Telemedicine Preparedness Among Older Adults With Chronic Illness: Survey of Primary Care Patients

Ufholz, Kelsey; Sheon, Amy R.; Bhargava, Daksh; Rao, Goutham

doi:10.2196/35028

Cited by 9 publications

(8 citation statements)

References 11 publications

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“…We showed that special attention should be placed on people living alone, with preexisting comorbidities or of old age. The same vulnerable groups have been identified in studies in the field of telehealth ( 18 – 20 , 24 , 65 , 68 ). In line with our results, continuity of staff and a trusted relationship with the telehealth provider have been identified as important to patients ( 18 ).…”

Section: Discussionmentioning

confidence: 59%

“…Severe courses of disease, leading to hospitalization (VS62), but also the unexpected intensity and duration of common symptoms such as pain (VS63-64), fever (VS62), cough (VS65) and especially weakness (VS60, 66-67) impaired the participants' illness experience. The unpredictability of COVID-19, with sudden changes in symptoms and severity and the undulating recovery process was perceived difficult (VS63, [68][69].…”

Section: Illness Experience-qualitative Survey Resultsmentioning

confidence: 99%

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Experiencing COVID-19, home isolation and primary health care: A mixed-methods study

Parisi

Lehner

Schrader

et al. 2023

Front. Public Health

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ObjectivesAlthough the vast majority of COVID-19 cases are treated in primary care, patients' experiences during home isolation have been little studied. This study aimed to explore the experiences of patients with acute COVID-19 and to identify challenges after the initial adaptation of the German health system to the pandemic (after first infection wave from February to June 2020).MethodsA mixed-method convergent design was used to gain a holistic insight into patients experience. The study consisted of a cross-sectional survey, open survey answers and semi-structured telephone interviews. Descriptive analysis was performed on quantitative survey answers. Between group differences were calculated to explore changes after the first infection wave. Qualitative thematic analysis was conducted on open survey answers and interviews. The results were then compared within a triangulation protocol.ResultsA total of 1100 participants from all German states were recruited by 145 general practitioners from August 2020 to April 2021, 42 additionally took part in qualitative interviews. Disease onset varied from February 2020 to April 2021. After the first infection wave, more participants were tested positive during the acute disease (88.8%; 95.2%; P < 0.001). Waiting times for tests (mean 4.5 days, SD 4.1; 2.7days, SD 2.6, P < 0.001) and test results (mean 2.4 days, SD 1.9; 1.8 days, SD 1.3, P < 0.001) decreased. Qualitative results indicated that the availability of repeated testing and antigen tests reduced insecurities, transmission and related guilt. Although personal consultations at general practices increased (6.8%; 15.5%, P < 0.001), telephone consultation remained the main mode of consultation (78.5%) and video remained insignificant (1.9%). The course of disease, the living situation and social surroundings during isolation, access to health care, personal resilience, spirituality and feelings of guilt and worries emerged as themes influencing the illness experience. Challenges were contact management and adequate provision of care during home isolation. A constant contact person within the health system helped against feelings of care deprivation, uncertainty and fear.ConclusionsOur study highlights that home isolation of individuals with COVID-19 requires a holistic approach that considers all aspects of patient care and effective coordination between different care providers.

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Section: Discussionmentioning

confidence: 59%

Section: Illness Experience-qualitative Survey Resultsmentioning

confidence: 99%

Experiencing COVID-19, home isolation and primary health care: A mixed-methods study

Parisi

Lehner

Schrader

et al. 2023

Front. Public Health

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“…The authors also note that not all populations have smartphones capable of running mobile apps. This may be especially true of older, low-income adults who only use a limited number of programs on their smartphones [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

