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Ying G, Perez-Lao A, Adrien T, Maraganore D, Marra D, Smith G. TICS-M scores in an oldest-old normative cohort identified by computable phenotype. Clin Neuropsychol 2024:1-12. [PMID: 38997666 DOI: 10.1080/13854046.2024.2374894] [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: 03/31/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024]
Abstract
Objective: To (1) examine the distribution of Telephone Interview for Cognitive Status modified (TICS-m) scores in oldest-old individuals (age 85 and above) identified as cognitively healthy by a previously validated electronic health records-based computable phenotype (CP) and (2) to compare different cutoff scores for cognitive impairment in this population. Method: CP identified 24,024 persons, 470 were contacted and 252 consented and completed the assessment. Associations of TICS-m score with age, sex, and educational categories (<10 years, 11-15 years, and >16 years) were examined. The number of participants perceived as impaired was studied with commonly used cutoff scores (27-31). Results: TICS-m score ranged from 18 to 44 with a mean of 32.6 (SD = 4.7) in older adults aged 85-99 years old. A linear regression model including (range-restricted) age, education, and sex, showed beta estimates comparable to previous findings. Different cutoff scores (27 to 31) generated slightly lower MCI and dementia prevalence rates of participants meeting the criteria for the impairments than studies of younger elderly using traditional recruitment methods. Conclusions: The use of validated computable phenotype to identify a normative cohort generated a normative distribution for the TICS-m consistent with prior findings from more effortful approaches to cohort identification and established expected TICS-m performance in the oldest-old population.
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Affiliation(s)
- Gelan Ying
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Ambar Perez-Lao
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Tamare Adrien
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Demetrius Maraganore
- Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA
| | - David Marra
- VA Boston Health Care System, Boston, MA, USA
| | - Glenn Smith
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Cai S, Qin Q, Veazie P, Temkin-Greener H. Telemedicine and Disparities in Mental Health Service Use Among Community-Dwelling Older Adults With Alzheimer Disease and Related Dementias. J Am Med Dir Assoc 2024; 25:105027. [PMID: 38768645 DOI: 10.1016/j.jamda.2024.105027] [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: 12/22/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE To examine disparities in mental health (MH) service utilization, via in-person and telemedicine (ie, tele-MH), by individuals' race, ethnicity, and community socioeconomic status, among community-dwelling older adults with Alzheimer disease and related dementias (ADRD) before and after the expansion of the Centers for Medicare and Medicaid Services' (CMS's) telemedicine policy. DESIGN Observational study. SETTING AND PARTICIPANTS A total of 3,003,571 community-dwelling Medicare beneficiaries with ADRD between 2019 and 2021 were included in the study. METHODS Multiple national data were linked. The unit of analysis was individual-quarter. Three outcomes were defined: any MH visits (in-person or tele-MH), in-person MH visits, and tele-MH visits per quarter. Key independent variables included individual race and ethnicity, the socioeconomic status of the community, and an indicator for the implementation of the telemedicine policy. Regression analyses with individual random effects were used. RESULTS In general, Black and Hispanic older adults with ADRD and those in socioeconomically deprived communities were less likely to have MH visits than white adults and those from less-deprived communities. In-person and tele-MH visits varied throughout the pandemic and across subpopulations. For instance, at the beginning of the pandemic, white, Black, and Hispanic older adults experienced 5.05, 3.03, and 2.87 percentage point reductions in in-person MH visits, and 3.53, 1.26, and 0.32 percentage point increases in tele-MH visits (with P < .01 for racial/ethnic differences), respectively. During the pandemic, the increasing trend in in-person MH visits and the decreasing trend in tele-MH visits varied across different subgroups. Overall, racial and ethnic differences in any MH visits were reduced, but the gap in any MH visits between deprived and less-deprived communities doubled during the pandemic (P < .01). CONCLUSIONS AND IMPLICATIONS Telemedicine may have provided an opportunity to improve access to MH services among underserved populations. However, although some disparities in MH care were reduced, others widened, underscoring the importance of equitable health care access strategies to address the unique needs of different populations.
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Affiliation(s)
- Shubing Cai
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
| | - Qiuyuan Qin
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Peter Veazie
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Helena Temkin-Greener
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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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
- Institute of Hygiene and Tropical Medicine, Global Health and Tropical Medicine, Universidade Nova de Lisboa, Lisbon, Portugal
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Komatsu T, Fraune MR, Tsui KM, Suda S, Kobayashi M. How did COVID-19 pandemic affect the older adults' needs for robot technologies in Japan?: comparison of participatory design workshops during versus after the COVID-19 pandemic. Front Robot AI 2024; 11:1363243. [PMID: 38894894 PMCID: PMC11184464 DOI: 10.3389/frobt.2024.1363243] [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: 12/30/2023] [Accepted: 04/29/2024] [Indexed: 06/21/2024] Open
Abstract
Social technology can improve the quality of social lives of older adults (OAs) and mitigate negative mental and physical health outcomes. When people engage with technology, they can do so to stimulate social interaction (stimulation hypothesis) or disengage from their real world (disengagement hypothesis), according to Nowland et al.'s model of the relationship between social Internet use and loneliness. External events, such as large periods of social isolation like during the COVID-19 pandemic, can also affect whether people use technology in line with the stimulation or disengagement hypothesis. We examined how the COVID-19 pandemic affected the social challenges OAs faced and their expectations for robot technology to solve their challenges. We conducted two participatory design (PD) workshops with OAs during and after the COVID-19 pandemic. During the pandemic, OAs' primary concern was distanced communication with family members, with a prevalent desire to assist them through technology. They also wanted to share experiences socially, as such OA's attitude toward technology could be explained mostly by the stimulation hypothesis. However, after COVID-19 the pandemic, their focus shifted towards their own wellbeing. Social isolation and loneliness were already significant issues for OAs, and these were exacerbated by the COVID-19 pandemic. Therefore, such OAs' attitudes toward technology after the pandemic could be explained mostly by the disengagement hypothesis. This clearly reflect the OA's current situation that they have been getting further digitally excluded due to rapid technological development during the pandemic. Both during and after the pandemic, OAs found it important to have technologies that were easy to use, which would reduce their digital exclusion. After the pandemic, we found this especially in relation to newly developed technologies meant to help people keep at a distance. To effectively integrate these technologies and avoid excluding large parts of the population, society must address the social challenges faced by OAs.
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Affiliation(s)
- Takanori Komatsu
- Department of Frontier Media Science, Meiji University, Tokyo, Japan
| | - Marlena R. Fraune
- Department of Psychology, New Mexico State University, Las Cruces, NM, United States
| | | | - Shogo Suda
- Department of Frontier Media Science, Meiji University, Tokyo, Japan
| | - Mizuki Kobayashi
- Department of Frontier Media Science, Meiji University, Tokyo, Japan
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Temkin-Greener H, Hua Y, Cai S. Assisted living residents with dementia: Disparities in mental health services pre and during COVID-19. J Am Geriatr Soc 2024; 72:1760-1769. [PMID: 38655803 PMCID: PMC11187647 DOI: 10.1111/jgs.18926] [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: 08/30/2023] [Revised: 02/17/2024] [Accepted: 03/26/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Little is known about mental health among Medicare beneficiaries with Alzheimer's disease or related dementias (ADRD) who reside in assisted living (AL) communities. The COVID-19 pandemic may have curtailed ambulatory care access for these residents, but telehealth may have expanded it. We examined in-person and telehealth use of ambulatory mental health visits among AL residents with ADRD, pre and during the COVID pandemic, focusing on race/ethnicity and Medicare/Medicaid dual status. METHODS A CY2018 cohort of AL residents with ADRD was identified. Outcome was any quarterly in-person or telemedicine mental health visit based on national CY2019-2020 Medicare claims. Key independent variables were individual race/ethnicity and dual status and the AL-level proportion of dual residents. We estimated a linear probability model with random effects and robust standard errors. Quarterly indicators captured service use before and after the onset of the pandemic. RESULTS The study included 102,758 fee-for-service Medicare beneficiaries with ADRD in 13,400 ALs. One in five residents had any mental health visits prior to the COVID-19 pandemic. Black residents, and those with dual Medicare/Medicaid eligibility, were significantly less likely to use mental health services prior to and during the pandemic. There were no significant differences in visits via telemedicine by race/ethnicity or individual dual status. Residents in AL communities with a higher proportion of duals had a lower likelihood of visits before and during the pandemic. CONCLUSIONS/IMPLICATIONS Mental health service use among AL residents with ADRD was low and declining prior to the pandemic. Telehealth allowed for mental health visits to continue during the pandemic, albeit at a lower level. Residents in ALs with a higher proportion of duals were less likely to have in-person or telehealth visits. The results suggest that some ALs may find it difficult to assure mental health service provision to this vulnerable population.
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Affiliation(s)
- Helena Temkin-Greener
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642
| | - Yechu Hua
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642
| | - Shubing Cai
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642
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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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Chant ED, Ritchie CS, Orav EJ, Ganguli I. Healthcare contact days among older adults living with dementia. J Am Geriatr Soc 2024; 72:1476-1482. [PMID: 38263877 PMCID: PMC11090707 DOI: 10.1111/jgs.18744] [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: 08/16/2023] [Revised: 11/03/2023] [Accepted: 12/10/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND For older adults with dementia and their care partners, accessing health care outside the home involves substantial time, direct and indirect costs, and other burdens. While prior studies have estimated days spent by these individuals in or out of hospitals and nursing homes, ambulatory care burdens are likely substantial yet poorly understand. Therefore, we characterized "health care contact days"-days spent receiving ambulatory or institutional care-in this population. METHODS We used 2019 Medicare Current Beneficiary Survey data linked to claims for community-dwelling, ≥65-year-old adults with dementia in Traditional Medicare. We measured contact days including ambulatory days (with an office visit, test, imaging, procedure, or treatment) and institutional days (spent in an emergency department, hospital, skilled nursing facility, or hospice facility). We described variation and patterns in contact days. Using multivariable Poisson regression, we identified sociodemographic and clinical factors associated with contact days. RESULTS In weighted analyses, 887 older adults with dementia (weighted: 2.9 million) had mean (SD) 31.1 (33.7) total contact days/year, of which 21.7 (20.6) were ambulatory. Ten percent had ≥68 contact days in the year. One-third (34%) of ambulatory contact days involved multiple services. In multivariable models, receipt of more ambulatory contact days was associated with younger age (65-74 reference vs. -32.3% [95% CI: -42.2%, -20.7%] for 85+), higher income (>200% Federal Poverty Level [FPL] reference versus -16.6% [95% CI: -26.7%, -5.0%] for ≤200% FPL), and lack of functional impairment (reference versus -14.6% [95% CI: -23.7%, -4.4%]). Each additional chronic condition was associated with 8.2% (95% CI: 6.7%, 9.8%) more ambulatory contact days. CONCLUSIONS Older adults with dementia spent 31 days a year accessing care which was mostly ambulatory. These days varied widely by both clinical and sociodemographic factors. These results highlight the need to reduce patient burden through strategies such as reducing unneeded care, coordinating care, and shifting care to home settings through telemedicine and home care.
