Abstract
Objectives
We examined the demographics and the clinical profile of teleconsultations conducted
between an acute geriatric medicine department and 8 nursing homes over a period of
6.5 years.
Design
This is a prospective, descriptive study.
Setting and Participants
This study was conducted in 8 nursing homes of Singapore. All nursing home patients
referred to the program for teleconsultation between December 2010 and May 2017 were
enrolled in the study.
Measures
The unit observed and studied was the individual telemedicine consultation. Each unique
patient contributed 1 or more observation points. The data collected included consultation
dates, patient demographics, background medical comorbidities, reasons for referral,
physical examination findings, primary diagnoses, and general management plans recommended
by the doctors.
Results
There were 1673 teleconsultations conducted with 850 unique patients. Most of these
patients were categorized as having moderate to severe disability. Ninety-five percent
of the consultations were scheduled. The main reasons for referral were for medication
review (47.6%) and behavioral problems (22.1%). The 4 commonest comorbidities were
hypertension (57.0%), dementia (40.0%), diabetes (39.0%), and hyperlipidemia (38%).
The most common primary diagnosis was dementia (21.6%), of which 227 of those diagnosed
(62.8%) were referred for behavioral and psychological symptoms of dementia.
Conclusions and Implications
A telemedicine service for older patients is feasible and could be of a high quality,
especially if made available in places where a high density of the latter reside,
such as in the care homes and other nursing and rehabilitation facilities.
Keywords
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Article info
Publication history
Published online: June 20, 2020
Footnotes
This study was funded by the Agency for Integrated Care, Ministry of Health, Singapore.
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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