Adélaïde de Mauleon Ph.D. , Antoine Piau Ph.D. , Marion Baziard M.D. , Clive Ballard Ph.D. , Pascal Saidlitz M.D. , Thierry Voisin M.D. , Pierre Rumeau M.D. , Achille Tchalla Ph.D. , Christelle Cantet M.Sc. , Fati Nourashemi Ph.D. , Benoît Lepage Ph.D. , Maria Soto Ph.D.
{"title":"远程医疗对长期护理机构中痴呆患者神经精神症状的管理：来自DETECT介入试点研究的二次和探索性分析","authors":"Adélaïde de Mauleon Ph.D. , Antoine Piau Ph.D. , Marion Baziard M.D. , Clive Ballard Ph.D. , Pascal Saidlitz M.D. , Thierry Voisin M.D. , Pierre Rumeau M.D. , Achille Tchalla Ph.D. , Christelle Cantet M.Sc. , Fati Nourashemi Ph.D. , Benoît Lepage Ph.D. , Maria Soto Ph.D.","doi":"10.1016/j.jagp.2025.01.012","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Design</h3><div>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).</div></div><div><h3>Setting</h3><div>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).</div></div><div><h3>Measurements</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":55534,"journal":{"name":"American Journal of Geriatric Psychiatry","volume":"33 8","pages":"Pages 850-862"},"PeriodicalIF":3.8000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"Adélaïde de Mauleon Ph.D. , Antoine Piau Ph.D. , Marion Baziard M.D. , Clive Ballard Ph.D. , Pascal Saidlitz M.D. , Thierry Voisin M.D. , Pierre Rumeau M.D. , Achille Tchalla Ph.D. , Christelle Cantet M.Sc. , Fati Nourashemi Ph.D. , Benoît Lepage Ph.D. , Maria Soto Ph.D.\",\"doi\":\"10.1016/j.jagp.2025.01.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>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.</div></div><div><h3>Design</h3><div>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).</div></div><div><h3>Setting</h3><div>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).</div></div><div><h3>Measurements</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>\",\"PeriodicalId\":55534,\"journal\":{\"name\":\"American Journal of Geriatric Psychiatry\",\"volume\":\"33 8\",\"pages\":\"Pages 850-862\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Geriatric Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1064748125000296\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/8 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Geriatric Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1064748125000296","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/8 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
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
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.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
