriatrics and Extended Care, VA Boston Healthcare System, Brigham and Women’s Hospital, Boston, MA
| | - Gregory A. Abel
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA
- Dana-Farber Cancer Institute, and
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46
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Schwartz AW, Driver JA, Pollara LM, Roefaro J, Harrington MB, Charness ME, Skarf LM. Increasing Telehealth Visits for Older Veterans Associated with Decreased No-Show Rate in a Geriatrics Consultation Clinic. J Gen Intern Med 2022; 37:3217-3219. [PMID: 35476240 PMCID: PMC9045203 DOI: 10.1007/s11606-022-07598-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 03/31/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Andrea Wershof Schwartz
- Veterans Affairs Boston Health Care System, 150 South Huntington Avenue #182, Boston, MA, 02130, USA. .,New England Geriatrics Research Education and Clinical Center, Boston, USA. .,Harvard Medical School, Boston, USA. .,Brigham and Women's Hospital Division of Aging, Boston, USA.
| | - Jane A Driver
- Veterans Affairs Boston Health Care System, 150 South Huntington Avenue #182, Boston, MA, 02130, USA.,New England Geriatrics Research Education and Clinical Center, Boston, USA.,Harvard Medical School, Boston, USA.,Brigham and Women's Hospital Division of Aging, Boston, USA
| | - Lisa M Pollara
- Veterans Affairs Boston Health Care System, 150 South Huntington Avenue #182, Boston, MA, 02130, USA
| | - John Roefaro
- Veterans Affairs Boston Health Care System, 150 South Huntington Avenue #182, Boston, MA, 02130, USA
| | - Mary Beth Harrington
- Veterans Affairs Boston Health Care System, 150 South Huntington Avenue #182, Boston, MA, 02130, USA.,New England Geriatrics Research Education and Clinical Center, Boston, USA
| | - Michael E Charness
- Veterans Affairs Boston Health Care System, 150 South Huntington Avenue #182, Boston, MA, 02130, USA.,Harvard Medical School, Boston, USA.,Boston University School of Medicine, Boston, USA
| | - Lara Michal Skarf
- Veterans Affairs Boston Health Care System, 150 South Huntington Avenue #182, Boston, MA, 02130, USA.,Harvard Medical School, Boston, USA
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Zhang WJ, Mansour DZ, Lee M, Brandt NJ. Interprofessional Education and Older Adults in the Shared Virtual Classroom: Lessons Learned During the COVID-19 Pandemic. J Gerontol Nurs 2022; 48:52-56. [PMID: 35914080 DOI: 10.3928/00989134-20220630-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current article provides an overview of an interprofessional service-learning course that became virtual in the setting of the coronavirus disease 2019 pandemic. Telehealth video technologies were used to build an intergenerational, virtual classroom and increase engagement of older adults with interdisciplinary health professional students. The virtual classroom involved group health education sessions, individualized Medicare wellness visits, and a clinical huddle. The course addressed the public health need for reliable health information during the early days of the pandemic, social connection, and meeting the educational goals for health care students and older adults in a novel virtual setting. Lessons learned for the interdisciplinary team and for engaging older adults included the need for preparation reading, team building exercises, training videos, and telehealth competency checklists. Beyond the pandemic, adoption of virtual methods enables hybrid approaches to interprofessional education and builds competencies for delivery of telehealth and computer-based visits in professional practice settings. [Journal of Gerontological Nursing, 48(8), 52-56.].
