Tele-health-care in the elderly living in nursing home: the first Sicilian multimodal approach

Luca, Rosaria De; Bramanti, Alessia; Cola, Maria Cristina De; Trifiletti, Antonino; Tomasello, Provvidenza; Torrisi, Michele; Reitano, Simone; Leo, Antonino; Bramantı, Placido; Calabrò, Rocco Salvatore

doi:10.1007/s40520-015-0463-8

Cited by 46 publications

(79 citation statements)

References 23 publications

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“…While our focus was not hospital based, only two RCTs were in nursing facilities. 53,79 Observational studies exist 80,81 ; yet, the lack of rigorous studies in older adults has considerable implications as they are sicker and require increased medical assessment and acuity, 77 ultimately leading to increased utilization. Research to evaluate TMed interventions in such facilities is needed.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Ambulatory Telemedicine Care in Older Adults: A Systematic Review

Batsis

DiMilia

Seo

et al. 2019

J American Geriatrics Society

182

160

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BACKGROUND Disparities in healthcare access and delivery, caused by transportation and health workforce difficulties, negatively impact individuals living in rural areas. These challenges are especially prominent in older adults. DESIGN We systematically evaluated the feasibility, acceptability, and effectiveness in providing telemedicine (TMed), searching the English‐language literature for studies (January 2012 to July 2018) in the following databases: Medline (PubMed); Cochrane Library (Wiley); Web of Science; CINAHL; EMBASE (Ovid); and PsycINFO (EBSCO). PARTICIPANTS Older adults (mean age = 65 years or older, and none were younger than 60 years). INTERVENTIONS Interventions consisted of live, synchronous, two‐way videoconferencing communication in nonhospital settings. All medical interventions were included. MEASUREMENTS Quality assessment, using the Cochrane Collaboration's Risk‐of‐Bias Tool, was applied on all included articles, including a qualitative summary of all articles. RESULTS Of 6616 citations, we reviewed the full text of 1173 articles, excluding 1047 that did not meet criteria. Of the 17 randomized controlled trials, the United States was the country with the most trials (6 [35%]), with cohort sizes ranging from 3 to 844 (median = 35) participants. Risk of bias among included studies varied from low to high. Our qualitative analysis suggests that TMed can improve health outcomes in older adults and that it could be used in this population. CONCLUSIONS TMed is feasible and acceptable in delivering care to older adults. Research should focus on well‐designed randomized trials to overcome the high degree of bias observed in our synthesis. Clinicians should consider using TMed in routine practice to overcome barriers of distance and access to care. J Am Geriatr Soc 67:1737–1749, 2019

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Ambulatory Telemedicine Care in Older Adults: A Systematic Review

Batsis

DiMilia

Seo

et al. 2019

J American Geriatrics Society

182

160

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“…Ten studies were conducted in the USA, 47,169,176,210,222,227,230,[299][300][301] two in Australia, 203,274 two in New Zealand 166,236 and one in each of Belgium, 54 Canada, 147 Italy, 101 Japan, 250 Singapore, 163 Norway, 160 Taiwan, 177 the Netherlands 56 and the UK. 277 Thirteen randomised studies were included (six individually randomised parallel group trials, two individually randomised crossover trials and five cluster randomised trials), 47,54,101,147,160,177,203,210,230,236,274,277,299 as were 11 non-randomised studies of interventions. 56,161,163,166,168,169,176,222,227,250,300,301 Details of the studies included in this systematic review are shown i...…”

Section: Findings Of Systematic Evidence Synthesismentioning

confidence: 99%

“…Ten studies described digital interventions aimed at influencing mental health and well-being in care home residents. 56,101,132,160,163,169,176,236,250,274 A majority measured symptoms of depression and dementia. They also report on agitation, a set of behaviours associated with emotional distress that impair social functioning and ADL.…”

Section: Studies Investigating the Effectiveness Of Interventions Formentioning

confidence: 99%

“…However, some caution is needed in extrapolating from this study, as it had a number of methodological limitations, including small sample size, baseline differences between the groups and method of allocation. 101 The impact on agitation of video calls with relatives was compared with that of standard telephone calls for people with dementia. Nine residents in five Australian care homes took part in a pilot randomised crossover study.…”

Section: Other Interventions To Influence Mood and Reduce Agitationmentioning

confidence: 99%

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Innovation to enhance health in care homes and evaluation of tools for measuring outcomes of care: rapid evidence synthesis

