Telemedicine and Geriatrics in France: Inventory of Experiments

Zulfiqar, Abrar Ahmad; Hassani, Amir Hajjam El; Talha, Samy; Hajjam, Mohamed; Hajjam, Jawad; Ervé, Sylvie

doi:10.1155/2018/9042180

Cited by 16 publications

(23 citation statements)

References 32 publications

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“…However, little is known about the experience of providing geriatric primary care via telemedicine, with the extant studies focusing on specialty care. 3 - 5 …”

mentioning

confidence: 99%

Converting a Geriatrics Clinic to Virtual Visits during COVID-19: A Case Study

Iyer

Mehta

Weith

et al. 2021

J Prim Care Community Health

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Background: To characterize the experience of converting a geriatrics clinic to telehealth visits in early stages of a pandemic. Design: An organizational case study with mixed methods evaluation from the first 8 weeks of converting a geriatrics clinic from in-person visits to video and telephone visits. Setting: Veteran’s Health Administration in Northern California Participants Community-dwelling older Veterans receiving care at VA Palo Alto Geriatrics clinic. Veterans had a mean age of 85.7 (SD = 6.8) and 72.1% had cognitive impairment. Intervention: Veterans with face-to-face appointments were converted to video or telephone visits to mitigate exposure to community spread of COVID-19. Measurements: Thirty-two patient evaluations and 80 clinician feedback evaluations were completed. This provided information on satisfaction, care access during pandemic, and travel and time savings. Results: Of the 62 scheduled appointments, 43 virtual visits (69.4%) were conducted. Twenty-six (60.5%) visits were conducted via video, 17 (39.5%) by telephone. Virtual visits saved patients an average of 118.6 minutes each. Patients and providers had similar, positive perceptions about telehealth to in-person visit comparison, limiting exposure, and visit satisfaction. After the telehealth appointment, patients indicated greater comfort with using virtual visits in the future. Thirty-one evaluations included comments for qualitative analysis. We identified 3 main themes of technology set-up and usability, satisfaction with visit, and clinical assessment and communication. Conclusion: During a pandemic that has limited the ability to safely conduct inperson services, virtual formats offer a feasible and acceptable alternative for clinically-complex older patients. Despite potential barriers and additional effort required for telehealth visits, patients expressed willingness to utilize this format. Patients and providers reported high satisfaction, particularly with the ability to access care similar to in-person while staying safe. Investing in telehealth services during a pandemic ensures that vulnerable older patients can access care while maintaining social distancing, an important safety measure.

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“…However, little is known about the experience of providing geriatric primary care via telemedicine, with the extant studies focusing on specialty care. 3 - 5 …”

mentioning

confidence: 99%

Converting a Geriatrics Clinic to Virtual Visits during COVID-19: A Case Study

Iyer

Mehta

Weith

et al. 2021

J Prim Care Community Health

View full text Add to dashboard Cite

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“… “Telemedicine group”: NHs are already equipped for InT as part of the regional deployment project of the telemedicine device of the Health Regional Agency (Aquitaine, France). The InT procedure was organized in accordance with the French Decree of October 19, 2010 related to telemedicine, 18 and included: o the consent of the resident or the resident’s legal representative and the consent of his attending GP; o a request sent by the NH staff on a secured regional platform called TELEmedicine Aquitaine (TELEA) including a file containing: patient characteristics, i.e., sociodemographic data, level of autonomy, comorbidities and severity, and treatments; and the reasons of telemedicine request; o a connection through TELEA platform between the expert team of the department of Clinical Gerontology and the included NHs; o a report sent by the expert team to the GP and the NH staff via a secured messaging system. “Control group”: NHs without telemedicine equipment.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Effectiveness and organizational conditions of effectiveness of telemedicine in nursing homes. A study protocol of a comparative prospective cohort (EFFORT study)

et al. 2021

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Introduction The profile of nursing home (NH) residents has changed over the past decade with more dependency, more severe chronic diseases and more treatments prescribed. For residents, the major consequence is the higher risk of unplanned hospitalization. French guidelines recommend the development of interactive telemedicine (InT) in NHs in order to improve access to care, and to decrease the rate of avoidable unplanned hospitalizations. Methods and analysis: The aim of this study is to analyze the impact of an InT protocol delivered in NHs on the rate of unplanned hospitalizations, and on the quality of life at work and the organizational conditions of effectiveness of telemedicine in NHs. We will perform a mixed methods study combining a cluster non-randomized controlled trial in two matched parallel arms (telemedicine group and control group) and qualitative analysis of the evolution of organizational and professional contexts in NHs. Ethics and dissemination: The study protocol was approved and sponsored by the French Ministry of Health. The study received ethical approval from the Bordeaux University Hospital Institutional Review Board. We will communicate the final results to the public via conferences and results will also be submitted for publication in international peer-reviewed scientific journals. Trial registration number NCT03486977

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“…Until the end of 2020, TE in France will only apply to patients requiring help with access to healthcare on account of their state of health or geographical circumstances; residents from nursing homes fall into this category. Accounts of telemedicine found in the literature essentially focus on TE (recommendations on findings from follow-up examinations related to dermatological problems or chronic wounds for example) and telemonitoring for chronic disease such as heart failure [17][18][19][20]. To our knowledge, there are no telemedication review (TMR) in the literature.…”

Section: Introductionmentioning

confidence: 99%

Impact of medication review via tele-expertise on unplanned hospitalizations at 3 months of nursing homes patients (TEM-EHPAD): study protocol for a randomized controlled trial

et al. 2020

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Background: Inappropriate drug prescribing causes preventable drug-related adverse events that result in increased morbidity and mortality, additional costs and diminished quality of life. Numerous initiatives have been launched to improve the quality of drug prescribing and safeguard the security of drug administration processes in nursing homes. Against the backdrop of implementation of telemedicine services, the focus of the present work is to evaluate the impact of a telemedication review carried out by a hospital physician and pharmacist as part of the telemedicine offer. Methods: The present study is a randomized controlled clinical trial. A total of 364 patients will be randomized into two groups: (1) an experimental group (182 patients) benefiting from a telemedication review using tele-expertise and (2) a control group (182 patients) receiving standard care. The primary endpoint will be rate of all-cause unplanned hospital admissions occurring within 3 months of randomization. The secondary endpoints will be rate of unplanned admissions at 6 months, patient quality of life, incidence of behavioral disturbances, number of falls, number of residents prescribed at least one inappropriate medication, nursing staff satisfaction, proposed medication reviews and their acceptability rate, characteristics of patients whose general practitioners have taken account of tele-expertise, efficacy of tele-expertise as compared to standard prescription and acceptability and satisfaction surveys of participating caregivers.

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Telemedicine and Geriatrics in France: Inventory of Experiments

Cited by 16 publications

References 32 publications

Converting a Geriatrics Clinic to Virtual Visits during COVID-19: A Case Study

Converting a Geriatrics Clinic to Virtual Visits during COVID-19: A Case Study

Effectiveness and organizational conditions of effectiveness of telemedicine in nursing homes. A study protocol of a comparative prospective cohort (EFFORT study)

Impact of medication review via tele-expertise on unplanned hospitalizations at 3 months of nursing homes patients (TEM-EHPAD): study protocol for a randomized controlled trial

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