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Affiliation(s)
- Emma D. Chant
- Brigham and Women’s Hospital Division of General Internal Medicine and Primary Care, Boston, MA
| | - Christine S. Ritchie
- Harvard University, Boston, MA
- Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA
| | - E. John Orav
- Brigham and Women’s Hospital Division of General Internal Medicine and Primary Care, Boston, MA
- Harvard University, Boston, MA
| | - Ishani Ganguli
- Brigham and Women’s Hospital Division of General Internal Medicine and Primary Care, Boston, MA
- Harvard University, Boston, MA
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Brooks D, Wyles K, Pachana NA, Beattie E, Gaugler JE. Tailored videoconferencing counselling program to support family carers of people living with dementia during the transition to permanent residential care: a pilot and feasibility randomised trial. BMC Geriatr 2024; 24:375. [PMID: 38671367 PMCID: PMC11055339 DOI: 10.1186/s12877-024-04907-4] [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: 10/10/2023] [Accepted: 03/20/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Decisions surrounding the permanent residential care placement of people living with dementia can be stressful and distressing; however, providing access to targeted information and support prior to placement may help carers better cope. This mixed methods study aimed to test the feasibility, acceptability, and potential benefits of providing a tailored, individual counselling program (the Residential Care Transition Module), delivered via videoconferencing, to Australian family carers of a relative with dementia during the transition to permanent residential care. METHODS A total of 18 family carers were randomly allocated to receive either the counselling intervention (six sessions delivered over 12 weeks) or a check-in call, delivered by a trained Transition Counsellor. Both groups received help-sheets about residential care, coping with placement, and managing feelings. Carers completed online surveys about stress, guilt, anxiety, depression, grief, and support for caring at baseline and four months post-baseline. Carers were also invited to participate in semi-structured exit interviews, conducted after follow-up surveys were completed. Process data relating to recruitment, retention, intervention dose and delivery were collected via logs. Quantitative data were analysed using descriptive statistics and repeated measures ANOVA. Qualitative data, relating to feasibility, acceptability, and perceived benefits of the program, were analysed using the 'framework' approach developed by the Medical Research Council to inform the process evaluation of complex interventions. RESULTS Qualitative findings indicated that delivery of the counselling program during the transition period was deemed by participants to be feasible and acceptable. Delivery via videoconferencing was deemed convenient and acceptable, with few technical issues. The skills and knowledge of the Transition Counsellor were perceived to be important mechanisms of impact. Though not statistically significant, promising quantitative findings were identified in terms of reduced carer stress and guilt and improved support for caring. CONCLUSIONS Delivery of a tailored counselling program via videoconferencing to family carers of people living with dementia during the transition to residential care was feasible and acceptable. The program has the potential to improve transitional support to family carers. TRIAL REGISTRATION This study was registered in the Australian New Zealand Clinical Trials Registry: ACTRN12621001462875.
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Affiliation(s)
- Deborah Brooks
- School of Nursing, Queensland University of Technology, Brisbane, Australia.
- The University of Queensland Centre for Clinical Research, Brisbane, Australia.
| | - Katy Wyles
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Elizabeth Beattie
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Joseph E Gaugler
- School of Psychology, The University of Queensland, Brisbane, Australia
- School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Silva-Valencia J, Lapadula C, Westfall JM, Gaona G, de Lusignan S, Kristiansson RS, Ling ZJ, Goh LH, Soto-Becerra P, Cuba-Fuentes MS, Wensaas KA, Flottorp S, Baste V, Chi-Wai Wong W, Pui Ng AP, Ortigoza A, Manski-Nankervis JA, Hallinan CM, Zingoni P, Scattini L, Heald A, Tu K. Effect of the COVID-19 pandemic on mental health visits in primary care: an interrupted time series analysis from nine INTRePID countries. EClinicalMedicine 2024; 70:102533. [PMID: 38495523 PMCID: PMC10940140 DOI: 10.1016/j.eclinm.2024.102533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/19/2024] Open
Abstract
Background The COVID-19 pandemic impacted mental health disorders, affecting both individuals with pre-existing conditions and those with no prior history. However, there is limited evidence regarding the pandemic's impact on mental health visits to primary care physicians. The International Consortium of Primary Care Big Data Researchers (INTRePID) explored primary care visit trends related to mental health conditions in Argentina, Australia, Canada, China, Norway, Peru, Singapore, Sweden, and the USA. Methods We conducted an interrupted time series analysis in nine countries to examine changes in rates of monthly mental health visits to primary care settings from January 1st, 2018, to December 31st, 2021. Sub-group analysis considered service type (in-person/virtual) and six categories of mental health conditions (anxiety/depression, bipolar/schizophrenia/other psychotic disorders, sleep disorders, dementia, ADHD/eating disorders, and substance use disorder). Findings Mental health visit rates increased after the onset of the pandemic in most countries. In Argentina, Canada, China, Norway, Peru, and Singapore, this increase was immediate ranged from an incidence rate ratio of 1·118 [95% CI 1.053-1.187] to 2.240 [95% CI 2.057-2.439] when comparing the first month of pandemic with the pre-pandemic trend. Increases in the following months varied across countries. Anxiety/depression was the leading reason for mental health visits in most countries. Virtual visits were reported in Australia, Canada, Norway, Peru, Sweden, and the USA, accounting for up to 40% of the total mental health visits. Interpretation Findings suggest an overall increase in mental health visits, driven largely by anxiety/depression. During the COVID-19 pandemic, many of the studied countries adopted virtual care in particular for mental health visits. Primary care plays a crucial role in addressing mental ill-health in times of crisis. Funding Canadian Institutes of Health Research grant #173094 and the Rathlyn Foundation Primary Care EMR Research and Discovery Fund.
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Affiliation(s)
- Javier Silva-Valencia
- Center for Research in Primary Health Care (CINAPS), Universidad Peruana Cayetano Heredia, Peru
| | - Carla Lapadula
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Zheng Jye Ling
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lay Hoon Goh
- Division of Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Knut-Arne Wensaas
- Research Unit for General Practice, NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Signe Flottorp
- Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
- Department of General Practice, University of Oslo, Oslo, Norway
| | - Valborg Baste
- National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway
| | - William Chi-Wai Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Amy Pui Pui Ng
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Angela Ortigoza
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jo-Anne Manski-Nankervis
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christine Mary Hallinan
- Department of General Practice and Primary Care, The University of Melbourne, Melbourne, Victoria, Australia
| | - Paula Zingoni
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
| | - Luciano Scattini
- Ministry of Health of the Autonomous City of Buenos Aires, Buenos Aires, Argentina
| | - Adrian Heald
- School of Medical Sciences, Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, UK
| | - Karen Tu
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Departments of Research and Innovation and Family Medicine-North York General Hospital, Toronto Western Family Health Team-University Health Network, Toronto, Ontario, Canada
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Zhu J, Carr F, Sun M, Tian P, McLeod M, De Coutere S. A Pilot Study to Evaluate a New Hep-GRP Care Pathway to Improve Outcomes Among Canadian Older Adults with Liver Cirrhosis. Can Geriatr J 2024; 27:1-19. [PMID: 38433879 PMCID: PMC10896207 DOI: 10.5770/cgj.27.725] [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] [Indexed: 03/05/2024] Open
Abstract
Background Older adults with cirrhosis have complex medical needs that are not satisfied by organ specific management. Interdisciplinary approach may mitigate comorbidity and improve patient satisfaction. Methods A pilot study consisted of dual specialist interdisciplinary referral pathway and mixed virtual care delivery model are prospectively evaluated in older adults (65 years and older) with cirrhosis during the COVID-19 pandemic between September and December 2022. Participant attitudes towards telemedicine were surveyed. Results 68 participants with cirrhosis were consecutively assessed by hepatology. The mean age was 73 years. 39 (57%) screened positive for one or more geriatric syndrome(s). Comprehensive geriatric assessments were conducted via telemedicine in 18 participants, with additional referrals to physiotherapy and nutritional education. Compared to a historic cohort matched for age, sex, and Child-Pugh class, acute health service utilization measured by ER visits among those received dual specialist interdisciplinary consultation were lowered by 1.11 per patient at three-month follow up period (p = .0006, 95% CI 0.47-1.74). Majority participants (87.6%) preferred telemedicine or mixed method visits. Conclusion An interdisciplinary approach to older adults with cirrhosis will likely be beneficial, and routine screening for geriatric syndrome may lead to reduced acute health-care utilization in the short term. Telemedicine and virtual screening tools in seniors should be fully explored to improve access to care.
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Affiliation(s)
- Julie Zhu
- Digestive Care and Endoscopy, Dalhousie University, Halifax, NS
| | | | - Michael Sun
- Geriatrics, Dalhousie University, Halifax, NS
| | - Peter Tian
- Family Medicine, University of Alberta, Edmonton, AB
| | - Magnus McLeod
- General Internal Medicine, Dalhousie University, Halifax, NS
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11
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Bertolazzi A, Quaglia V, Bongelli R. Barriers and facilitators to health technology adoption by older adults with chronic diseases: an integrative systematic review. BMC Public Health 2024; 24:506. [PMID: 38365698 PMCID: PMC10873991 DOI: 10.1186/s12889-024-18036-5] [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: 04/30/2023] [Accepted: 02/07/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND In recent years, healthcare systems have progressively adopted several technologies enhancing access to healthcare for older adults and support the delivery of efficient and effective care for this specific population. These technologies include both assistive technologies designed to maintain or improve the independence, social participation and functionality of older people at home, as well as health information technology developed to manage long-term conditions. Examples of such technologies include telehealth, wearable devices and mobile health. However, despite the great promise that health technology holds for promoting independent living among older people, its actual implementation remains challenging. METHODS This study aimed to conduct an integrative systematic review of the research evidence on the factors that facilitate or hinder the adoption of different types of technology by older individuals with chronic diseases. For this purpose, four electronic databases (PsycArticles, Scopus, Web of Science and PubMed) were queried to search for indexed published studies. The methodological quality of the selected papers has been assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS Twenty-nine articles were selected, including 6.213 adults aged 60 or older. The studies have been synthesised considering the types of technological interventions and chronic diseases, as well as the main barriers and facilitators in technology acceptance. The results revealed that the majority of the selected articles focused on comorbid conditions and the utilisation of telemedicine tools. With regard to hindering and facilitating factors, five main domains were identified: demographic and socioeconomic, health-related, dispositional, technology-related and social factors. CONCLUSION The study results have practical implications not only for technology developers but also for all the social actors involved in the design and implementation of healthcare technologies, including formal and informal caregivers and policy stakeholders. These actors could use this work to enhance their understanding of the utilisation of technology by the ageing population. This review emphasises the factors that facilitate technology adoption and identifies barriers that impede it, with the ultimate goal of promoting health and independent living.
