Telemedicine for the Management of Neuropsychiatric Symptoms in Patients With Dementia Living in Long Term Care Facilities: Secondary and Exploratory Analyses From the DETECT Interventional Pilot Study.
Adélaïde de Mauleon, Antoine Piau, Marion Baziard, Clive Ballard, Pascal Saidlitz, Thierry Voisin, Pierre Rumeau, Achille Tchalla, Christelle Cantet, Fati Nourashemi, Benoît Lepage, Maria Soto
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Abstract
Objective: This study aimed to compare the effects of telemedicine use in management of neuropsychiatric symptoms (NPS) in patients with dementia in long-term care facilities (LTCFs) versus usual care.
Design: DETECT is a prospective randomized controlled cluster pilot study with two arms: "usual care" and "intervention arm" utilizing telemedicine for NPS management. Our study includes secondary and exploratory analyses from the DETECT study (primary analyses were the subject of a separate publication).
Setting: Nineteen LTCFs participated. Patient outcomes included total hospitalizations including emergency room admittance, psychotropic drug prescriptions, NPS based on NPI-NH, quality of life based on QolAD, and functional status based on Activity Daily Living (ADL).
Measurements: Analyses were conducted on a modified intention-to-treat population. Mixed models were used for outcome measures, considering data correlation over time and intra-LTCF correlation.
Results: One hundred forty-one patients were included: 65 in the control group and 76 in the intervention group, 99 women (70.2%) with a mean age of 86.8 years ± 6.6 (SD). No difference was identified regarding hospitalizations and psychotropic drug prescriptions in the intervention group. During exploratory analyses, telemedicine showed significant improvement in the intervention group for NPI frequency × severity score (p = 0.001), NPI distress score (p = 0.03), ADL (p = 0.006), and several quality-of-life items compared to usual care.
Conclusions: Secondary analyses form DETECT study show no difference in the use of telemedicine on management of NPS in patients with dementia in LTCFs, in terms of hospitalizations and psychotropic drug prescription. However, some exploratory analyses indicated a positive effect of Telemedicine, including severity, frequency, distress, and functional autonomy compared to usual care.
期刊介绍：
The American Journal of Geriatric Psychiatry is the leading source of information in the rapidly evolving field of geriatric psychiatry. This esteemed journal features peer-reviewed articles covering topics such as the diagnosis and classification of psychiatric disorders in older adults, epidemiological and biological correlates of mental health in the elderly, and psychopharmacology and other somatic treatments. Published twelve times a year, the journal serves as an authoritative resource for professionals in the field.
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