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Use of Clinical Video Telehealth as a Tool for Optimizing Medications for Rural Older Veterans with Dementia
- Source :
- Geriatrics, Volume 3, Issue 3, Geriatrics, Vol 3, Iss 3, p 44 (2018)
- Publication Year :
- 2018
- Publisher :
- MDPI AG, 2018.
-
Abstract
- Community-Based Outpatient Clinics (CBOCs) allow delivery of primary care to rural veterans who are far from a main Veterans Affairs (VA) campus. However, CBOCs often do not have physicians with geriatric training. We used a clinical video telehealth (CVT) dementia service (Teledementia clinic) based in the Pittsburgh VA Healthcare System to optimize dementia patients&rsquo<br />medications and potentially inappropriate medications (PIMs). We analyzed 199 CVT patient encounters from 1 January 2016 to 31 December 2016 and compared different medication changes per encounter between the initial CVT consults and the follow-up visits for all medications and PIMs as listed in the 2015 Beers Criteria, to see if there was a decrease of each kind of change, which is being used as a surrogate for optimization. We found that initial CVT consults, compared to follow-up visits, had greater medications added (0.731 vs. 0.434, p = 0.0092), total overall medications changes (1.769 vs. 1.130, p = 0.0078), and the stopping of 2015 Beers Criteria PIMs (0.208 vs. 0.072, p = 0.0255) per encounter. The fewer PIMs discontinued and fewer medication additions in follow-ups implies that our patients&rsquo<br />medications tend to stay optimized between visits. The teledementia service represents a novel way to provide geriatric assistance to CBOC VA primary care physicians for rural veterans with dementia.
- Subjects :
- Aging
Health (social science)
telehealth
education
Beers Criteria
Telehealth
Primary care
lcsh:Geriatrics
Article
03 medical and health sciences
medications
0302 clinical medicine
Medicine
Dementia
Outpatient clinic
veterans
030212 general & internal medicine
Veterans Affairs
health care economics and organizations
Service (business)
business.industry
Potentially Inappropriate Medications
medicine.disease
humanities
lcsh:RC952-954.6
rural
Medical emergency
Geriatrics and Gerontology
business
Gerontology
Beers list
030217 neurology & neurosurgery
dementia
Subjects
Details
- ISSN :
- 23083417
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- Geriatrics
- Accession number :
- edsair.doi.dedup.....736911c3aaf792b424b7859b938a45f1