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Affiliation(s)
- Alessia Bertolazzi
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy.
| | - Valeria Quaglia
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy
| | - Ramona Bongelli
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy
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12
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Nadeau V, Osuji E, Dennett L, Ferguson-Pell M. Identifying and Overcoming the Barriers to Virtual Electromyography Assessments: A Scoping Review. Telemed J E Health 2024; 30:354-363. [PMID: 37585548 DOI: 10.1089/tmj.2023.0121] [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] [Indexed: 08/18/2023] Open
Abstract
Introduction: Electromyography (EMG) assessments have been conducted virtually more frequently in recent years, leading researchers to explore the barriers to EMG assessments in a telehealth setting and how to overcome them. Methods: A scoping review was conducted according to the methodology described by Arksey and O'Malley. A comprehensive search using controlled vocabulary and keywords for two concepts, EMG and telehealth, was conducted using Medline and EMBASE on February 7, 2022. Two independent reviewers screened titles, abstracts, and full-text articles. Two reviewers also extracted the data and described the findings in a descriptive analysis. Results: A total of 248 articles were screened during the abstract and title review, of which 64 full texts were screened for eligibility. Of these, 15 publications met the inclusion criteria. Most articles were published in 2018 or later (66.7%). The most frequently mentioned barrier to conducting a virtual EMG assessment was poor data and signal transmission (53.3%). Another frequently mentioned barrier was poor patient usability (33.3%). Solutions most frequently reported related to patient usability (33.3%). These included interactive instructions and video chat to monitor and provide the patient with technical support. Conclusion: The last 4 years have seen an increase in articles published on EMGs' use in telehealth to monitor or diagnose patients. Further research is required to determine if the proposed solutions have improved clinical outcomes for the patient.
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Affiliation(s)
- Valerie Nadeau
- Faculty of Rehabilitation Medicine, University of Alberta Edmonton, Edmonton, Alberta, Canada
| | - Emmanuella Osuji
- Faculty of Rehabilitation Medicine, University of Alberta Edmonton, Edmonton, Alberta, Canada
| | - Liz Dennett
- Scott Health Sciences Library, University of Alberta Edmonton, Edmonton, Alberta, Canada
| | - Martin Ferguson-Pell
- Faculty of Rehabilitation Medicine, University of Alberta Edmonton, Edmonton, Alberta, Canada
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13
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Emedoli D, Houdayer E, Della Rosa PA, Zito A, Brugliera L, Cimino P, Padul JD, Tettamanti A, Iannaccone S, Alemanno F. Continuity of care for patients with dementia during COVID-19 pandemic: flexibility and integration between in-person and remote visits. Front Public Health 2024; 11:1301949. [PMID: 38259745 PMCID: PMC10800651 DOI: 10.3389/fpubh.2023.1301949] [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: 09/25/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction During the pandemic, the Cognitive Disorders Unit of San Raffaele Hospital (Milan, Italy) offered patients the opportunity to undergo neuropsychological evaluations and cognitive training through telemedicine. Method We conducted an investigation to assess how patients responded to this option and to determine if telemedicine could ensure continuity of care. Results Between October 2019 and May 2022, a total of 5,768 telemedicine appointments and 8,190 in-person outpatient appointments were conducted, resulting in an increase in the rate of telemedicine activity from 16.81% in January 2020 to 23.21% in May 2022. Peaks in telemedicine activity reached 85.64% in May 2020 and 83.65% in February 2021, both representing a significant portion of the total activity. Interestingly, there was a notable positive correlation between telemedicine activity and the worsening of the Italian pandemic (r = 0.433, p = 0.027). Discussion During the peaks of contagion, the total number of visits remained stable, highlighting that telemedicine effectively served as a valuable and efficient tool to ensure continuity of care for vulnerable patients. This was evident from the integration of remote visits with in-person appointments.
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Affiliation(s)
- Daniele Emedoli
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elise Houdayer
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Alice Zito
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luigia Brugliera
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Cimino
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jeffrey David Padul
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Tettamanti
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Alemanno
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
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14
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Lippi L, Ferrillo M, Turco A, Folli A, Moalli S, Refati F, Perrero L, Ammendolia A, de Sire A, Invernizzi M. Multidisciplinary Rehabilitation after Hyaluronic Acid Injections for Elderly with Knee, Hip, Shoulder, and Temporomandibular Joint Osteoarthritis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2047. [PMID: 38004096 PMCID: PMC10672933 DOI: 10.3390/medicina59112047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/12/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
Osteoarthritis (OA) is a prevalent degenerative joint condition characterized by cartilage deterioration, joint inflammation, and functional limitations, particularly impacting the elderly population. Rehabilitation and hyaluronic acid (HA) injections are common therapeutic approaches routinely used in clinical practice, but their synergistic potential is far from being fully characterized. Thus, the aim of this narrative review was to elucidate the multilevel benefits and synergies of integrating these two approaches in multidisciplinary OA rehabilitation. This narrative review follows the scale for the assessment of narrative review articles (SANRA) criteria and involves a comprehensive literature search from July to August 2023. Two independent reviewers screened studies, including those involving human subjects with OA, rehabilitation strategies, and outcomes following HA injection, published in English. Results: HA injections might improve joint biomechanics, reducing friction, absorbing shocks, and potentially regulating inflammation. Rehabilitation plays a pivotal role in strengthening muscles, increasing the range of motion, and enhancing overall function. Optimizing rehabilitation following HA injection might provide additional benefits in joint health. OA management requires a multidisciplinary approach integrating HA injections, rehabilitation, and personalized care. Challenges in patient adherence and healthcare resources currently exist, but emerging technologies offer opportunities to enhance patient engagement and monitoring optimizing sustainability and outcomes of patients with knee, hip, shoulder, and temporomandibular joint OA.
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Affiliation(s)
- Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Martina Ferrillo
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alessio Turco
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Arianna Folli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Stefano Moalli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Fjorelo Refati
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Luca Perrero
- Neurorehabilitation Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (A.A.); (A.d.S.)
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (A.A.); (A.d.S.)
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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15
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Ruggiero F, Zirone E, Molisso MT, Carandini T, Fumagalli G, Pietroboni A, Ferrucci R, Aiello EN, Poletti B, Silani V, Comi G, Scarpini E, Barbieri S, Arighi A, Mameli F. Telemedicine for cognitive impairment: a telephone survey of patients' experiences with neurological video consultation. Neurol Sci 2023; 44:3885-3894. [PMID: 37365397 PMCID: PMC10570200 DOI: 10.1007/s10072-023-06903-9] [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: 01/27/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE This study aimed to evaluate the experience with telemedicine in patients with cognitive impairments and their caregivers. METHODS We conducted a survey-based study of patients who completed neurological consultation via video link between January and April 2022. RESULTS A total of 62 eligible neurological video consultations were conducted for the following categories of patients: Alzheimer's disease (33.87%), amnesic mild cognitive impairment (24.19%), frontotemporal dementia (17.74%), Lewy body dementia (4.84%), mixed dementia (3.23%), subjective memory disorders (12.90%), non-amnesic mild cognitive impairment (1.61%), and multiple system atrophy (1.61%). The survey was successfully completed by 87.10% of the caregivers and directly by the patients in 12.90% of cases. Our data showed positive feedback regarding the telemedicine experience; both caregivers and patients reported that they found neurological video consultation useful (caregivers: 87.04%, 'very useful'; patients: 87.50%, 'very useful') and were satisfied overall (caregivers: 90.74%, 'very satisfied'; patients: 100%, 'very satisfied'). Finally, all caregivers (100%) agreed that neurological video consultation was a useful tool to reduce their burden (Visual Analogue Scale mean ± SD: 8.56 ± 0.69). CONCLUSIONS Telemedicine is well received by patients and their caregivers. However, successful delivery incorporates support from staff and care partners to navigate technologies. The exclusion of older adults with cognitive impairment in developing telemedicine systems may further exacerbate access to care in this population. Adapting technologies to the needs of patients and their caregivers is critical for the advancement of accessible dementia care through telemedicine.
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Affiliation(s)
- Fabiana Ruggiero
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Eleonora Zirone
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Takeko Molisso
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Tiziana Carandini
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giorgio Fumagalli
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Pietroboni
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberta Ferrucci
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- ASST Santi Paolo e Carlo, Milan, Italy
| | - Edoardo Nicolò Aiello
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Barbara Poletti
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Neuroscience Section, Milan, Italy
| | - Giacomo Comi
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Neuroscience Section, Milan, Italy
| | - Elio Scarpini
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation (DEPT), Dino Ferrari Centre, University of Milan, Neuroscience Section, Milan, Italy
| | - Sergio Barbieri
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Arighi
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesca Mameli
- Department of Neuroscience and Mental Health, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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16
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Kim KH, Lee SM, Hong M, Han KM, Paik JW. Trends in telemedicine utilization for mental illness during the COVID-19 pandemic: an analysis of a nationwide database in Korea. BMC Psychiatry 2023; 23:777. [PMID: 37875854 PMCID: PMC10598914 DOI: 10.1186/s12888-023-05258-x] [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: 03/07/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has worsened mental health and reduced access to mental health services. During the pandemic, the demand for telemedicine has increased and related laws have been enacted. This study aimed to investigate telemedicine use for cases of major mental illnesses during the COVID-19 pandemic and to compare the characteristics of patients who received telemedicine service with those of patients who received in-person care. METHODS This population-based, cross-sectional, observational study was based on health insurance claims data, and included 2,749,872 patients who received outpatient treatment for mental illness from February 24, 2020 to June 30, 2022. Logistic regression was performed to assess the relationships between patient characteristics and telemedicine service use. Patients who received telemedicine services were analyzed in subgroups of each mental illness. RESULTS During the study period, 80,157 patients (2.9%), with an average age of 63 years, received at least one telemedicine treatment. There was a predominance of women and medical aid recipients. The lowest proportion of telemedicine treatments was for depression (2.1%), and the highest was for dementia (6.7%). The proportion of patients receiving telemedicine in long-term care hospitals was high (22.6%), with the highest odds ratio (OR) (5.84), compared with that in tertiary or general hospitals, followed by that in psychiatric hospitals and clinics. The proportions were high in the departments of internal medicine, neurology, and psychiatry. Patients aged > 80 years received most telemedicine treatment (OR: 1.23) across all diagnoses. Cases of dementia and other mental disorders had higher ORs (2.60 and 2.36, respectively) compared with cases of depression. Except for dementia and behavioral/emotional disorders, hospitalization increased the probability of telemedicine treatment. Comorbidities were positively associated with telemedicine treatment. CONCLUSIONS Older people and people with other physical illnesses were more likely to use telemedicine treatments temporarily provided during the pandemic. Telemedicine maintained continuity of treatment for patients with dementia and severe mental illnesses. Telemedicine can be useful for filling the medical gaps for vulnerable populations other than those with mild mental illnesses. This aspect should be considered for the future establishment of telemedicine systems.
