Navigating the controversies of cognitive screening

Frank, Chris; Molnar, Frank

doi:10.46747/cfp.6707509

Cited by 14 publications

(18 citation statements)

References 8 publications

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“…They should recognize the unique opportunity to obtain confirmatory information from additional reporters who otherwise may not be able to attend an in‐person appointment. Within their scope of practice, clinicians should be able to employ telemedicine‐appropriate assessments of cognitive impairment and other psychological disorders when indicated 23 while recognizing their potential limitations 24 …”

Section: Resultsmentioning

confidence: 99%

“…They should recognize the unique opportunity to obtain confirmatory information from additional reporters who otherwise may not be able to attend an in-person appointment. Within their scope of practice, clinicians should be able to employ telemedicine-appropriate assessments of cognitive impairment and other psychological disorders when indicated 23 while recognizing their potential limitations. 24 For Mobility, clinicians should consider patient safety when performing a virtual mobility assessment, and adapt assessments of mobility, falls, and function to telemedicine (e.g., asking a patient to perform a chair stand to assess fall risk).…”

Section: Exam During the Telemedicine Visitmentioning

confidence: 99%

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Competencies for video telemedicine with older adult patients

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Schwartz

et al. 2023

J American Geriatrics Society

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Background Telemedicine has recently become a part of mainstream clinical practice. Many curricula have been developed to teach general and specialty‐specific video telemedicine skills; however, a lack of defined best practices for translating comprehensive interprofessional geriatric care to the virtual setting presents a unique challenge to educators and clinicians. This manuscript introduces and describes the development of competencies for video telemedicine with older adults for all health professionals who treat them. Methods A modified Delphi process was used in competency development. In 2019, interprofessional clinicians and educators who had expertise in telemedicine formed a competency development workgroup. The aim was to draft competencies for interprofessional video telemedicine with older adults while not duplicating existing competencies in geriatrics, interprofessional care, or general telemedicine. Draft competencies were circulated among experts in geriatric telemedicine and geriatric education for two rounds of comments. The competencies incorporated comments from 41 clinicians representing 7 professions. Results Twenty‐three competencies were created spanning six domains. A temporal organization by domain was used: (1) Overarching considerations, (2) Pre‐visit preparation, (3) Beginning of the visit, (4) History taking and communication during the visit, (5) Exam during the visit (organized by the 5Ms: Mind, Mobility, Medication, Multicomplexity, and Matters Most), and (6) Post‐visit coordination. Conclusions These newly developed competencies fill a gap left by those developed for specific disciplines or that do not address considerations for older adults. They lay the groundwork for curriculum development and the development of virtual Age‐Friendly care.

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Section: Resultsmentioning

confidence: 99%

Section: Exam During the Telemedicine Visitmentioning

confidence: 99%

Competencies for video telemedicine with older adult patients

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Zuilen

Schwartz

et al. 2023

J American Geriatrics Society

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“…A rapid scan of the literature yielded more than 100 journal articles, reports, and clinical practice guidelines, which were reviewed and extracted by a member of the SWFSS team. A number of themes emerged from the extraction table, such as barriers to technology use (Frank, St. John, & Molnar, 2020; van Ineveld, Huang, Varshney, & Merkley, 2020); issues around privacy (Canadian Medical Association, The College of Family Physicians of Canada & Royal College of Physicians & Surgeons of Canada, 2020); determining urgency (College of Physicians & Surgeons of Alberta, 2020; Regional Geriatric Program of Toronto, 2020); virtual care versus in-person care (Alberta Health Services, 2020; Ontario College of Family Physicians, 2020; Ontario Health, 2020; OTN, 2020); using a patient-centred approach (Health Standards Organization & Accreditation Canada, 2019); obtaining informed consent (Agency for Healthcare Research and Quality, 2020) and equity (British Columbia Ministry of Health, 2020; Donaghy et al, 2019; Shaw et al, 2019). Also, it was noted that there were many resources on virtual care in general, but none that were solely focused on decision making, planning, and delivery of virtual care to this specific population.…”

Section: Resultsmentioning

confidence: 99%

Co-Designing Together through Crisis: Development of a Virtual Care Guidance Document to Support Providers, Older Adults, and Caregivers

Glover

Elliott²,

Muddle³

2022

Can. J. Aging

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COVID-19 has had a disproportionate and devastating impact on older adults. As health care resources suddenly shifted to emergency response planning, many health and community support services were cancelled, postponed, or shifted to virtual care. This rapid transformation of geriatric care resulted in an immediate need for practical guidance on decision making, planning and delivery of virtual care for older adults and caregivers. This article outlines the rapid co-design process that supported the development of a guidance document intended to support health and community support services providers. Data were collected through consultation sessions, surveys, and a rapid literature review, and analyzed using appropriate qualitative and quantitative methods. Although this work took place within the context of the COVID-19 pandemic, the resulting resources and lessons learned related to collective impact, co-design, population-based planning, and digital technologies can be applied more broadly.

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“…Owing to global migrations, the deficient alleles are newly prevalent in other countries and regions of the world, notably North America and northern Europe 2 . G6PD deficiency usually presents as acute hemolysis, neonatal jaundice, or chronic hemolysis 3 . Ingestion of fava beans, infections, and oxidative drugs are the most typical cause of acute hemolysis in people with G6PD deficiency 3 .…”

Section: Introductionmentioning

confidence: 99%

Late‐onset aspirin‐related hemolysis and subsequent subdural hemorrhage in patient with glucose‐6‐phosphate dehydrogenase deficiency

Li,

Chen,

Deng

et al. 2024

Clinical Case Reports

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Key Clinical MessageAspirin‐related hemolysis in G6PD deficiency could be late‐onset during long‐term administration. Hemolytic anemia could continue for a relatively long time in elder patient with G6PD deficiency, which might be related to other adverse events.AbstractAspirin‐related hemolysis in G6PD‐deficient individuals was generally reported among patients who received high‐dose supplements within several days after ingestion. The safety of long‐term and low‐dose (50–325 mg/day) aspirin in patients coexist G6PD deficiency and cardiovascular disease is neglected in clinical practice. In this case, we observed a late‐onset hemolysis and subsequent fatal subdural hemorrhage in one G6PD‐deficient individual who had received long‐term and low‐dose aspirin. An 83‐year‐old male was diagnosed with acute ischemic stroke and treated with 100 mg/day aspirin at the emergency room. After admission, the patient was diagnosed with severe G6PD deficiency based on enzyme activity, but no hemolysis occurred within 10‐day aspirin therapy in the hospital. Hence, 100 mg/day aspirin was continued on discharge. Two months later, the patient presented acute hemolysis manifested as fatigue, dark urine, and moderate jaundice. Although hemolysis was self‐limit in a few days, hemoglobin decline continued for 20 days until a fatal subdural hemorrhage occurred. Our study indicated aspirin‐related hemolysis could be late‐onset in G6PD‐deficient individual even receiving low‐dose treatment and is probably linked to subsequent major bleeding events.

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Navigating the controversies of cognitive screening

Abstract: Who and when should clinicians screen for cognitive impairment, and what tests should they use?

Cited by 14 publications

References 8 publications

Competencies for video telemedicine with older adult patients

Competencies for video telemedicine with older adult patients

Co-Designing Together through Crisis: Development of a Virtual Care Guidance Document to Support Providers, Older Adults, and Caregivers

Late‐onset aspirin‐related hemolysis and subsequent subdural hemorrhage in patient with glucose‐6‐phosphate dehydrogenase deficiency

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