The Efficacy of Mobile Applications for Weight Loss

Ufholz

Werner

2023

Curr Cardiovasc Risk Rep

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Purpose of Review A variety of mobile-based applications aimed at weight loss have become popular in recent years. This review describes the features and effectiveness of mobile weight loss apps. Recent Findings Overall, mobile apps can help patients lose weight either as well as or better than traditional paper-and-pencil weight loss interventions and often better than minimal intervention control groups. Mobile apps promote multiple strategies, including self-monitoring of diet, exercise, and weight, as well as social support and educational content. Significant variation exists in app types, which makes it difficult to conclude which features drive program effectiveness. Intervention success varies based on patients’ level of engagement with the app. There is a deficit of apps and app-based studies of older, less tech-savvy adults, ethnic/racial minorities, and low-income individuals, as well as longer-term studies. Summary Mobile apps can successfully help patients lose weight and represent a cost-effective, accessible alternative to intensive in-person weight loss programs. More research is needed into their long-term potential, especially for hard-to-reach populations.

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“…Of the remaining 10 articles, 1 was excluded because it did not have access to full text, leaving 9. The reverse search procedure of the references cited obtained a further 9 eligible articles, resulting in a final total of 18 papers included in the definitive analysis [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] (see Figure 1).…”

Section: Characteristic Of the Studies Includedmentioning

confidence: 99%

“…Ufholz et al [33] reported that older patients showed less use of telemedicine (23%) despite near to 80% having access to technology.…”

Section: Telemedicine Consult Perceptionmentioning

confidence: 99%

Telemedicine in Elderly Hypertensive and Patients with Chronic Diseases during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Quesada-Caballero,

Carmona-García,

Chami-Peña

et al. 2023

JCM

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Background: One aspect of the distancing measures imposed in response to the COVID-19 pandemic is that telemedicine consultations have increased exponentially. Among these consultations, the assessment and follow-up of patients with chronic diseases in a non-presential setting has been strengthened considerably. Nevertheless, some controversy remains about the most suitable means of patient follow-up. Objective: To analyze the impact of the telemedicine measures implemented during the COVID-19 period on chronic patients. Material and Methods: A systematic review was carried out using the following databases: PubMed, Pro-Quest, and Scopus. The systematic review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search equation utilized descriptors sourced from the Medical Subject Headings (MeSH) thesaurus. The search equation was: “hypertension AND older AND primary care AND (COVID-19 OR coronavirus)” and its Spanish equivalent. Results: The following data were obtained: 14 articles provided data on 6,109,628 patients and another 4 articles focused on a study population of 9684 physicians. Telemedicine was less likely to be used by elderly patients (OR 0.85; 95% C.I. 0.83–0.88; p = 0.05), those of Asian race (OR 0.69; 95% C.I. 0.66–0.73; p = 0.05), and those whose native language was not English (OR 0.89; 95% C.I. 0.78–0.9; p = 0.05). In primary care, lower use of telemedicine was associated with residents of rural areas (OR 0.81; p = 0.05), patients of African American race (OR 0.65, p = 0.05), and others (OR 0.64; p = 0.05). A high proportion (40%) of physicians had no prior training in telemedicine techniques. The highest quality in terms of telephone consultation was significantly associated with physicians who did not increase their prescription of antibiotherapy during the pandemic (OR = 0.30, p = 0.05) or prescribe more tests (OR 0.06 p = 0.05), i.e., who maintained their former clinical criteria despite COVID-19. Conclusions: Telemedicine is of proven value and has been especially useful in the COVID-19 pandemic. A mixed remote–presential model is most efficient. Appropriate training in this area for physicians and patients, together with correct provision, is essential to prevent errors in implementation and use.

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Telemedicine Preparedness Among Older Adults With Chronic Illness: Survey of Primary Care Patients

Cited by 9 publications

References 11 publications

Experiencing COVID-19, home isolation and primary health care: A mixed-methods study

Experiencing COVID-19, home isolation and primary health care: A mixed-methods study

The Efficacy of Mobile Applications for Weight Loss

Telemedicine in Elderly Hypertensive and Patients with Chronic Diseases during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

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