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Affiliation(s)
- Kyoung Hoon Kim
- Department of Health Administration, College of Nursing and Health, Kongju National University, Gongju, Republic of Korea
| | - Sang Min Lee
- Department of Psychiatry, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- UNC Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA
| | - Minha Hong
- UNC Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Kyu-Man Han
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jong-Woo Paik
- Department of Psychiatry, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
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Pessoa Lima D, Rosa ID. People affected by dementia had mixed experiences of using technology during COVID-19. Evid Based Nurs 2023; 26:162. [PMID: 37116981 DOI: 10.1136/ebnurs-2022-103635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 04/30/2023]
Affiliation(s)
- Danielle Pessoa Lima
- Faculdade de Medicina, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, Ceará, Brazil
- Serviço de Geriatria, Departamento de Clínica Médica, Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Isabele Dantas Rosa
- Serviço de Geriatria, Departamento de Clínica Médica, Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
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18
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Abstract
PURPOSE OF REVIEW The use of digital tools for remote cognitive measurement of older adults is generating increasing interest due to the numerous advantages offered for accessibility and scalability. However, these tools also pose distinctive challenges, necessitating a thorough analysis of their psychometric properties, feasibility and acceptability. RECENT FINDINGS In this narrative review, we present the recent literature on the use of web-based cognitive assessment to characterize cognition in older adults and to contribute to the diagnosis of age-related neurodegenerative diseases. We present and discuss three types of web-based cognitive assessments: conventional cognitive tests administered through videoconferencing; unsupervised web-based assessments conducted on a computer; and unsupervised web-based assessments performed on smartphones. SUMMARY There have been considerable progress documenting the properties, strengths and limitations of web-based cognitive assessments. For the three types of assessments reported here, the findings support their promising potential for older adults. However, certain aspects, such as the construct validity of these tools and the development of robust norms, remain less well documented. Nonetheless, the beneficial potential of these tools, and their current validation and feasibility data, justify their application [see Supplementary Digital Content (SDC), http://links.lww.com/CONR/A69 ].
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Affiliation(s)
- Sylvie Belleville
- Research Center, Institut universitaire de gériatrie de Montréal
- Psychology Department, Université de Montréal
| | - Annalise Aleta LaPlume
- Research Center, Institut universitaire de gériatrie de Montréal
- Psychology Department, Université de Montréal
- Brain Imaging Centre, Douglas Mental Health University Institute, Montreal, Canada
| | - Rudy Purkart
- Research Center, Institut universitaire de gériatrie de Montréal
- Psychology Department, Université de Montréal
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Hostiuc S, Drima E. Dignity as a Central Issue in Treating Patients with Dementia Associated with COVID-19 Infection. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1588. [PMID: 37763707 PMCID: PMC10537082 DOI: 10.3390/medicina59091588] [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: 06/29/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023]
Abstract
COVID-19 was initially considered a primary respiratory disorder associated with various short- and long-term complications, affecting many patients and imposing a significant burden. Patients who have dementia are especially vulnerable to the SARS-CoV2 infection, which is associated with an increased risk for neuropsychiatric complications. These patients need a unique approach to managing ethical issues related to the COVID-19 pandemic, including autonomy, veracity, non-maleficence, justice, compassion, and dignity. The latter is one of the most elusive and misunderstood concepts in medical ethics and is extremely important in debates surrounding the proper management of patients with dementia. However, it is often left out of ethical analysis, as most clinicians, when debating issues associated with clinical practice, often evaluate only the "classical" principles of biomedical ethics. In this article, we aim to assess the unique features of dignity in treating this group of patients during the COVID-19 pandemic. We will briefly analyze dignity as a bioethical concept. We will further explore its principal axes, namely compassion, creating a humane and purposeful environment, employing persuasion to meet the person's essential needs, exerting a certain degree of mild restraint to meet the person's critical needs, minimizing harm in terminal care, and justice, through the lens of people who had dementia during the COVID-19 pandemic. Applying this principle in clinical practice requires significant commitment from all healthcare workers. New approaches to the analysis of dignity, such as through the Ring Theory of Personhood, may facilitate its understanding by practitioners and aid its implementation in populations with multiple vulnerabilities, such as dementia patients, during an infectious outbreak that generates significant social and medical changes.
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Affiliation(s)
- Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Eduard Drima
- Medical Clinical Department, Dunărea de Jos University, 800201 Galați, Romania;
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20
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Baik D, Reeder B, Coats H, Baker C, Jankowski C. Perceptions and Attitudes toward a Proposed Digital Health Physical Activity Program among Older Family Caregivers of Persons with Heart Failure: A Qualitative Study. Inform Health Soc Care 2023; 48:239-251. [PMID: 37417465 PMCID: PMC10990475 DOI: 10.1080/17538157.2023.2227704] [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] [Indexed: 07/08/2023]
Abstract
Tailored physical activity (PA) programs using digital health technologies in the home can promote family caregivers' (FCGs) physical function and psychological wellbeing. However, there is a gap in research for digital health PA interventions targeting older FCGs of persons with HF (HF-FCGs). The burden of caregiving for persons with HF may displace the FCG's self-care, including PA. Therefore, we examined older HF-FCGs' perceptions and attitudes toward three technology components (video-conferencing, fitness tracker, text messaging) that would be most useful in delivering a digital health PA program. Interviews were conducted with 13 HF-FCGs (≥65 years old) between January and April 2021. Directed content analysis was used and the analysis was guided by the adapted unified theory of acceptance and use of technology (UTAUT) model. In addition to HF-FCGs' perceptions and attitudes toward each technology component in each construct of the adapted UTAUT model (ease of use, usefulness, facilitating conditions), three additional factors were associated with intention to use technology. These were: (1) HF patients' positive experience, (2) digital skills, and (3) quality of internet connectivity. The findings provide digital health requirements for design and modification of a technology-supported PA program that engages older FCGs who care for persons with HF.
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Affiliation(s)
- Dawon Baik
- College of Nursing, University of Colorado College of Nursing, Aurora, Colorado, USA
| | - Blaine Reeder
- Sinclair School of Nursing, MU Institute for Data Science and Informatics, University of Missouri, Columbia, Missouri, USA
| | - Heather Coats
- College of Nursing, University of Colorado College of Nursing, Aurora, Colorado, USA
| | - Christina Baker
- College of Nursing, University of Colorado College of Nursing, Aurora, Colorado, USA
| | - Catherine Jankowski
- College of Nursing, University of Colorado College of Nursing, Aurora, Colorado, USA
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21
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De Pue S, Gillebert C, Dierckx E, Van den Bussche E. The longer-term impact of the COVID-19 pandemic on wellbeing and subjective cognitive functioning of older adults in Belgium. Sci Rep 2023; 13:9708. [PMID: 37322085 PMCID: PMC10272225 DOI: 10.1038/s41598-023-36718-9] [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: 12/22/2022] [Accepted: 06/08/2023] [Indexed: 06/17/2023] Open
Abstract
In earlier survey research, we observed a severe impact of the first peak of the COVID-19 pandemic on the subjective wellbeing, sleep and activity of adults aged 65 years or older in Flanders, Belgium. The impact on subjective cognitive functioning, however, was limited. Since then, periods of lockdown and periods with less strict regulations alternated, but social distancing remained, especially for older adults. To study the longer-term impact of the pandemic on wellbeing and subjective cognitive functioning, we re-assessed the older adults from the first measurement moment (May-June 2020) in a second (June-July 2020) and third (December 2020) wave of the survey (n = 371, M = 72 years old, range 65-97 years old). Results indicated that wellbeing fluctuated with the severity of the pandemic. Results for self-reported cognitive functioning were mixed. While participants indicated a slightly better general subjective cognitive functioning at the end of the study, experienced problems with most cognitive subdomains significantly increased over time. The presence of depressive and anxiety symptoms were related to the longer-term impact of the pandemic on wellbeing and subjective cognitive functioning. Our study shows the long-lasting impact of the pandemic on the wellbeing and subjective cognitive functioning of older adults, without full recovery from the first wave.
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Affiliation(s)
- Sarah De Pue
- Brain and Cognition, KU Leuven, Leuven, Belgium.
| | | | - Eva Dierckx
- Personality and Psychopathology, Vrije Universiteit Brussel, Brussels, Belgium
- Psychiatric Hospital, Alexianen Zorggroep Tienen, Tienen, Belgium
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22
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Loring DW, Lah JJ, Goldstein FC. Telehealth equivalence of the Montreal cognitive assessment (MoCA): Results from the Emory healthy brain study (EHBS). J Am Geriatr Soc 2023; 71:1931-1936. [PMID: 36762513 PMCID: PMC10258135 DOI: 10.1111/jgs.18271] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/10/2023] [Accepted: 01/15/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND We investigated potential differences between in-person cognitive testing and video telehealth administration of the Montreal Cognitive Assessment (MoCA). In addition to the MoCA, the Patient Health Questionnaire-8 (PHQ-8) and Generalized Anxiety Disorder-7 (GAD-7) were administered. METHODS MoCA scores from participants in the Emory Health Brain Study (EHBS) were contrasted based upon whether they were administered the MoCA in the standard face-to-face (F2F) assessment setting (n = 1205) or using a video telehealth administration (n = 491). All EHBS participants were self-reported to be cognitively normal. RESULTS MoCA scores did not differ across administration method (F2F MoCA = 26.6, SD = 2.4; telehealth MoCA = 26.5, SD = 2.4). The 95% confidence interval for difference in administration was small (CI = -0.16 to 0.34). When examining MoCA domain scores, administration differences were either associated with no statistically significant effect, or if present due to large sample sizes, were associated with small effects and differences <0.5 point. Telehealth patients reported slightly lower PHQ-8 scores (F2F PHQ-8 = 2.0, SD = 2.5; telehealth PHQ-8 = 1.6, SD = 2.1), although these scores are well within the normal range. No group difference in GAD-7 scores was present (F2F GAD-7 = 1.4, SD = 2.4; telehealth PHQ-8 = 1.4, SD = 2.4). DISCUSSION This report with its large sample size and between subject cohort provides complementary evidence to smaller test-retest studies, further supporting equivalence of MoCA telehealth testing to F2F MoCA administration. These findings provide additional reassurance that administration mode does not introduce systematic performance differences for MoCA test administration, thereby permitting telehealth MoCA testing to be applied confidently for both clinical and research applications.
