Caregiver Satisfaction with a Video Telehealth Home Safety Evaluation for Dementia

Gately, Megan; Tickle-Degnen, Linda; Trudeau, Scott; Ward, Nathan; Ladin, Keren; Moo, Lauren

doi:10.5195/ijt.2020.6337

Cited by 14 publications

(17 citation statements)

References 25 publications

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“…Expectations that already-burdened caregivers, whether possessing high or low proficiency in information and communication technology (ICT), master a new platform may be impractical 121 ; for it is often incommensurate with patient-monitoring responsibilities. 122 In absence of any thorough investigation, high attrition is a persistent issue in internet-facilitated technology intervention studies.…”

Section: Discussionmentioning

confidence: 99%

Internet-facilitated interventions for informal caregivers of patients with neurodegenerative disorders: Systematic review and meta-analysis

Boyt

Morris-Bankole

et al. 2022

DIGITAL HEALTH

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Objective This systematic review explored the effectiveness of internet-delivered interventions in improving psychological outcomes of informal caregivers for neurodegenerative-disorder (ND) patients. Methods We searched seven databases for English-language papers published from 1999 to May 2021. Study-eligibility required that interventions used a minimum 50% internet-facilitation, targeting unpaid, adult informal caregivers of community-based ND-patients. We included randomised controlled trials (RCTs) and pre-post evaluative studies reporting outcomes for at least one-time point post-intervention. Independent quality checks on abstract and full-text screening were completed. Data extraction encompassed interventions’ features, approaches, theoretical bases and delivery-modes. The Integrated quality Criteria for the Review Of Multiple Study designs (ICROMS) framework assessed risk of bias. Alongside narrative synthesis, we calculated meta-analyses on post-intervention using outcome measures from at least two RCTs to assess effectiveness. Results Searches yielded 51 eligible studies with 3180 participants. In 48 studies, caregivers supported a dementia-diagnosed individual. Intervention-durations encompassed four weeks to 12 months, with usage-frequency either prescribed or participant-determined. The most frequently-used approach was education, followed by social support. We calculated meta-analyses using data from 16 RCTs. Internet-delivered interventions were superior in improving mastery (g = 1.17 [95% CI; 0.1 to 2.24], p = 0.03) and reducing anxiety (g = -1.29 [95% CI; −1.56 to −1.01], p < 0.01), compared to all controls. Findings were equivocal for caregivers’ quality of life, burden and other outcomes. High heterogeneity reflected the multifarious combinations of approaches and delivery-modes, precluding assessment of the most efficacious intervention features. Analyses using burden and self-efficacy outcomes’ follow-up data were also non-significant compared to all comparator-types. Although 32 studies met the ICROMS threshold scores, we rated most studies’ evidence quality as ‘very-low’. Conclusions This review demonstrated some evidence for the efficacy of internet-delivered interventions targeting informal ND-caregivers. However, more rigorous studies, with longer follow-ups across outcomes and involving NDs other than dementia, are imperative to enhance the knowledge-base.

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Section: Discussionmentioning

confidence: 99%

Internet-facilitated interventions for informal caregivers of patients with neurodegenerative disorders: Systematic review and meta-analysis

Boyt

Morris-Bankole

et al. 2022

DIGITAL HEALTH

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…In Brazil, for some years now, some isolated strategies have been employed that have proven the effectiveness of education programs in dementia, involving the use of printed support material at psychoeducational meetings, later delivered to caregivers or sent by email to those unable to attend faceto-face support meetings (19,20). These studies have shown that patients and caregivers monitored in specialized services benefit from counseling measures and support groups focused on individualized needs, conferring numerous benefits in terms of both functional and behavioral aspects of patients with dementia, alleviating the burden of caregivers (21,22). These support materials, such as management and educational manuals that focus on information inherent to health promotion and disease prevention, are very useful in the primary healthcare network, helping both professionals and caregivers in the appropriate management of dementia, and their content can be delivered in person or remotely.…”

Section: Discussionmentioning

confidence: 99%

Virtual Support in Dementia: A Possible Viable Strategy for Caregivers

Ferretti

Nitrini

2021

Front. Neurol.

