Impact of an Area Agency on Aging pharmacist-led Community Care Transition Initiative

Coe, Antoinette B.; Rowell, Brigid; Whittaker, Paige A.; Ross, Andy T.; Nguyen, Kim T.L.; Bergman, Nathaniel; Farris, Karen B.

doi:10.1016/j.japh.2023.04.008

Cited by 1 publication

(2 citation statements)

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“…5,7,10 Although some aspects of virtual care have been well-studied, only a little is known about the challenges that older adults face just before joining their visit and during their visit periods where technological challenges occur. [7][8][9]11,12 For example, in a 2021 study of older adults in California, 77% of patients had access to a smart device, yet only 37% of patients could connect via a video visit. 5 To address this access gap and this knowledge gap, we changed our approach to virtual visits with older adults 11 to include an in-home team member.…”

Section: Introductionmentioning

confidence: 99%

“…Beyond 2020, older adults continued to complete virtual visits and faced similar and new barriers and facilitators 5,7,10 . Although some aspects of virtual care have been well‐studied, only a little is known about the challenges that older adults face just before joining their visit and during their visit periods where technological challenges occur 7–9,11,12 . For example, in a 2021 study of older adults in California, 77% of patients had access to a smart device, yet only 37% of patients could connect via a video visit 5 …”

Section: Introductionmentioning

confidence: 99%

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Connecting the disconnected: Leveraging an in‐home team member for video visits for older adults

Hawley,

Wagner,

Venegas

et al. 2023

J American Geriatrics Society

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BackgroundOlder adults are interested and able to complete video visits, but often require coaching and practice to succeed. Data show a widening digital divide between older and younger adults using video visits. We conducted a qualitative feasibility study to investigate these gaps via ethnographic methods, including a team member in older participants' homes.MethodsThis ethnographic feasibility study included a virtual medication reconciliation visit with a clinical pharmacist for Veterans aged 65 and older taking 5 or more medications. An in‐home study team member joined the participant and recorded observations in structured fieldnotes derived from the Updated Consolidated Framework for Implementation Research and Age‐Friendly Health Systems. Fieldnotes included behind‐the‐scenes facilitators, barriers, and solutions to challenges before and during the visits. We conducted a thematic analysis of these observations and matched themes to implementation solutions from the Expert Recommendations for Implementing Change.ResultsTwenty participants completed a video visit. Participants were 74 years old (range 68–80) taking 12 daily medications (range 7–24). Challenges occurred in half of the visits and took the in‐home team member and/or pharmacist an average of 10 minutes to troubleshoot. Challenges included notable new findings, such as that half of the participants required technology assistance for challenges that would not have been able to be solved by the pharmacist virtually. Furthermore, although many participants had a device or had used video visits before, some did not have a single device with video, audio, Internet, and access to their email username and password.ConclusionsClinicians may apply these evidence‐based implementation solutions to their approach to video visits with older adults, including having a team member join the visit before the clinician, involving tech‐savvy family members, ensuring the device works with the visit platform ahead of time, and creating a troubleshooting guide from our common challenges.

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