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Affiliation(s)
- David W. Loring
- Department of Neurology, Emory University School of Medicine
- Department of Pediatrics, Emory University School of Medicine
| | - James J. Lah
- Department of Neurology, Emory University School of Medicine
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23
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Hua Y, Temkin-Greener H, Cai S. Primary Care Telemedicine Use Among Assisted Living Residents With Dementia During COVID-19: Race and Dual Enrollment Status. J Am Med Dir Assoc 2023:S1525-8610(23)00468-1. [PMID: 37308091 PMCID: PMC10192593 DOI: 10.1016/j.jamda.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 06/14/2023]
Affiliation(s)
- Yechu Hua
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Helena Temkin-Greener
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY.
| | - Shubing Cai
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY
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24
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Cinalioglu K, Elbaz S, Sekhon K, Su CL, Rej S, Sekhon H. Exploring Differential Perceptions of Artificial Intelligence in Health Care Among Younger Versus Older Canadians: Results From the 2021 Canadian Digital Health Survey. J Med Internet Res 2023; 25:e38169. [PMID: 37115588 PMCID: PMC10182456 DOI: 10.2196/38169] [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: 06/28/2022] [Revised: 11/14/2022] [Accepted: 12/19/2022] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The changing landscape of health care has led to the incorporation of powerful new technologies like artificial intelligence (AI) to assist with various services across a hospital. However, despite the potential outcomes that this tool may provide, little work has examined public opinion regarding their use. OBJECTIVE In this study, we aim to explore differences between younger versus older Canadians with regard to the level of comfort and perceptions around the adoption and use of AI in health care settings. METHODS Using data from the 2021 Canadian Digital Health Survey (n=12,052), items related to perceptions about the use of AI as well as previous experience and satisfaction with health care were identified. We conducted Mann-Whitney U tests to compare the level of comfort of younger versus older Canadians regarding the use of AI in health care for a variety of purposes. Multinomial logistic regression was used to predict the comfort ratings based on categorical indicators. RESULTS Younger Canadians had greater knowledge of AI, but older Canadians were more comfortable with AI applied to monitoring and predicting health conditions, decision support, diagnostic imaging, precision medicine, drug and vaccine development, disease monitoring at home, tracking epidemics, and optimizing workflow to save time. Additionally, for older respondents, higher satisfaction led to higher comfort ratings. Only 1 interaction effect was identified between previous experience, satisfaction, and comfort with AI for drug and vaccine development. CONCLUSIONS Older Canadians may be more open to various applications of AI within health care than younger Canadians. High satisfaction may be a critical criterion for comfort with AI, especially for older Canadians. Additionally, in the case of drug and vaccine development, previous experience may be an important moderating factor. We conclude that gaining a greater understanding of the perceptions of all health care users is integral to the implementation and sustainability of new and cutting-edge technologies in health care settings.
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Affiliation(s)
- Karin Cinalioglu
- Department of Psychiatry, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Sasha Elbaz
- Department of Psychology, Université du Québec à Montréal (UQAM), Montreal, QC, Canada
| | - Kerman Sekhon
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Chien-Lin Su
- Department of Psychiatry, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Soham Rej
- Department of Psychiatry, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Harmehr Sekhon
- Department of Psychiatry, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, United States
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25
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Louras N, Reading Turchioe M, Shafran Topaz L, Demetres MR, Ellison M, Abudu-Solo J, Blutinger E, Munjal KG, Daniels B, Masterson Creber RM. Mobile Integrated Health Interventions for Older Adults: A Systematic Review. Innov Aging 2023; 7:igad017. [PMID: 37090165 PMCID: PMC10114527 DOI: 10.1093/geroni/igad017] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Indexed: 03/04/2023] Open
Abstract
Background and Objectives Mobile integrated health (MIH) interventions have not been well described in older adult populations. The objective of this systematic review was to evaluate the characteristics and effectiveness of MIH programs on health-related outcomes among older adults. Research Design and Methods We searched Ovid MEDLINE, Ovid EMBASE, CINAHL, AgeLine, Social Work Abstracts, and The Cochrane Library through June 2021 for randomized controlled trials or cohort studies evaluating MIH among adults aged 65 and older in the general community. Studies were screened for eligibility against predefined inclusion/exclusion criteria. Using at least 2 independent reviewers, quality was appraised using the Downs and Black checklist and study characteristics and findings were synthesized and evaluated for potential bias. Results Screening of 2,160 records identified 15 studies. The mean age of participants was 67 years. The MIH interventions varied in their focus, community paramedic training, types of assessments and interventions delivered, physician oversight, use of telemedicine, and post-visit follow-up. Studies reported significant reductions in emergency call volume (5 studies) and immediate emergency department (ED) transports (3 studies). The 3 studies examining subsequent ED visits and 4 studies examining readmission rates reported mixed results. Studies reported low adverse event rates (5 studies), high patient and provider satisfaction (5 studies), and costs equivalent to or less than usual paramedic care (3 studies). Discussion and Implications There is wide variability in MIH provider training, program coordination, and quality-based metrics, creating heterogeneity that make definitive conclusions challenging. Nonetheless, studies suggest MIH reduces emergency call volume and ED transport rates while improving patient experience and reducing overall health care costs.
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Affiliation(s)
- Nathan Louras
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Leah Shafran Topaz
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Michelle R Demetres
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medical College, New York, New York, USA
| | - Melani Ellison
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Jamie Abudu-Solo
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Erik Blutinger
- Department of Emergency Medicine, Mount Sinai Icahn School of Medicine, New York, New York, USA
| | - Kevin G Munjal
- Department of Emergency Medicine, Mount Sinai Icahn School of Medicine, New York, New York, USA
| | - Brock Daniels
- Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, USA
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26
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Sari YM, Burton E, Lee DCA, Hill KD. A Telehealth Home-Based Exercise Program for Community-Dwelling Older People with Dementia in Indonesia: A Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3397. [PMID: 36834093 PMCID: PMC9966659 DOI: 10.3390/ijerph20043397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: This study aimed to evaluate the feasibility of a telehealth home-based exercise program for older people with dementia living in Indonesia with support from their informal carers. (2) Methods: Pre-post intervention single group study with three assessment time-points (baseline, 12 and 18 weeks). Participants with dementia underwent a 12-week physiotherapist-delivered telehealth exercise program, with informal carer supervision between supervised online sessions, and continued the exercises for a further six weeks without physiotherapist online supervision. (3) Results: Thirty dyads of older people with dementia and their informal carers were recruited; four (13.3%) withdrew across the 12-week intervention and one (3.3%) in the 6-week self-maintenance period. Median adherence was 84.1% (IQR [25, 75] = 17.1) during the 12-week intervention, and 66.7% (IQR [25, 75] = 16.7) in the self-maintenance period. No falls/adverse events were reported. Physical activity level, some aspects of function and disability, health-related benefits of exercise, exercise enjoyment and quality of life of older people with dementia improved significantly at 12 and 18 weeks. (4) Conclusions: The telehealth exercise program is feasible and safe and may have benefits for the health outcomes of community-living older people with dementia in Indonesia. Additional strategies are necessary to enhance longer-term adherence to the program.
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Affiliation(s)
- Yulisna Mutia Sari
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne 3800, Australia
| | - Elissa Burton
- Curtin School of Allied Health, Curtin University, Perth 6102, Australia
- enAble Institute, Curtin University, Perth 6845, Australia
| | - Den-Ching A. Lee
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne 3800, Australia
- National Centre for Healthy Ageing, Monash University and Peninsula Health, Melbourne 3199, Australia
| | - Keith D. Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne 3800, Australia
- National Centre for Healthy Ageing, Monash University and Peninsula Health, Melbourne 3199, Australia
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27
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Fragkiadaki S, Kontaxopoulou D, Stanitsa E, Angelopoulou E, Pavlou D, Šemrov D, Colnar S, Lustrek M, Blažica B, Vučica I, Matković R, Vukojevic K, Jelicic A, Guzzi PH, Martinović V, Medina AP, Piccoli G, Menon M, Kozetinac S, Miljković M, Kiskini C, Kokorotsikos T, Zilidou V, Radević I, Papatriantafyllou J, Thireos E, Tsouros A, Dimovski V, Papageorgiou SG. How Well Did the Healthcare System Respond to the Healthcare Needs of Older People with and without Dementia during the COVID-19 Pandemic? The Perception of Healthcare Providers and Older People from the SI4CARE Project in the ADRION Region. Geriatrics (Basel) 2023; 8:geriatrics8010021. [PMID: 36826363 PMCID: PMC9957093 DOI: 10.3390/geriatrics8010021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
One major challenge during the COVID-19 pandemic was the limited accessibility to healthcare facilities, especially for the older population. The aim of the current study was the exploration of the extent to which the healthcare systems responded to the healthcare needs of the older people with or without cognitive impairment and their caregivers in the Adrion/Ionian region. Data were collected through e-questionnaires regarding the adequacy of the healthcare system and were anonymously administered to older individuals and stakeholder providers in the following countries: Slovenia, Italy (Calabria), Croatia, Bosnia and Herzegovina, Greece, Montenegro, and Serbia. Overall, 722 older people and 267 healthcare stakeholders participated in the study. During the COVID-19 pandemic, both healthcare stakeholders and the older population claimed that the healthcare needs of the older people and their caregivers increased dramatically in all countries, especially in Italy (Calabria), Croatia and BiH. According to our results, countries from the Adrion/Ionian regions faced significant challenges to adjust to the special needs of the older people during the COVID-19 pandemic, which was possibly due to limited accessibility opportunities to healthcare facilities. These results highlight the need for the development of alternative ways of providing medical assistance and supervision when in-person care is not possible.