Hanratty

Craig

Spilsbury

et al. 2019

Health Serv Deliv Res

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BackgroundFlexible, integrated models of service delivery are being developed to meet the changing demands of an ageing population. To underpin the spread of innovative models of care across the NHS, summaries of the current research evidence are needed. This report focuses exclusively on care homes and reviews work in four specific areas, identified as key enablers for the NHS England vanguard programme.AimTo conduct a rapid synthesis of evidence relating to enhancing health in care homes across four key areas: technology, communication and engagement, workforce and evaluation.Objectives(1) To map the published literature on the uses, benefits and challenges of technology in care homes; flexible and innovative uses of the nursing and support workforce to benefit resident care; communication and engagement between care homes, communities and health-related organisations; and approaches to the evaluation of new models of care in care homes. (2) To conduct rapid, systematic syntheses of evidence to answer the following questions. Which technologies have a positive impact on resident health and well-being? How should care homes and the NHS communicate to enhance resident, family and staff outcomes and experiences? Which measurement tools have been validated for use in UK care homes? What is the evidence that staffing levels (i.e. ratio of registered nurses and support staff to residents or different levels of support staff) influence resident outcomes?Data sourcesSearches of MEDLINE, CINAHL, Science Citation Index, Cochrane Database of Systematic Reviews, DARE (Database of Abstracts of Reviews of Effects) and Index to Theses. Grey literature was sought via Google™ (Mountain View, CA, USA) and websites relevant to each individual search.DesignMapping review and rapid, systematic evidence syntheses.SettingCare homes with and without nursing in high-income countries.Review methodsPublished literature was mapped to a bespoke framework, and four linked rapid critical reviews of the available evidence were undertaken using systematic methods. Data were not suitable for meta-analysis, and are presented in narrative syntheses.ResultsSeven hundred and sixty-one studies were mapped across the four topic areas, and 65 studies were included in systematic rapid reviews. This work identified a paucity of large, high-quality research studies, particularly from the UK. The key findings include the following. (1) Technology: some of the most promising interventions appear to be games that promote physical activity and enhance mental health and well-being. (2) Communication and engagement: structured communication tools have been shown to enhance communication with health services and resident outcomes in US studies. No robust evidence was identified on care home engagement with communities. (3) Evaluation: 6 of the 65 measurement tools identified had been validated for use in UK care homes, two of which provide general assessments of care. The methodological quality of all six tools was assessed as poor. (4) Workforce: joint working within and beyond the care home and initiatives that focus on staff taking on new but specific care tasks appear to be associated with enhanced outcomes. Evidence for staff taking on traditional nursing tasks without qualification is limited, but promising.LimitationsThis review was restricted to English-language publications after the year 2000. The rapid methodology has facilitated a broad review in a short time period, but the possibility of omissions and errors cannot be excluded.ConclusionsThis review provides limited evidential support for some of the innovations in the NHS vanguard programme, and identifies key issues and gaps for future research and evaluation.Future workFuture work should provide high-quality evidence, in particular experimental studies, economic evaluations and research sensitive to the UK context.Study registrationThis study is registered as PROSPERO CRD42016052933, CRD42016052933, CRD42016052937 and CRD42016052938.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…A recent study by De Luca et al [4] has demonstrated that telemedicine can be considered as an important tool in improving health and quality of life in the elderly living in nursing homes, potentially reducing healthcare service access, hospitalization and costs. It also appears that a telehealth system integrated in a local healthcare service may significantly improve elderly persons' behaviour and reduce the caregivers' burden [5].…”

Section: Dear Editormentioning

confidence: 99%

Telemedicine in neurology: where are we going?

Bramanti

Calabrò

2017

Euro J of Neurology

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Tele-health-care in the elderly living in nursing home: the first Sicilian multimodal approach

Abstract: Telemedicine can be considered as an important tool in improving health and quality of life in the elderly living in nursing homes, and potentially reducing healthcare service access, hospitalization, and costs.

Cited by 46 publications

References 23 publications

Effectiveness of Ambulatory Telemedicine Care in Older Adults: A Systematic Review

Effectiveness of Ambulatory Telemedicine Care in Older Adults: A Systematic Review

Innovation to enhance health in care homes and evaluation of tools for measuring outcomes of care: rapid evidence synthesis

Telemedicine in neurology: where are we going?

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