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48
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Galvin E, Desselle S, Gavin B, Quigley E, Flear M, Kilbride K, McNicholas F, Cullinan S, Hayden J. Implementation of telemedicine consultations for people with mental health conditions in the community: a protocol for a systematic review. HRB Open Res 2022; 4:125. [DOI: 10.12688/hrbopenres.13435.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 01/14/2023] Open
Abstract
Background: The COVID-19 pandemic response has led to an exponential increase in the use and spread of telemedicine internationally. In community mental health care settings, telemedicine services were implemented within a few weeks, with little time for rigorous planning. Despite the reported acceptability of telemedicine by patients and clinicians, barriers to its implementation have come to light. There is now a need to investigate these barriers, and facilitators, as telemedicine begins to show potential promise beyond the pandemic. We propose a review that aims to identify the factors affecting the implementation of telemedicine consultations for patients with mental health conditions in the community. Methods: A systematic review will be conducted and reported according to the PRISMA guidelines. Five electronic databases will be searched using a pre-defined search strategy from 2016 to 2021. Only studies of synchronous, interactive telemedicine consultations conducted via video, phone or live messaging between patients and providers will be included. Quantitative, qualitative and mixed methods studies will be eligible for inclusion. Only studies published in the English language will be included. Titles and abstracts will be screened by two reviewers. Full text articles will be screened by two reviewers. The methodological quality of studies will be assessed using the Mixed Method Appraisal Tool (MMAT) by two reviewers. Data will be extracted and tabulated to address the aims of the review. A narrative synthesis will be conducted and reported factors will be mapped to the domains of the Consolidated Framework for Implementation Research (CFIR). Conclusion: By identifying the factors that influence the implementation of telemedicine consultations for patients with mental conditions in the community, consideration can be given to both barriers and facilitators that could be addressed in future mental health services planning. PROSPERO registration: CRD42021273422 (04/10/2021)
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Fjellså HMH, Husebø AML, Storm M. eHealth in Care Coordination for Older Adults Living at Home: A Scoping Review (Preprint). J Med Internet Res 2022; 24:e39584. [DOI: 10.2196/39584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022] Open
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50
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Jacob C, Sezgin E, Sanchez-Vazquez A, Ivory C. Sociotechnical Factors Affecting Patients' Adoption of Mobile Health Tools: Systematic Literature Review and Narrative Synthesis. JMIR Mhealth Uhealth 2022; 10:e36284. [PMID: 35318189 PMCID: PMC9121221 DOI: 10.2196/36284] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) tools have emerged as a promising health care technology that may contribute to cost savings, better access to care, and enhanced clinical outcomes; however, it is important to ensure their acceptance and adoption to harness this potential. Patient adoption has been recognized as a key challenge that requires further exploration. OBJECTIVE The aim of this review was to systematically investigate the literature to understand the factors affecting patients' adoption of mHealth tools by considering sociotechnical factors (from technical, social, and health perspectives). METHODS A structured search was completed following the participants, intervention, comparators, and outcomes framework. We searched the MEDLINE, PubMed, Cochrane Library, and SAGE databases for studies published between January 2011 and July 2021 in the English language, yielding 5873 results, of which 147 studies met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Handbook were followed to ensure a systematic process. Extracted data were analyzed using NVivo (QSR International), with thematic analysis and narrative synthesis of emergent themes. RESULTS The technical factors affecting patients' adoption of mHealth tools were categorized into six key themes, which in turn were divided into 20 subthemes: usefulness, ease of use, data-related, monetary factors, technical issues, and user experience. Health-related factors were categorized into six key themes: the disease or health condition, the care team's role, health consciousness and literacy, health behavior, relation to other therapies, integration into patient journey, and the patients' insurance status. Social and personal factors were divided into three key clusters: demographic factors, personal characteristics, and social and cultural aspects; these were divided into 19 subthemes, highlighting the importance of considering these factors when addressing potential barriers to mHealth adoption and how to overcome them. CONCLUSIONS This review builds on the growing body of research that investigates patients' adoption of mHealth services and highlights the complexity of the factors affecting adoption, including personal, social, technical, organizational, and health care aspects. We recommend a more patient-centered approach by ensuring the tools' fit into the overall patient journey and treatment plan, emphasizing inclusive design, and warranting comprehensive patient education and support. Moreover, empowering and mobilizing clinicians and care teams, addressing ethical data management issues, and focusing on health care policies may facilitate adoption.
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Affiliation(s)
- Christine Jacob
- University of Applied Sciences Northwestern Switzerland, Olten, Switzerland
| | - Emre Sezgin
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
- NORC at the University of Chicago, Chicago, IL, United States
| | - Antonio Sanchez-Vazquez
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chris Ivory
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
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