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Affiliation(s)
- Stella Fragkiadaki
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Evangelia Stanitsa
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Efthalia Angelopoulou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Dimosthenis Pavlou
- School of Topography and Geoinformatics, University of West Attica, Ag. Spyridonos Str., 12243 Aigalew, Greece
| | - Darja Šemrov
- Faculty of Civic and Geodetic Engineering, University of Ljubljana Jamova cesta 2, 1000 Ljubljana, Slovenia
| | - Simon Colnar
- School of Economics and Business, University of Ljubljana Kardeljeva ploščad 17, 1000 Ljubljana, Slovenia
| | - Mitja Lustrek
- Department of Intelligent Systems, Jožef Stefan Institute, Jamova cesta 39, 1000 Ljubljana, Slovenia
| | - Bojan Blažica
- Computer Systems Department, Jožef Stefan Institute, Jamova cesta 39, 1000 Ljubljana, Slovenia
| | - Inga Vučica
- Department of Gerontology, Teaching Institute for Public Health of Split and Dalmatian County, Vukovarska 46, 21000 Split, Croatia
| | - Roberta Matković
- Department for Research Data Collecting and Analysis, Teaching Institute for Public Health of Split and Dalmatian County, Vukovarska 46, 21000 Split, Croatia
| | - Katarina Vukojevic
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Šoltanska ul. 2, 21000 Split, Croatia
| | - Ana Jelicic
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Šoltanska ul. 2, 21000 Split, Croatia
| | - Pietro Hiram Guzzi
- Municipality of Miglierina, Street B. Telesio 88040, Italy and University of Catanzaro, viale Europa, 88100 Catanzaro, Italy
| | - Vlatka Martinović
- Faculty of Medicine, University Hospital Mostar, 88000 Mostar, Bosnia and Herzegovina
| | - Amina Pekmez Medina
- Health Insurance and Reinsurance Fund of Federation of Bosnia and Herzegovina, Trg Heroja 14, 71000 Sarajevo, Bosnia and Herzegovina
| | - Guido Piccoli
- ALOT, SI4CARE-TEAM Street Cipro, 16, 25124 Brescia, Italy
| | | | - Srdjan Kozetinac
- Special Hospital Merkur, Cara Dusana 3, 36210 Vrnjaka Banja, Serbia
| | | | - Chrysanthi Kiskini
- Department of European Union, Projects of Regional Development Fund of Central Macedonia, Vas. Olgas 198, 54 655, Thessaloniki, Greece
| | - Themis Kokorotsikos
- Department of European Union, Projects of Regional Development Fund of Central Macedonia, Vas. Olgas 198, 54 655, Thessaloniki, Greece
| | - Vasiliki Zilidou
- Lab of Medical Physics & Digital Innovation, and Thessaloniki Active & Healthy Ageing Living Lab, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ivan Radević
- Faculty of Economics, University of Montenegro, 37 Bulevar Jovana Tomaševića, 81000 Podgorica, Montenegro
| | - John Papatriantafyllou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Eleftherios Thireos
- National Health System, Athens Medical Society, Meandrou 23, 115 28 Athens, Greece
| | - Agis Tsouros
- Department of Global Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Vlado Dimovski
- School of Economics and Business, University of Ljubljana Kardeljeva ploščad 17, 1000 Ljubljana, Slovenia
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
- Correspondence:
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28
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Huang P, Zhang LY, Tan YY, Chen SD. Links between COVID-19 and Parkinson's disease/Alzheimer's disease: reciprocal impacts, medical care strategies and underlying mechanisms. Transl Neurodegener 2023; 12:5. [PMID: 36717892 PMCID: PMC9885419 DOI: 10.1186/s40035-023-00337-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/12/2023] [Indexed: 01/31/2023] Open
Abstract
The impact of coronavirus disease 2019 (COVID-19) pandemic on patients with neurodegenerative diseases and the specific neurological manifestations of COVID-19 have aroused great interest. However, there are still many issues of concern to be clarified. Therefore, we review the current literature on the complex relationship between COVID-19 and neurodegenerative diseases with an emphasis on Parkinson's disease (PD) and Alzheimer's disease (AD). We summarize the impact of COVID-19 infection on symptom severity, disease progression, and mortality rate of PD and AD, and discuss whether COVID-19 infection could trigger PD and AD. In addition, the susceptibility to and the prognosis of COVID-19 in PD patients and AD patients are also included. In order to achieve better management of PD and AD patients, modifications of care strategies, specific drug therapies, and vaccines during the pandemic are also listed. At last, mechanisms underlying the link of COVID-19 with PD and AD are reviewed.
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Affiliation(s)
- Pei Huang
- grid.16821.3c0000 0004 0368 8293Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Lin-Yuan Zhang
- grid.412478.c0000 0004 1760 4628Department of Neurology, Shanghai General Hospital, Shanghai, 200080 China
| | - Yu-Yan Tan
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Sheng-Di Chen
- Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China. .,Lab for Translational Research of Neurodegenerative Diseases, Shanghai Institute for Advanced Immunochemical Studies (SIAIS), Shanghai Tech University, Shanghai, 201210, China.
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29
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Silva ÍDS, Silva CRDV, Lopes RH, de Araújo AJ, de Figueirêdo RC, Bay ODG, Lapão LV, Xavier PB, Uchôa SADC. Digital health interventions and quality of home-based primary care for older adults: A scoping review protocol. Front Public Health 2023; 10:1022587. [PMID: 36699882 PMCID: PMC9870288 DOI: 10.3389/fpubh.2022.1022587] [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: 08/19/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction The use of digital health interventions has expanded, particularly in home-based primary care (HBPC), following the increase in the older adult population and the need to respond to the higher demand of chronic conditions, weakness and loss of autonomy of this population. There was an even greater demand with COVID-19 and subsequent isolation/social distancing measures for this risk group. The objective of this study is to map and identify the uses and types of digital health interventions and their reported impacts on the quality of HBPC for older adults worldwide. Methods and analysis This is a scoping review protocol which will enable a rigorous, transparent and reliable synthesis of knowledge. The review will be developed from the theoretical perspective of Arksey and O'malley, with updates by Levac and Peters and respective collaborators based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Data from white literature will be extracted from multidisciplinary health databases such as: the Virtual Health Library, LILACS, MEDLINE/PubMed, Scopus, Web of Science, Cinahl and Embase; while Google Scholar will be used for gray literature. No date limit or language restrictions will be determined. The quantitative data will be analyzed through descriptive statistics and qualitative data through thematic analysis. The results will be submitted to stakeholder consultation for preliminary sharing of the study and will later be disseminated through publication in open access scientific journals, scientific events and academic and community journals. The full scoping review report will present the main impacts, challenges, opportunities and gaps found in publications related to the use of digital technologies in primary home care. Discussion The organization of this protocol will increase the methodological rigor, quality, transparency and accuracy of scoping reviews, reducing the risk of bias.
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Affiliation(s)
- Ísis de Siqueira Silva
- Postgraduate in Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil,*Correspondence: Ísis de Siqueira Silva ✉
| | | | - Rayssa Horácio Lopes
- Postgraduate in Collective Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | | | - Osvaldo de Goes Bay
- Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
| | - Luís Velez Lapão
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Pedro Bezerra Xavier
- Postgraduate in Collective Health, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
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30
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Alghamdi MM, Burrows T, Barclay B, Baines S, Chojenta C. Culinary Nutrition Education Programs in Community-Dwelling Older Adults: A Scoping Review. J Nutr Health Aging 2023; 27:142-158. [PMID: 36806869 PMCID: PMC9872757 DOI: 10.1007/s12603-022-1876-7] [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: 10/19/2022] [Accepted: 12/04/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Culinary nutrition education programs are increasingly used as a public health intervention for older adults. These programs often integrate nutrition education in addition to interactive cooking workshops or displays to create programs suitable for older adults' needs, ability and behaviour change. Synthesising the existing literature on nutrition education and interactive cooking programs for older adults is important to guide future program development to support healthy ageing. OBJECTIVES To determine the extent of published literature and report the characteristics and outcomes of interactive culinary nutrition education programs for older adults (> 51 years). DESIGN This scoping review followed the PRISMA-ScR guidelines recommended for reporting and conducting a scoping review. METHODS Five databases were searched of relevant papers published to May 2022 using a structured search strategy. Inclusion criteria included: older adults (≥ 51 years), intervention had both an interactive culinary element and nutrition education and reported dietary outcome. Titles and abstracts were screened by two reviewers, followed by full-text retrieval. Data were charted regarding the characteristics of the program and outcomes assessed. RESULTS A total of 39 articles met the full inclusion criteria. The majority of these studies (n= 23) were inclusive of a range of age groups where older adults were the majority but did not target older adults exclusively. There were large variations in the design of the programs such as the number of classes (1 to 20), duration of programs (2 weeks to 2 years), session topics, and whether a theoretical model was used or not and which model. All programs were face-to-face (n= 39) with only two programs including alternatives or additional delivery approaches beside face-to-face settings. The most common outcomes assessed were dietary behaviour, dietary intake and anthropometrics. CONCLUSION Culinary nutrition education programs provide an environment to improve dietary habits and health literacy of older adults. However, our review found that only a small number of programs were intentionally designed for older adults. This review provides a summary to inform researchers and policy makers on current culinary nutrition education programs for older adults. It also recommends providing face-to-face alternatives that will be accessible to a wider group of older adults with fewer restrictions.
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Affiliation(s)
- M M Alghamdi
- Maryam M Alghamdi, PhD candidate, MSc, RD, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia,
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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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Tanaka S, Saida K, Murayama A, Higuchi D, Shinohara T. Associated factors of new subjective cognitive decline complaints after a 6-month period among community-dwelling older adults during the COVID-19 pandemic in Japan. Psychogeriatrics 2023; 23:136-140. [PMID: 36412008 DOI: 10.1111/psyg.12917] [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] [Received: 03/25/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The aim of this study was to determine the number of new subjective cognitive decline (SCD) complaints and associated factors in community-dwelling older adults during the COVID-19 pandemic in Japan. METHOD A prospective cohort study was conducted in two periods: May to June 2020, and November 2020 to January 2021. We mailed a questionnaire to 1953 older adults in the first survey, and received 700 responses in the second. We analysed 534 participants without SCD in the first survey. We collected data on sociodemographic characteristics and administered the Questionnaire for Medical Checkup of Old-Old (QMCOO) to assess respondents' health condition. SCD was operationally defined using the QMCOO as reports of (1) forgetfulness, and (2) difficulty in naming dates. The subjects were divided into two groups by their condition at the second survey: an SCD (new SCD complaints) and a no-SCD (no new SCD complaints) group. RESULTS A total of 85 (15.9%) participants had new SCD complaints. The Mann-Whitney U-test and chi-squared test showed that the SCD group had significantly more risk factors of SCD: walking speed (P = 0.001), smoking (P = 0.001), and existence of person with whom the patient could consult when disordered (P = 0.002). Multiple logistic regression analysis revealed that walking speed (odds ratio (OR) = 2.115, 95% confidence interval (CI): 1.259-3.553) and the presence of person to consult (OR = 3.619, 95% CI: 1.553-8.433) were significant related factors of new SCD complaints. CONCLUSION Maintenance of physical condition and social support were associated with new SCD complaints during the COVID-19 pandemic.
