The Urgent Need for Rigorous Studies of Telehealth for Older Adults Who Are Homebound

Moo, Lauren; Schwartz, Andrea Wershof

doi:10.1001/jamanetworkopen.2021.13451

Cited by 5 publications

(7 citation statements)

References 8 publications

(15 reference statements)

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“…There is a recognized need for more research in this area. 20 The results of this study are similar to those reported recently by Li et al 21 They evaluated the feasibility of delivering a virtual falls prevention intervention (dual-task Tai Ji Quan balance training) via Zoom to 30 adults aged 65 years or older with mild cognitive impairment (MCI). 21 The intervention included an augmented dual-task Tai Ji Quan training program based on Tai Ji Quan: Moving for Better Balance.…”

Section: Discussionsupporting

confidence: 84%

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Rapid conversion of Tai Chi classes from face‐to‐face to virtual during the COVID‐19 pandemic: A quality improvement project

et al. 2022

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Purpose: The purpose of this quality improvement project was to examine the feasibility of rapidly converting a Tai Chi program for older Veterans from face-toface to virtual classes.Methods: Eighteen Veterans attending our face-to-face Tai Chi course were invited to transition to virtual classes. Feasibility was defined as the ability of program staff and participants to successfully connect and complete the initial and subsequent classes by VA Video Connect (VVC) with little to no technical difficulties, participant ability to participate in the course without safety concerns, and favorable feedback from participants and program staff.Results: Nine of 18 Veterans agreed to transition to the virtual program and attended a median (interquartile range) of 11 (4-15) classes; they were younger (62.7 + 11.5 vs. 70.5 + 7.0 years, p < .05) and more likely to have the knowledge and equipment needed to participate (78% vs. 0%, p < .01) than nonparticipants. Tai Chi instructors and participating Veterans reported being able to connect to and complete the classes virtually with only minimal technical problems. No adverse events were reported. Feedback from the instructors and Veterans was positive and included comments on ease of use and enjoyability. Conclusion:Results suggest that virtual Tai Chi classes via VVC are feasible for some older Veterans.

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Section: Discussionsupporting

confidence: 84%

“…It is not clear why more of the Veterans over the age of 69 years did not participate virtually. There is a recognized need for more research in this area 20 …”

Section: Discussionmentioning

confidence: 99%

Rapid conversion of Tai Chi classes from face‐to‐face to virtual during the COVID‐19 pandemic: A quality improvement project

et al. 2022

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“…For these patients, the telephone may be a viable option. 3,4,[29][30][31] Competencies were disproportionately circulated for comment to VHA stakeholders as clinicians in the VHA, especially non-physicians, have more years of experience with video telemedicine. Efforts to obtain non-VHA input were undertaken by including workgroup members with both VHA and non-VHA experience and circulating the competencies for comment to non-VA groups through the American Geriatrics Society Teachers' Section, the Gerontological Society of America, and Aquifer Geriatrics.…”

Section: Discussionmentioning

confidence: 99%

“…We recognize that some older adults may not be willing or able to engage in video visits and have difficulty getting to in‐person visits. For these patients, the telephone may be a viable option 3,4,29–31 …”

Section: Discussionmentioning

confidence: 99%

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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“…Despite this being a simple outcome measure, it may have meaningful implications for adults dealing with chronic consequences of ABI, and there is a need for more research regarding this measure as a rehabilitation outcome in this population. We would point out that this issue is even more urgent now that the COVID-19 pandemic is causing an increase in homebound older adults [ 86 , 87 ]. During the COVID era, social isolation has become the preferred default option, particularly for people with recent morbidity, such as the subjects included in our study.…”

Section: Discussionmentioning

confidence: 99%

A Performance-Based Teleintervention for Adults in the Chronic Stage after Acquired Brain Injury: An Exploratory Pilot Randomized Controlled Crossover Study

et al. 2022

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This pilot study aimed to investigate the initial effect of a remotely delivered performance-based client-centered intervention on activity performance and participation among adults in the chronic phase after acquired brain injury (ABI). Sixteen participants living at home with little to no assistance in basic daily activities were allocated into intervention or waitlist control groups. Assessments were conducted at the baseline, after the 3-month intervention/wait period, and at a 3-month follow-up. The primary outcomes were activity performance using the Canadian Occupational Performance Measure (COPM) and the Performance Quality Rating Scale (PQRS) and participation using the Mayo-Portland Adaptability Inventory-4 (MPAI-4). The intervention included weekly videoconferencing sessions using the Cognitive Orientation to Daily Occupational Performance approach (tele-CO-OP). The participants identified five functional goals, of which three were directly addressed. Wilcoxon signed-ranks test results showed no significant improvements in the control group at the end of the 3-month wait period. Pooled data from both groups showed significant improvements in COPM scores for trained and untrained goals following the intervention. Significant improvements were also found in the PQRS and MPAI-4 scores. Improvements were partially maintained at follow-up. Our preliminary results suggest that tele-CO-OP may positively impact the lives of adults after ABI who are coping with long-term disability.

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The Urgent Need for Rigorous Studies of Telehealth for Older Adults Who Are Homebound

Cited by 5 publications

References 8 publications

Rapid conversion of Tai Chi classes from face‐to‐face to virtual during the COVID‐19 pandemic: A quality improvement project

Rapid conversion of Tai Chi classes from face‐to‐face to virtual during the COVID‐19 pandemic: A quality improvement project

Competencies for video telemedicine with older adult patients

A Performance-Based Teleintervention for Adults in the Chronic Stage after Acquired Brain Injury: An Exploratory Pilot Randomized Controlled Crossover Study

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