Telemedicine and Dementia Care: A Systematic Review of Barriers and Facilitators

Yi, Julie; Pittman, Corinne A.; Price, Carrie; Nieman, Carrie L.; Oh, Esther S.

doi:10.1016/j.jamda.2021.03.015

Cited by 81 publications

(71 citation statements)

References 57 publications

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“…20,21 Despite these barriers, it appears to be both feasible and beneficial to continue to deliver psychological interventions during the pandemic and beyond. 22,23 These findings pave the way for further expansion of e-health application to a wide variety of existing programmes for people living with dementia. CST is one such intervention that could benefit from adaptation for online use, especially in the context of the COVID-19 pandemic where in-person services may be restricted.…”

Section: Digital Technology In Psychological Interventionsmentioning

confidence: 89%

Delivering Cognitive Stimulation Therapy (CST) Virtually: Developing and Field-Testing a New Framework

L¹,

Fisher²,

C³

et al. 2022

CIA

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This feasibility and pilot study aimed to develop and field-test a 14-session virtual Cognitive Stimulation Therapy (vCST) programme for people living with dementia, developed as a result of services moving online during the COVID-19 pandemic. Methods: The vCST protocol was developed using the existing group CST manual, through stakeholder consultation with people living with dementia, caregivers, CST group facilitators and dementia service managers. This protocol was then field-tested with 10 groups of people living with dementia in the Brazil, China (Hong Kong), India, Ireland and the UK, and feedback on the protocol was gathered from 14 facilitators. Results: Field testing in five countries indicated acceptability to group facilitators and participants. Feedback from these groups was used to refine the developed protocol. The final vCST protocol is proposed, including session materials for delivery of CST over videoconferencing and a framework for offering CST virtually in global settings. Conclusion: vCST is a feasible online intervention for many people living with dementia. We recommend that it is offered to those unable to access traditional in-person CST for health reasons, lack of transport or COVID-19 restrictions. Further research is needed to explore if participant outcomes are comparable to in-person CST groups.

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Section: Digital Technology In Psychological Interventionsmentioning

confidence: 89%

Delivering Cognitive Stimulation Therapy (CST) Virtually: Developing and Field-Testing a New Framework

L¹,

Fisher²,

C³

et al. 2022

CIA

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“…Barriers include lack of access to equipment and ability to independently use technological devices, and sensory impairments leading to communication challenges. 9 41 It is important to consider whether older persons are comfortable with using video technology and/or have disabilities that would limit the optimal use of video conferencing. 42 There are also barriers of access and equity issues related to the social determinants of health (eg, socioeconomic factors, geography, culture/language, gender).…”

Section: Discussionmentioning

confidence: 99%

“… 42 There are also barriers of access and equity issues related to the social determinants of health (eg, socioeconomic factors, geography, culture/language, gender). 9 Virtual care barriers can be addressed with support from family, friends or clinicians.…”

Section: Discussionmentioning

confidence: 99%

Virtual team-based care planning with older persons in formal care settings: a scoping review protocol

et al. 2021

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IntroductionCOVID-19 has necessitated greater adoption of virtual care (eg, telephone (audio), videoconference) delivery models. Virtual care provides opportunities for innovative practice in care planning with older persons and meaningful family engagement by synchronously involving multiple care providers. Nevertheless, there remains a paucity of summarising evidence regarding virtual team-based care planning for older persons. The purpose of this scoping review is to summarise evidence on the utilisation of virtual team-based care planning for older persons in formal care settings. Specifically, (1) what has been reported in the literature on the impact or outcomes of virtual team-based care planning? (2) What are the facilitators and barriers to implementation?Methods and analysisThis scoping review will follow a rigorous and well-established methodology by the Joanna Briggs Institute, supplemented by the Arksey & O’Malley and Levac, Colquhoun, & O’Brien frameworks. A three-step search strategy will be used to conduct a search on virtual team-based care planning for older persons in formal care settings. Keywords and index terms will be identified from an initial search in PubMed and AgeLine, and used to conduct the full search in the databases PubMed, EMBASE, CINAHL, AgeLine, PsycInfo and Scopus. Reference lists of included articles and grey literature retrieved through Google and Google Scholar will also be reviewed. Three researchers will screen titles and abstracts, and will conduct full-text review for inclusion. Extracted data will be mapped in a table.Ethics and disseminationResearch ethics approval is not required for data collection from publicly accessible information. Findings will be presented at conferences, submitted for open-access publication in a peer-reviewed journal and made accessible to multiple stakeholders. The scoping review will summarise the literature on virtual team-based care planning for the purpose of informing the implementation of a virtual PIECES™ intervention (Physical/Intellectual/Emotional health, Capabilities, Environment, and Social).

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“… 27 A recent systematic review analyzed 17 studies of the efficacy of telemedicine for dementia care and reported that while 5 studies excluded patients with visual or hearing disability, all 17 studies found that both patients and care partners were satisfied with the telecare received. 28 Data also suggest that patients with hallucinations and delusions can be reliably assessed via videoconferencing, without a worsening in symptoms. 29 Additionally, remote assessments have been used in the clinical trial setting to evaluate the efficacy of antipsychotics in patients with schizophrenia.…”

Section: Introductionmentioning

confidence: 91%

Using Telemedicine to Assess and Manage Psychosis Among Outpatients with Neurodegenerative Disease

Chepke¹,

Shaughnessy²,

Brunton³

et al. 2021

IJGM

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The presence of hallucinations and delusions in patients with neurodegenerative disease correlates negatively with function, cognition, quality of life, and survival. When these patients still have insight, the treatment of mild hallucinations may reduce the risk of progression to more severe symptoms, specifically hallucinations without insight or delusions. On October 22, 2020, a multidisciplinary consensus panel comprising United States-based experts in geriatric psychiatry, geriatric medicine, family medicine, movement disorders, and neuropsychology was convened remotely to discuss best practices for using telemedicine to evaluate, diagnose, and treat psychosis in patients with neurodegenerative diseases. This review reflects the opinions and recommendations discussed at this meeting. Despite drawbacks, telemedicine can offer several advantages over in-person care, particularly for older adults, and may be a unique opportunity for care of patients with neuropsychiatric symptoms. While telemedicine may not be suitable for all patients, it allows the involvement of specialists from multiple geographic locations and the extension of care to homebound individuals. Patients with neurodegenerative diseases who are likely to become homebound as the disease advances may benefit greatly from telemedicine as a standard of care. Healthcare provided via telemedicine should be nothing less than what would be offered to the patient in person. Telemedicine may present some difficulties, including technological issues and inherent constraints of remote care, but with proper planning many problems could be diminished. Technical issues associated with telemedicine are inevitable but may be partially offset by providing clear directions ahead of any televisit to ensure connectivity and access to the videoconferencing platform. Alternative procedures to communicate should be established in the eventuality of technological issues. Using these strategies, telemedicine can serve as a valuable complement to traditional in-person practices for the diagnosis and management of hallucinations and delusions associated with Parkinson's disease psychosis or dementia-related psychosis.

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Telemedicine and Dementia Care: A Systematic Review of Barriers and Facilitators

Cited by 81 publications

References 57 publications

Delivering Cognitive Stimulation Therapy (CST) Virtually: Developing and Field-Testing a New Framework

Delivering Cognitive Stimulation Therapy (CST) Virtually: Developing and Field-Testing a New Framework

Virtual team-based care planning with older persons in formal care settings: a scoping review protocol

Using Telemedicine to Assess and Manage Psychosis Among Outpatients with Neurodegenerative Disease

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