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During the COVID-19 pandemic, policymakers had to quickly offer telehealth services to address older adults' needs. This study aimed to understand the experiences of providers who implemented a telephone-based telehealth tool named Socio-Geriatric Evaluation (ESOGER), which assessed health and social isolation risks in community-dwelling older adults in Quebec (Canada). This qualitative study used 20 semi-structured online/phone interviews with health and social service providers coming from publicly-funded healthcare facilities and community organizations. We included adopters and non-adopters of the telehealth tool. Interviews were audio-recorded and transcribed verbatim. We used reflexive thematic analysis to interpret the data. Three dimensions of providers' practice influenced the tool's implementation: service organization, working conditions, and interactions with older adults. Participants reported that the tool fostered continuity of care, provided guidance for their pandemic-related new tasks, and helped identify and support socially isolated older adults. Challenges to implementation included limited appropriateness of the telehealth tool for diverse services, feasibility barriers to adopting a new tool amid the health crisis, and acceptability challenges with some older adults. Despite relevance of the telehealth tool for providers, organizational, professional, and interactional barriers could hinder implementation success. Participatory approaches to telehealth may be promising avenues for future policies in this field. [ABSTRACT FROM AUTHOR]

Background and Objectives People aged 65 and older, deemed most "vulnerable" by public health, were targeted by the coronavirus disease 2019 protection measures, which sought to minimize physical contact and social activities. Older adults living alone were particularly affected by these measures. However, such measures meant to protect the older population may not have necessarily reflected older adults' individual prioritization choices. This study therefore aimed to understand how protecting oneself over the virus was considered in the prioritization of other health and social needs of older adults living alone during the pandemic. Research Design and Methods This study adopted a qualitative design. A total of 17 semistructured interviews were conducted between May 2021 and June 2022 with older adults living alone. All interviews were audio-recorded and transcribed verbatim. A reflexive thematic analysis as defined by Braun and Clarke was performed. Results Our analysis showed 2 forms of prioritization across 2 themes. This first theme focused on participants who reported prioritizing protecting themselves over the virus by limiting in-person contact and activities. The second theme showed that although several participants reported that protecting themselves over the virus was important to them, the prioritization of this need was not shared by all and, in some cases, evolved over the course of the pandemic. Discussion and Implications Our study demonstrated heterogeneity in the prioritization of older adults needs. Future public health recommendations should consider these variations in the needs and priorities of older adults when determining public health measures. [ABSTRACT FROM AUTHOR]

Presenters Nadia Sourial, PhD, Janusz Kaczorowski, PhD, Amelie Quesnel-Vallee, Marie Therese Lussier, MD, FCFP, MSc, Vladimir Khanassov, MD, MSc, Mylaine Breton, PhD, Elise Develay, MSc, Geraldine Layani, MD, MSc, Clinical [...], Context: Virtual pre-consultation screening of patient needs may offer opportunities to improve the care and health outcomes of older patients in primary care, especially those with multiple care needs. Objective: We sought to implement and evaluate the effectiveness of a multidimensional virtual pre-consultation tool in the primary care setting to support rapid and standardized needs assessment for older persons. Study Design and Analysis: Pragmatic, multi-center, 1:1 individually randomized trial design. Implementation was conducted using a participatory approach over a 3-month period. Baseline and 3-month follow-up data were collected through phone-based questionnaires. An intention-to-treat analysis was carried out. Setting: Four university-affiliated interprofessional primary care clinics, two clinics in one urban region (Montreal) and two in one rural region (Abitibi) in Quebec, Canada. Population Studied: Patients 65 years and older with a consultation with a primary care provider (physician, nurse, social worker, other) during the implementation period in one of the participating clinics. Intervention: A virtual pre-consultation tool, ESOGER, was administered as a phone-based questionnaire by a member of the clinic staff to eligible patients prior to their consultation with the primary care provider. The ESOGER tool provides a general assessment of the physical, social, mental and cognitive health needs of older adults and produces a summary report available to clinicians at the time of consultation. Outcome Measures: The primary endpoint consisted of the EQ-5D quality of life score at 3-month follow-up. Secondary endpoints were unplanned primary care visits, visits to the ED and hospital admissions in last 3 months. Results: Of the 659 eligible patients contacted to date, 345 (52.3%) agreed to participate and have been randomized. Follow-up assessments are ongoing with a loss to follow-up of 22.8% and will be completed by August 2022. Final results of the intention-to-treat analysis will be presented overall and stratified by urban and rural sites. Conclusions: Intended consequences of this intervention include an increased responsiveness of consultations for providers resulting in improved care of older patients. Overall, we hope results will support the implementation of evidence-based, multidimensional and virtual pre-consultation tools for older persons in the primary care setting.