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Background: In the last 10 months, due to the Covid-19 pandemic, several studies have shown that health education and virtual support strategies for caregivers of patients with dementia, in the management of home care, can be viable. Low and middle income countries, in particular, have sought to use these means to reduce the daily burden of caregivers, through virtual meetings of education and support.Objectives: To present the feasibility of a pilot study on the use of a support action contemplated by the Caad Project–indirect costs of dementia–from HC-FMUSP.Methods: Observational study in which 93 caregivers were invited to participate in virtual meetings on a frequency of three times/week, lasting 1 h each.Results: Of the 93 invited family members, and after 3 months, 42 answered eight questions about the effectiveness of the action. High percentages of positive responses regarding program satisfaction ranged from 86 to 100%.Conclusion: This study showed results of a very simple intervention that suggests that it is possible to offer caregivers of patients with dementia a program that can be used in primary care, in order to understand the difficulty of caregivers in their daily care of patients with dementia, with daily management guidelines on a case-by-case basis, in addition to promoting the implementation of an education strategy about the importance of knowing, and recognizing anatomophysiological changes in the aging process and its implications for the rupture of the imaginary line that involves senescence and senility. This allows the caregiver to feel able to protect his patient and himself by preventing the emergence of common diseases in this age group. Further studies are needed to explore this type of non-pharmacological support.

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“…Particularly for stroke, unlike telephone visits, video visits allow for assessment of stroke-related deficits through remote physical and neurologic examinations, facilitate interactions with caregivers (outpatient care), and allow for visualization of the home environment. 11 Understanding patient characteristics in relation to telemedicine visits among stroke survivors may help identify barriers and facilitators of telemedicine implementation into routine stroke practice during and after the pandemic. In this study, we sought to evaluate relationships between sociodemographic characteristics and access to telemedicine (video vs telephonic) for outpatient care among patients presenting to stroke clinics associated with 3 different comprehensive stroke centers across the United States during the early time of the pandemic.…”

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confidence: 99%

Inequities in Telemedicine Use Among Patients With Stroke and Cerebrovascular Diseases

et al. 2023

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Background and ObjectivesIn response to the COVID-19 pandemic, outpatient stroke care delivery was rapidly transformed to outpatient evaluation through video (VTM) and telephone (TPH) telemedicine (TM) visits around the world. We sought to evaluate the sociodemographic differences in outpatient TM use among stroke patients.MethodsWe conducted a retrospective chart review of outpatients evaluated at 3 tertiary stroke centers in the early period of the pandemic, 3/16/2020 through 7/31/2020. We compared the use of TM by patient characteristics including age, sex, race/ethnicity, insurance status, stroke type, patient type, and site. The association between TM use and patient characteristics was measured using the relative risk (RR) from a modified Poisson regression, and site-specific effects were controlled using a multilevel analysis.ResultsA total of 2,024 visits were included from UTHealth (n = 878), MedStar Health (n = 269), and Columbia (n = 877). The median age was 64 [IQR 52–74] years, and 53% were female. Approximately half of the patients had private insurance, 36% had Medicare, and 15% had Medicaid. Two-thirds of the visits were established patients. TM accounted for 90% of total visits, and the use of TM over office visits was primarily associated with site, not patient characteristics. TM utilization was associated with Asian and other/unknown race. Among TM users, older age, Black race, Hispanic ethnicity, and Medicaid insurance were associated with lower VTM use. Black (aRR 0.88, 95% CI 0.86–0.91,p< 0.001) and Hispanic patients (aRR 0.92, 95% CI 0.87–0.98,p= 0.005) had approximately 10% lower VTM use, while Asian patients (aRR 0.98, 95% CI 0.89–1.07,p= 0.59) had similar VTM use compared with White patients. Patients with Medicaid were less likely to use VTM compared with those with private insurance (aRR 0.86, 95% CI 0.81–0.91,p< 0.001).DiscussionIn our diverse cohort across 3 centers, we found differences in TM visit type by race and insurance early during the COVID-19 pandemic. These findings suggest disparities in VTM access across different stroke populations. As VTM remains an integral part of outpatient neurology practice, steps to ensure equitable access are essential.

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Caregiver Satisfaction with a Video Telehealth Home Safety Evaluation for Dementia

Cited by 14 publications

References 25 publications

Internet-facilitated interventions for informal caregivers of patients with neurodegenerative disorders: Systematic review and meta-analysis

Internet-facilitated interventions for informal caregivers of patients with neurodegenerative disorders: Systematic review and meta-analysis

Virtual Support in Dementia: A Possible Viable Strategy for Caregivers

Inequities in Telemedicine Use Among Patients With Stroke and Cerebrovascular Diseases

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