Telemedicine in the primary care of older adults: a systematic mixed studies review

Ilali, Marwa; Berre, Mélanie Le; Vedel, Isabelle; Khanassov, Vladimir

doi:10.1186/s12875-023-02085-7

Cited by 3 publications

(3 citation statements)

References 54 publications

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“…One strength is how the qualitative findings confirm the results of our systematic review, previously conducted by our research team, from the point of view of different stakeholders [ 9 ]. Future studies should continue to improve virtual care, exploring the compensation model, which refers to how healthcare providers are reimbursed for telemedicine services, as a key factor in enhancing accessibility and sustainability [ 40 ].…”

Section: Discussionmentioning

confidence: 57%

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Telemedicine in primary care of older adults: a qualitative study

Khanassov,

Ilali,

Ruiz

et al. 2024

BMC Prim. Care

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Background The COVID-19 pandemic changed the healthcare system, leading to the rapid evolution and implementation of telemedicine (TM). TM has the potential to improve the quality of primary health care and increase accessibility for the population. However, its use may represent challenges for older people, as they may have distinct needs from the general population due to age-related changes in perceptual, motor, and cognitive capacities. We, thus, aimed to identify potential facilitators and barriers to TM use in primary care for older adults and develop recommendations accordingly. Methods We conducted a qualitative study to explore the challenges associated with TM use among older adults and healthcare professionals (HCPs) in primary care practice. Interviews were conducted with 29 older adults, and three focus groups involving HCPs from four McGill family medicine sites were organized. Employing a hybrid codebook thematic analysis, guided by the Consolidated Framework for Implementation Research (CFIR), we identified facilitators and barriers affecting the optimal use of TM by older adults and HCPs. We synthesized the results from semi-structured interviews and focus groups. These findings were then presented during a deliberative dialogue with eight participants, including family physicians, nurses, a social worker, and a government-level TM expert, to validate our results. The purpose was to gather feedback, identify and refine actionable recommendations. Subsequently, we utilized a thematic analysis using the same codebook to synthesize findings from the deliberative dialogue. Results Participants agreed that TM contributed to maintaining the continuity of care and was particularly convenient when there was an existing or established patient-physician relationship or for addressing minor health issues. TM was found to be beneficial for people with limited mobility, reducing their exposure to potentially high-risk environments. However, participants expressed concerns about the lack of visual contact, causing essential details to be overlooked. Additionally, issues related to miscommunication due to language or hearing barriers were identified. HCPs perceived that most older adults did not consider phone consultations a medical act. Participants were open to a hybrid approach, combining in-person consultations and TM, based on their specific health conditions. Building upon these results, we formulated seven key recommendations. Conclusions Both older adults and HCPs consider TM a good alternative for accessing healthcare services. To improve the effective use of TM, it’s crucial to advocate for a hybrid approach that integrates both in-person and virtual methods. This approach should actively encourage and support individuals in becoming familiar with technological tools.

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Section: Discussionmentioning

confidence: 57%

“…Prior to starting our qualitative study, our team conducted an extensive systematic mixed-methods studies review focusing on telemedicine in the primary care of older adults [ 9 ]. After analyzing a substantial pool of 3,328 references, we identified 20 relevant studies.…”

Section: Introductionmentioning

confidence: 99%

Telemedicine in primary care of older adults: a qualitative study

Khanassov,

Ilali,

Ruiz

et al. 2024

BMC Prim. Care

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“…Regular monitoring [172] Monitoring lung function, symptoms, and medication adherence, scheduled follow-ups End-of-life planning [173] Open discussions about end-of-life preferences and palliative care options Home healthcare and telemedicine [174] Continuous monitoring and timely interventions, remote consultations…”

Section: Approach Proceduresmentioning

confidence: 99%

Pulmonary Diseases in Older Patients: Understanding and Addressing the Challenges

Joshi

2024

Geriatrics

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As the global population ages, pulmonary diseases among older people have emerged as a significant and growing public health concern. The increasing incidence of these conditions has led to higher rates of morbidity and mortality among older adults. This perspective study offers a thorough overview of the prevalent pulmonary diseases affecting the elderly demographic. It delves into the challenges encountered during the diagnosis and management of these conditions in older individuals, considering factors such as comorbidities, functional limitations, and medication complexities. Furthermore, innovative strategies and personalized interventions such as precision medicine, advanced therapies, telemedicine solutions, and patient-centered support systems aimed at enhancing the care provided to older individuals grappling with pulmonary disorders are thoroughly explored. By addressing the unique needs and complexities of this vulnerable population, healthcare systems can strive towards improving outcomes and enhancing the quality of life for elderly individuals affected by pulmonary diseases.

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