Cognitive Assessment of Patients With Alzheimer's Disease by Telemedicine: Pilot Study

Carotenuto, Anna; Rea, Raffaele; Traini, Enea; Ricci, Giovanna; Fasanaro, Angiola Maria; Amenta, Francesco

doi:10.2196/mental.8097

Cited by 57 publications

(71 citation statements)

References 46 publications

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“…They are predominantly used in primary care with the majority of the use restricted to routine or common primary health conditions or situations including the common cold, skin rash, and prescription renewals [12]. Published reports of eVisits (home virtual visits) is limited to certain specific diseases or conditions such as acute respiratory illnesses or urinary tract symptoms [34-38]. Overall, specialist use of virtual visits is higher (9%) compared with primary care (4%) [32].…”

Section: Discussionmentioning

confidence: 99%

Home Virtual Visits for Outpatient Follow-Up Stroke Care: Cross-Sectional Study

Appireddy¹,

Khan²,

Leaver³

et al. 2019

J Med Internet Res

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BackgroundTimely, in-person access to health care is a challenge for people living with conditions such as stroke that result in frailty, loss of independence, restrictions in driving and mobility, and physical and cognitive decline. In Southeastern Ontario, access is further complicated by rurality and the long travel distances to visit physician clinics. There is a need to make health care more accessible and convenient. Home virtual visits (electronic visits, eVisits) can conveniently connect physicians to patients. Physicians use a secure personal videoconferencing tool to connect to patients in their homes. Patients use their device of choice (smartphone, tablet, laptop, or desktop) for the visit.ObjectiveThis study aimed to assess the feasibility and logistics of implementing eVisits in a stroke prevention clinic for seniors.MethodsA 6-month eVisit pilot study was initiated in the Kingston Health Sciences Centre stroke prevention clinic in August 2018. eVisits were used only for follow-up patient encounters. An integrated evaluation was used to test the impact of the program on clinic workflow and patient satisfaction. Patient satisfaction was evaluated by telephone interviews, using a brief questionnaire. Access and patient satisfaction metrics were compared with concurrent standard of care (patients’ prior personal experience with in-person visits). Values are presented as median (interquartile range).ResultsThere were 75 subjects in the pilot. The patients were aged 65 (56-73.5) years, and 39% (29/75) resided in rural areas. There was a shorter wait for an appointment by eVisit versus in-person (mean 59.98 [SD 48.36] days vs mean 78.36 [SD 50.54] days; P<.001). The eVisit was also shorter, taking on an average of only 10 min to deliver follow-up care with a high degree of patient satisfaction versus 90 (60-112) min for in-person care. The total time saved by patients per eVisit was 80 (50-102) min, 44 (21-69) min of which was travel time. Travel distance avoided by the patients was 30.1 km (11.2-82.2). The estimated total out-of-pocket cost savings for patients per eVisit was Can $52.83 (31.26-94.53). The estimated savings (opportunity cost for in-person outpatient care) for our eVisit pilot project was Can $23,832-$28,584. The patient satisfaction with eVisits was very good compared with their prior personal experience with in-person outpatient care.ConclusionsThe eVisit program was well received by patients, deemed to be safe by physicians, and avoided unnecessary patient travel and expense. It also has the potential to reduce health care costs. We plan to scale the project within the department and the institution.

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Section: Discussionmentioning

confidence: 99%

Home Virtual Visits for Outpatient Follow-Up Stroke Care: Cross-Sectional Study

Appireddy¹,

Khan²,

Leaver³

et al. 2019

J Med Internet Res

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“…We detected 15 articles related to the DG. Half of these articles aim to compare the efficacy of in‐person (IP) diagnosis versus a telemedicine assessment (TM) . Among those, four were case‐control accuracy studies, nine were paired comparative accuracy studies, and two were prospective single‐arm accuracy studies.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic and interventional implications of telemedicine in Alzheimer's disease and mild cognitive impairment: A literature review

Costanzo

Arcidiacono

Rodolico

et al. 2019

Int J Geriat Psychiatry

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Introduction Worldwide, life expectancy, and aging‐related disorders as mild cognitive impairment (MCI) and Alzheimer disease (AD) are increasing, having a rising impact on patients' quality of life and caregivers' distress. Telemedicine offers many possibilities, such as remote diagnosing and monitoring of patients. Objective The purpose of this study is to provide a narrative synthesis of the literature about the implementation of telemedicine for diagnosis, treatment, and follow‐up of patients with AD and MCI and their caregivers. Methods A systematic literature review was conducted on MEDLINE, EMBASE, and the Cochrane Library databases up to September 2018. MCI or AD diagnoses were the conditions of interest. We excluded other dementias. Results Fifty‐six articles met inclusion criteria. We identified two main categories: diagnosis group (DG) and follow‐up/interventional group (FIG). Fifteen articles suggested how to make a remote or earlier diagnosis: four were case‐control accuracy studies, nine were paired comparative accuracy studies, and two were prospective single‐arm accuracy studies. Among these, four focused on MCI, six on AD, and five on both. Forty one focused on supporting patients during the stages of the disease (28 articles), patient's caregivers (nine articles), or both (four articles). Conclusions The rising use of telemedicine could actively improve AD and MCI patients' lives, reduce caregivers' burden, and facilitate an early diagnosis if patients live in remote places. However, as some studies report, it is relevant to take into account the emotional impact of telemedicine on patients and not only on the effectiveness.

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“…The advances in the technology of healthcare devices, including electronic health records, portal technologies, and wireless communications [59, 60], will probably have a key role in future dementia care. For example, tools for remote surveillance are very important and they give an important contribution to improving and making safer the environment in which patients and families live [59, 60].…”

Section: Social Aspects Of Dementia: From Caregivers To Related Costsmentioning

confidence: 99%

Social Aspects of Dementia Prevention from a Worldwide to National Perspective: A Review on the International Situation and the Example of Italy

Ricci

2019

Behavioural Neurology

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At the moment, dementia is affecting around 47 million people worldwide, with a forecast amount of 135 million affected people in 2050. Dementia is a growing health concern worldwide with no treatment currently available, but only symptomatic medication. Effective interventions in the prevention and management of dementia are urgently needed to contain direct and indirect costs of this disease. Indeed, the economic impact of dementia is a vast and continually growing figure, but it is still difficult to quantify. Due to an increase in both the disease spreading and its direct and indirect costs, national and international action plans have to be implemented. As a virtuous example, the Italian national plan for dementia has been summarized. Faced with an increasingly less sustainable disease impact at national and international levels, the plan suggests that it is certainly the entire welfare model that should be rethought, strengthening the network of services and providing interventions to support affected people and their caregivers. Alongside this synergistic approach, scientific research could play a crucial role for pharmacological and nonpharmacological treatments capable of delaying the state of loss of self-sufficiency of the patient, with a significant impact on social and health costs.

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Cognitive Assessment of Patients With Alzheimer's Disease by Telemedicine: Pilot Study

Cited by 57 publications

References 46 publications

Home Virtual Visits for Outpatient Follow-Up Stroke Care: Cross-Sectional Study

Home Virtual Visits for Outpatient Follow-Up Stroke Care: Cross-Sectional Study

Diagnostic and interventional implications of telemedicine in Alzheimer's disease and mild cognitive impairment: A literature review

Social Aspects of Dementia Prevention from a Worldwide to National Perspective: A Review on the International Situation and the Example of Italy

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