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Affiliation(s)
- Shigeya Tanaka
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Kosuke Saida
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Akihiko Murayama
- Department of Physical Therapy, Faculty of Rehabilitation, Gunma University of Health and Welfare, Maebashi, Japan
| | - Daisuke Higuchi
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan
| | - Tomoyuki Shinohara
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Takasaki, Japan
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Gould CE, Iyer S, Filips J, Alfaro AJ, Carlson C, Trivedi R. Delivering Virtual Care to Patients with Cognitive Impairment within the Veterans Health Administration: Multi-level Barriers and Solutions. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2022; 8:1-9. [PMID: 36530384 PMCID: PMC9734576 DOI: 10.1007/s41347-022-00291-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/19/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022]
Abstract
Older patients with cognitive impairment, including dementia, may benefit from virtual care that increases access to geriatric specialties. Here, we identify clinician-level strategies to address the numerous barriers that reduce utilization of virtual services. We describe two innovative programs in the Veterans Health Administration that deliver geriatric medicine and geriatric psychiatry services virtually. This commentary outlines concrete strategies addressing identified barriers, including technology access, digital literacy, and ambivalence and communication challenges during video visits. Two virtual care programs (tele-geriatric psychiatry consultation; tele-dementia care) that address complex medical and mental health issues in older adults with cognitive impairment are described. The Consolidated Framework for Implementation Research (CFIR) is used to categorize the clinician-level strategies and program elements as they relate to the implementation domains and constructs. Clinicians can use education strategies prior to and during virtual care visits to facilitate access to video, optimize the virtual experience, and promote information retention. These strategies rely on aspects of the inner setting, outer setting, and characteristics of individuals. The two virtual programs vary in their intervention characteristics and the inner setting, yet both programs share similar characteristics of individuals. Key elements contributing to adoption and sustainment of these virtual care programs for patients with cognitive impairment include the relative advantage of virtual care to leverage access to specialists over alternative solutions in each setting. Other factors to consider include the importance of communication, program champions, and the role of the Veterans Health Administration.
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Affiliation(s)
- Christine E. Gould
- Geriatric Research, Education, and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, CA USA
- Deptartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, USA
| | - Sowmya Iyer
- Geriatric Research, Education, and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, CA USA
- Division of Primary Care and Population Health, Geriatrics Section, Stanford University School of Medicine, Palo Alto, USA
| | - Julie Filips
- VISN 23 Clinical Resource Hub, VA Minneapolis Health Care System, Minneapolis, MN USA
| | - Ana Jessica Alfaro
- Geriatric Research, Education, and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, CA USA
- Deptartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, USA
| | - Chalise Carlson
- Geriatric Research, Education, and Clinical Center, VA Palo Alto Health Care System, 3801 Miranda Ave., Palo Alto, CA USA
| | - Ranak Trivedi
- Deptartment of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, USA
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA USA
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How Telemedicine Can Improve the Quality of Care for Patients with Alzheimer's Disease and Related Dementias? A Narrative Review. Medicina (B Aires) 2022; 58:medicina58121705. [PMID: 36556907 PMCID: PMC9783876 DOI: 10.3390/medicina58121705] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/13/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives: Dementia affects more than 55 million patients worldwide, with a significant societal, economic, and psychological impact. However, many patients with Alzheimer's disease (AD) and other related dementias have limited access to effective and individualized treatment. Care provision for dementia is often unequal, fragmented, and inefficient. The COVID-19 pandemic accelerated telemedicine use, which holds promising potential for addressing this important gap. In this narrative review, we aim to analyze and discuss how telemedicine can improve the quality of healthcare for AD and related dementias in a structured manner, based on the seven dimensions of healthcare quality defined by the World Health Organization (WHO), 2018: effectiveness, safety, people-centeredness, timeliness, equitability, integrated care, and efficiency. Materials and Methods: MEDLINE and Scopus databases were searched for peer-reviewed articles investigating the role of telemedicine in the quality of care for patients with dementia. A narrative synthesis was based on the seven WHO dimensions. Results: Most studies indicate that telemedicine is a valuable tool for AD and related dementias: it can improve effectiveness (better access to specialized care, accurate diagnosis, evidence-based treatment, avoidance of preventable hospitalizations), timeliness (reduction of waiting times and unnecessary transportation), patient-centeredness (personalized care for needs and values), safety (appropriate treatment, reduction of infection risk),integrated care (interdisciplinary approach through several dementia-related services), efficiency (mainly cost-effectiveness) and equitability (overcoming geographical barriers, cultural diversities). However, digital illiteracy, legal and organizational issues, as well as limited awareness, are significant potential barriers. Conclusions: Telemedicine may significantly improve all aspects of the quality of care for patients with dementia. However, future longitudinal studies with control groups including participants of a wide educational level spectrum will aid in our deeper understanding of the real impact of telemedicine in quality care for this population.
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Lippi L, Folli A, Curci C, D’Abrosca F, Moalli S, Mezian K, de Sire A, Invernizzi M. Osteosarcopenia in Patients with Chronic Obstructive Pulmonary Diseases: Which Pathophysiologic Implications for Rehabilitation? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114314. [PMID: 36361194 PMCID: PMC9657186 DOI: 10.3390/ijerph192114314] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 10/28/2022] [Accepted: 10/30/2022] [Indexed: 05/10/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a burdensome condition affecting a growing number of people worldwide, frequently related to major comorbidities and functional impairment. In these patients, several factors might have a role in promoting both bone and muscle loss, including systemic inflammation, corticosteroid therapies, sedentary behaviours, deconditioning, malnutrition, smoking habits, and alcohol consumption. On the other hand, bone and muscle tissues share several linkages from functional, embryological, and biochemical points of view. Osteosarcopenia has been recently defined by the coexistence of osteoporosis and sarcopenia, but the precise mechanisms underpinning osteosarcopenia in patients with COPD are still unknown. In this scenario, a deeper understanding of the molecular basis of osteosarcopenia might guide clinicians in a personalized approach integrating skeletal muscle health with the pulmonary rehabilitation framework in COPD. Taken together, our results summarized the currently available evidence about the multilevel interactions between osteosarcopenia and COPD to pave the way for a comprehensive approach targeting the most common risk factors of these pathological conditions. Further studies are needed to clarify the role of modern clinical strategies and telemedicine solutions to optimize healthcare delivery in patients with COPD, including osteopenia, osteoporosis, and sarcopenia screening in these subjects.
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Affiliation(s)
- Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Arianna Folli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy
| | - Francesco D’Abrosca
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Stefano Moalli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital, 12800 Prague, Czech Republic
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, 15006 Prague, Czech Republic
- Correspondence: ; Tel.: +390961369768
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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Saigí-Rubió F, Borges do Nascimento IJ, Robles N, Ivanovska K, Katz C, Azzopardi-Muscat N, Novillo Ortiz D. The Current Status of Telemedicine Technology Use Across the World Health Organization European Region: An Overview of Systematic Reviews. J Med Internet Res 2022; 24:e40877. [DOI: 10.2196/40877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/16/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Several systematic reviews evaluating the use of telemedicine by clinicians, patients, and health authorities to improve the delivery of care in the 53 member states of the World Health Organization (WHO) European Region have been conducted in recent years. However, a study summarizing the findings of these reviews has not been conducted.
Objective
This overview of systematic reviews aimed to summarize findings regarding the use of telemedicine across the 53 member states and identify the medical fields and levels of care in and at which the effectiveness, feasibility, and applicability of telemedicine have been demonstrated. The barriers to and facilitators of telemedicine use were also evaluated and collated to help with the design and implementation of telemedicine interventions.
Methods
Through a comprehensive systematic evaluation of the published and unpublished literature, we extracted clinical, epidemiological, and technology-related data from each review included in the study. We focused on evaluating the barriers to and facilitators of the use of telemedicine apps across the 53 member states considered. We rated the methodological quality of each of the included reviews based on A Measurement Tool to Assess Systematic Review 2 approach and judged the overall certainty of evidence by using the Grading of Recommendations, Assessment, Development, and Evaluations methodology. The entire process was performed by 2 independent authors.
Results
This overview drew on data from >2239 primary studies, with >20,000 enrolled patients in total, within the WHO European Region. On the basis of data from randomized trials, observational studies, and economic evaluations from several countries, the results show a clear benefit of telemedicine technologies in the screening, diagnosis, management, treatment, and long-term follow-up of a series of chronic diseases. However, we were unable to pool the results into a reliable numeric parameter because of the high heterogeneity of intervention methodologies, scheduling, primary study design discrepancies, settings, and geographical locations. In addition to the clinical outcomes of the interventions, the social and economic outcomes are highlighted.
Conclusions
The application of telemedicine is well established across countries in the WHO European Region; however, some countries could still benefit from the many uses of these digital solutions. Barriers related to users, technology, and infrastructure were the largest. Conversely, the provision of health services using technological devices was found to significantly enhance patients’ clinical outcomes, improve the long-term follow-up of patients by medical professionals, and offer logistical benefits for both patients and health workers.
Trial Registration
PROSPERO (International Prospective Register of Systematic Reviews) CRD42022309375; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=309375
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Pharmacological, Nutritional, and Rehabilitative Interventions to Improve the Complex Management of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease: A Narrative Review. J Pers Med 2022; 12:jpm12101626. [PMID: 36294765 PMCID: PMC9604650 DOI: 10.3390/jpm12101626] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
Osteoporosis is a highly prevalent condition affecting a growing number of patients affected by chronic obstructive pulmonary disease (COPD), with crucial implications for risk of fragility fractures, hospitalization, and mortality. Several risk factors have been identified to have a role in osteoporosis development in COPD patients, including corticosteroid therapy, systemic inflammation, smoke, physical activity levels, malnutrition, and sarcopenia. In this scenario, a personalized multitarget intervention focusing on the pathological mechanisms underpinning osteoporosis is mandatory to improve bone health in these frail patients. Specifically, physical exercise, nutritional approach, dietary supplements, and smoke cessation are the cornerstone of the lifestyle approach to osteoporosis in COPD patients, improving not only bone health but also physical performance and balance. On the other hand, pharmacological treatment should be considered for both the prevention and treatment of osteoporosis in patients at higher risk of fragility fractures. Despite these considerations, several barriers still affect the integration of a personalized approach to managing osteoporosis in COPD patients. However, digital innovation solutions and telemedicine might have a role in optimizing sustainable networking between hospital assistance and community settings to improve bone health and reduce sanitary costs of the long-term management of COPD patients with osteoporosis.
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Diagnostic accuracy of telemedicine for detection of surgical site infection: a systematic review and meta-analysis. NPJ Digit Med 2022; 5:108. [PMID: 35922663 PMCID: PMC9349203 DOI: 10.1038/s41746-022-00655-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/04/2022] [Indexed: 11/09/2022] Open
Abstract
The Sars-CoV-2 pandemic catalysed integration of telemedicine worldwide. This systematic review assesses it’s accuracy for diagnosis of Surgical Site Infection (SSI). Databases were searched for telemedicine and wound infection studies. All types of studies were included, only paired designs were taken to meta-analysis. QUADAS-2 assessed methodological quality. 1400 titles and abstracts were screened, 61 full text reports were assessed for eligibility and 17 studies were included in meta-analysis, mean age was 47.1 ± 13.3 years. Summary sensitivity and specificity was 87.8% (95% CI, 68.4–96.1) and 96.8% (95% CI 93.5–98.4) respectively. The overall SSI rate was 5.6%. Photograph methods had lower sensitivity and specificity at 63.9% (95% CI 30.4–87.8) and 92.6% (95% CI, 89.9–94.5). Telemedicine is highly specific for SSI diagnosis is highly specific, giving rise to great potential for utilisation excluding SSI. Further work is needed to investigate feasibility telemedicine in the elderly population group.
