Acceptability of a Novel Telemedication Review for Older Adults in Nursing Homes in France: A Qualitative Study.

Purpose: In France, polypharmacy among older people living in nursing homes (NH) is a major public health concern. In this context, the randomized controlled trial TEM-EHPAD was recently launched in various NH in southern France to evaluate the impact of implementing a novel telemedication review (TMR) on hospital admission rates of NH residents at high risk of iatrogenic disease. A qualitative study was integrated into the main trial study to assess general practitioners' (GP) and other NH healthcare professionals' (HP) acceptability of the proposed TMR before its implementation.
Material and Methods: A qualitative study using face-to-face semi-structured interviews was conducted with 16 HP before the beginning of the intervention. A manual thematic analysis was performed on the transcribed interviews.
Results: Four main themes emerged from the thematic analysis: HP perceptions of the TMR, difficulties related to medication management for NH residents, HP perceptions of the roles of different professionals, and facilitators of good practices. Most participants were favorable to the TMR, but some GP expressed fears about loss of control over their prescription writing.
Conclusion: This study fulfilled its objective to assess pre-intervention acceptability by GP and other HP. Results provided important information about how to adapt the TMR intervention to make it more acceptable to HP who will be involved in TEM-EHPAD. One of the main recommendations is the importance of providing participating GP with the opportunity to take part in the process of reviewing prescriptions.
Competing Interests: Florian Correard reports grants from PREPS-2017-0574, during the conduct of the study; personal fees from NOVARTIS, personal fees from PIERRE FABRE, personal fees from ASTRAZENECA, personal fees from BMS, outside the submitted work. Maeva Montaleytang reports grants from PREPS-2017-0574, during the conduct of the study. Stephane Honore report grants from DGOS (French government), during the conduct of the study. The authors report no other potential conflicts of interest for this work.
(© 2021 Costa et al.)