Telemedicine for the management of neuropsychiatric symptoms in long-term care facilities: the DETECT study, methods of a cluster randomised controlled trial to assess feasibility

Abstract

IntroductionNeuropsychiatric symptoms (NPSs) in elderly patients with dementia are frequent in long-term care facilities (LTCFs) and are associated with adverse events. Telemedicine is an emerging way to provide consultation and care to dependent LTCF residents who may not have easy access to specialty services. Several studies have evaluated telemedicine for dementia care but to date, no study has evaluated its impact in the management of NPS in patients with dementia living in LTCF.Methods and analysisThe Dementia in long-term care facilities: Telemedicine for the management of neuropsychiatric symptoms (DETECT) study is a 24-month multicentre prospective cluster randomised controlled study with two arms: a control arm (usual care) and an intervention arm (telemedicine consultation) for NPSs management. DETECT enrolled 20 LTCFs. The primary outcome is based on the acceptability of the telemedicine among the LTCF staff which will be assessed in the intervention group by quantitative and qualitative indicators. The rate of unscheduled hospitalisations and/or consultations due to disruptive NPSs, psychotropic drug use and health costs will be described in both groups. Approximately, 200 patients are expected to be recruited.Ethics and disseminationThe study protocol was approved and sponsored by the French Ministry of Health. The study received ethical approval from the Toulouse 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 numberNCT02472015.

Health workers perception on telemedicine in management of neuropsychiatric symptoms in long-term care facilities: Two years follow-up

“…A total of 10 LTCF were included for 24 months and were equipped with TM for NPS management in addition to the standard health care services available in their area (for full details of the procedure see Piau et al. 26 ) The LTCF had a mean number of 85 beds (min 60, max 133). The distribution of the number of beds, “specialized” professions in the LTCF (in addition to nurses, auxiliary nurses and night shift workers), full-time equivalent jobs for each profession, and whether or not non-pharmacological approaches were used in the LTCF are presented in Table 1 .…”

Telemedicine and Geriatrics in France: Inventory of Experiments

“…20 nursing homes are involved. The main objective is to evaluate the acceptability of expert teleconsultation, with the secondary goals of tracing and comparing specific parameters in the two nursing home groups, such as the rate of hospitalizations and consultations for behavioral and psychological symptoms of dementia (BPSD), the rate of prescriptions for neuroleptic and psychotropic drugs, patient care costs, and patient quality of life [46]. …”

A coaching tele-consultation service to improve care for behavioral and psychological symptoms of dementia: A pilot study

“…Also, clinical data were collected on chart review, by an unblinded assistant, which could have added a bias. More research in this field is needed, with controlled trials such as the ongoing one by Piau et al (2018) that includes quantitative and qualitative indicators as well as economic evaluation. Ideally, comparison with a controlled group (e.g.…”