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Lippi L, D’Abrosca F, Folli A, Dal Molin A, Moalli S, Maconi A, Ammendolia A, de Sire A, Invernizzi M. Closing the Gap between Inpatient and Outpatient Settings: Integrating Pulmonary Rehabilitation and Technological Advances in the Comprehensive Management of Frail Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159150. [PMID: 35954506 PMCID: PMC9368185 DOI: 10.3390/ijerph19159150] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/21/2022] [Accepted: 07/24/2022] [Indexed: 02/03/2023]
Abstract
Pulmonary rehabilitation (PR) is a well-established intervention supported by strong evidence that is used to treat patients affected by chronic respiratory diseases. However, several barriers still affect its spreading in rehabilitation clinical practices. Although chronic respiratory diseases are common age-related disorders, there is still a gap of knowledge regarding the implementation of sustainable strategies integrating PR in the rehabilitation management of frail patients at high risk of respiratory complications. Therefore, in the present study, we characterized the effects of PR in frail patients, highlighting the evidence supporting its role in improving the complex rehabilitative management of these patients. Moreover, we propose a novel organizational model promoting PR programs for frail patients in both inpatient and outpatient settings. Our model emphasizes the role of interdisciplinary care, specifically tailored to patients and environmental characteristics. In this scenario, cutting-edge technology and telemedicine solutions might be implemented as safe and sustainable strategies filling the gap between inpatient and outpatient settings. Future research should focus on large-scale sustainable interventions to improve the quality of life and global health of frail patients. Moreover, evidence-based therapeutic paths should be promoted and taught in training courses promoting multiprofessional PR knowledge to increase awareness and better address its delivery in frail patients.
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Affiliation(s)
- Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (F.D.); (A.F.); (S.M.)
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Francesco D’Abrosca
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (F.D.); (A.F.); (S.M.)
| | - Arianna Folli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (F.D.); (A.F.); (S.M.)
| | - Alberto Dal Molin
- Department of Translational Medicine, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy;
- Health Professions’ Direction, “Ospedale Maggiore della Carità” University Hospital, 28100 Novara, Italy
| | - Stefano Moalli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (F.D.); (A.F.); (S.M.)
| | - Antonio Maconi
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Antonio Ammendolia
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy; (A.A.); (A.d.S.)
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy; (A.A.); (A.d.S.)
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (F.D.); (A.F.); (S.M.)
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
- Correspondence: ; Tel.: +39-0131-206111
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Zhang Y, Leuk JSP, Teo WP. Domains, feasibility, effectiveness, cost, and acceptability of telehealth in aging care: a scoping review of systematic reviews (Preprint). JMIR Aging 2022; 6:e40460. [PMID: 37071459 PMCID: PMC10155091 DOI: 10.2196/40460] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/02/2022] [Accepted: 01/29/2023] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Aging is becoming a major global challenge. Compared with younger adults, the older population has greater health needs but faces inadequate access to appropriate, affordable, and high-quality health care. Telehealth can remove geographic and time boundaries, as well as enabling socially isolated and physically homebound people to access a wider range of care options. The impacts of different telehealth interventions in terms of their effectiveness, cost, and acceptability in aging care are still unclear. OBJECTIVE This scoping review of systematic reviews aimed to provide an overview of the domains of telehealth implemented in aging care; synthesize evidence of telehealth's feasibility, effectiveness, cost benefits, and acceptability in the context of aging care; identify gaps in the literature; and determine the priorities for future research. METHODS Guided by the methodological framework of the Joanna Briggs Institute, we reviewed systematic reviews concerning all types of telehealth interventions involving direct communication between older users and health care providers. In total, 5 major electronic databases, PubMed, Embase (Ovid), Cochrane Library, CINAHL, and PsycINFO (EBSCO), were searched on September 16, 2021, and an updated search was performed on April 28, 2022, across the same databases as well as the first 10 pages of the Google search. RESULTS A total of 29 systematic reviews, including 1 post hoc subanalysis of a previously published large Cochrane systematic review with meta-analysis, were included. Telehealth has been adopted in various domains in aging care, such as cardiovascular diseases, mental health, cognitive impairment, prefrailty and frailty, chronic diseases, and oral health, and it seems to be a promising, feasible, effective, cost-effective, and acceptable alternative to usual care in selected domains. However, it should be noted that the generalizability of the results might be limited, and further studies with larger sample sizes, more rigorous designs, adequate reporting, and more consistently defined outcomes and methodologies are needed. The factors affecting telehealth use among older adults have been categorized into individual, interpersonal, technological, system, and policy levels, which could help direct collaborative efforts toward improving the security, accessibility, and affordability of telehealth as well as better prepare the older population for digital inclusion. CONCLUSIONS Although telehealth remains in its infancy and there is a lack of high-quality studies to rigorously prove the feasibility, effectiveness, cost benefit, and acceptability of telehealth, mounting evidence has indicated that it could play a promising complementary role in the care of the aging population.
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Affiliation(s)
- Yichi Zhang
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
- Ageing Research Institute for Society and Education, Interdisciplinary Graduate Programme, Nanyang Technological University, Singapore, Singapore
| | - Jessie Siew-Pin Leuk
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Wei-Peng Teo
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
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Guterman EL. Addressing Vulnerability and Dementia in the Era of COVID-19. JAMA Neurol 2022; 79:327-328. [PMID: 35226069 DOI: 10.1001/jamaneurol.2021.5330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Elan L Guterman
- Department of Neurology, University of California, San Francisco
- Weill Institute for Neurosciences, University of California, San Francisco
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
- Viewpoints Editor, JAMA Neurology
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A Scoping Review for Usage of Telerehabilitation among Older Adults with Mild Cognitive Impairment or Cognitive Frailty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074000. [PMID: 35409683 PMCID: PMC8997970 DOI: 10.3390/ijerph19074000] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/12/2022]
Abstract
Older adults are vulnerable towards cognitive frailty that can lead to adverse health outcomes and telerehabilitation appears to be a potential platform to reverse cognitive frailty among older adults. The aim of this coping review is to identify the usage of telerehabilitation and its common platform of delivery among older adults with mild cognitive impairment (MCI) or cognitive frailty (CF). Articles published from January 2015 until October 2020 were selected. Out of the 1738 articles retrieved, six studies were identified. Two articles were randomized controlled trials, one was a pilot study and three were qualitative studies. The outcome suggests that telerehabilitation may improve the quality of life among participants as well as it can be a useful and supportive digital platform for health care. Some types of technologies commonly used were smartphones or telephones with internet, television-based assistive integrated technology, mobile application and videoconference. Telerehabilitation utilization in managing cognitive frailty among older adults is still limited and more research is required to evaluate its feasibility and acceptability. Although telerehabilitation appears to be implemented among older adults with MCI and CF, some social support is still required to improve the adherence and effectiveness of telerehabilitation. Future research should focus on the evaluation of acceptance and participants’ existing knowledge towards telerehabilitation to achieve its target.
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Jafari N, Lim M, Hassani A, Cordeiro J, Kam C, Ho K. Human-like tele-health robotics for older adults – A preliminary feasibility trial and vision. J Rehabil Assist Technol Eng 2022; 9:20556683221140345. [PMID: 36408129 PMCID: PMC9666707 DOI: 10.1177/20556683221140345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction The global increase of the aging population presents major challenges to healthcare service delivery. Further, the COVID-19 pandemic exposed older adults’ vulnerability to rapid deterioration of health when deprived of access to care due to the need for social distancing. Robotic technology advancements show promise to improve provision of quality care, support independence for patients and augment the capabilities of clinicians to perform tasks remotely. Aim This study explored the feasibility and end-user acceptance of using a novel human-like tele-robotic system with touch feedback to conduct a remote medical examination and deliver safe care. Method Testing of a remotely controlled robot was conducted with in-person clinician support to gather ECG readings of 11 healthy participants through a digital medical device. Post-study feedback about the system and the remote examinations conducted was obtained from study participants and study clinicians. Results The findings demonstrated the system’s capability to support remote examination of participants, and validated the system’s perceived acceptability by clinicians and end-users who all reported feeling safe interacting with the robot and 72% preferred remote robotic exam over in-person examination. Conclusion This paper discusses potential implications of robot-assisted telehealth for patients including older adults who are precluded from having in-person medical visits due to geographic distance or mobility, and proposes next steps for advancing robot-assisted telehealth delivery.
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Affiliation(s)
- Nooshin Jafari
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Michael Lim
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Aida Hassani
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Cordeiro
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Crystal Kam
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kendall Ho
- Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada
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Grover S, Naskar C, Mehra A, Sahoo S. Clinician's experience of telepsychiatry consultations with elderly patients. JOURNAL OF GERIATRIC MENTAL HEALTH 2022. [DOI: 10.4103/jgmh.jgmh_31_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Albers EA, Mikal J, Millenbah A, Finlay J, Jutkowitz E, Mitchell L, Horn B, Gaugler JE. Technology Use Among Persons with Memory Concerns and Their Caregivers in the United States During the COVID-19 Pandemic: A Qualitative Study (Preprint). JMIR Aging 2021; 5:e31552. [PMID: 35134748 PMCID: PMC8972107 DOI: 10.2196/31552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 01/15/2022] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Elizabeth A Albers
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Jude Mikal
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Ashley Millenbah
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Jessica Finlay
- Social Environment and Health Program, Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Eric Jutkowitz
- Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, United States
| | - Lauren Mitchell
- Department of Psychology, Emmanuel College, Boston, MA, United States
| | - Brenna Horn
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Joseph E Gaugler
- Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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Smith RJ, Bryant RG. Metal substitutions incarbonic anhydrase: a halide ion probe study. Biochem Biophys Res Commun 1975; 66:1281-6. [PMID: 0000-0003-1376-8556 PMCID: PMC10704303 DOI: 10.1016/0006-291x(75)90498-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/18/2023] [Accepted: 09/26/2023] [Indexed: 02/07/2023]
Abstract
Monitoring of the mental health status of the population and assessment of its determinants are 2 of the most relevant pillars of public mental health, and data from population health surveys could be instrumental to support them. Although these surveys could be an important and suitable resource for these purposes, due to different limitations and challenges, they are often relegated to the background behind other data sources, such as electronic health records. These limitations and challenges include those related to measurement properties and cross-cultural validity of the tools used for the assessment of mental disorders, their degree of representativeness, and possible difficulties in the linkage with other data sources. Successfully addressing these limitations could significantly increase the potential of health surveys in the monitoring of mental disorders and ultimately maximize the impact of the relevant policies to reduce their burden at the population level. The widespread use of data from population health surveys, ideally linked to electronic health records data, would enhance the quality of the information available for research, public mental health decision-making, and ultimately addressing the growing burden of mental disorders.
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