Search

BackgroundThe role of primary healthcare is pivotal in the management of the surge of dementia prevalence particularly in low-resource areas. In this study, two telehealth-based memory clinics in primary healthcare operating within the frames of the INTegRated InterveNtion of pSychogerIatric Care (INTRINSIC) are presented.MethodsThe first clinic, which is led by a general practitioner, operates at a primary healthcare center in a semi-mountainous area and closely collaborates with the geriatric psychiatry outpatient clinic of the Patras University General Hospital via a telehealth medicine platform. The second clinic is embedded at the General Hospital Center for Interconnected Psychiatric Support on the island of Syros, is led by registered nurses, and is interconnected with the geriatric psychiatry unit at the Eginition University Hospital in Athens.ResultsBoth memory clinics are in their infancy. At the general practitioner-led memory clinic, 13 beneficiaries were assessed and treated during the first 6 months of its operation. Cognitive decline and depressive and/or anxiety symptoms were detected in 10 and eight individuals, respectively. In 9 of the 27 beneficiaries of the registered nurse-led memory clinic, either mild cognitive impairment or dementia was diagnosed, while affective and/or anxiety symptoms were detected in almost all of them. Of note, only 14 beneficiaries of both clinics had received a diagnosis of a mental or neurocognitive disorder prior to their assessment at the memory clinics.ConclusionDeveloping memory clinics in primary healthcare may be a pragmatic strategy to improve access of older adults living in low-resource areas to cognitive healthcare services.

Abstract Background Even though communities in low-resource areas across the globe are aging, older adult mental and cognitive health services remain mainly embedded in tertiary- or secondary hospital settings, and thus not easily accessible by older adults living in such communities. Here, the iterative development of INTegRated InterveNtion of pSychogerIatric Care (INTRINSIC) services addressing the mental and cognitive healthcare needs of older adults residing in low-resource areas of Greece is depicted. Methods INTRINSIC was developed and piloted in three iterative phases: (i) INTRINSIC initial version conceptualization; (ii) A 5-year field testing in Andros island; and (iii) Extending the services. The INTRINSIC initial version relied on a digital platform enabling videoconferencing, a flexible battery of diagnostic tools, pharmacological treatment and psychosocial support and the active involvement of local communities in service shaping. Results Ιn 61% of the 119 participants of the pilot study, new diagnoses of mental and/or neurocognitive disorders were established. INTRINSIC resulted in a significant reduction in the distance travelled and time spent to visit mental and cognitive healthcare services. Participation was prematurely terminated due to dissatisfaction, lack of interest or insight in 13 cases (11%). Based on feedback and gained experiences, a new digital platform, facilitating e-training of healthcare professionals and public awareness raising, and a risk factor surveillance system were created, while INTRINSIC services were extended to incorporate a standardized sensory assessment and the modified problem adaptation therapy. Conclusion The INTRINSIC model may be a pragmatic strategy to improve access of older adults with mental and cognitive disorders living in low-resource areas to healthcare services.