A coaching tele-consultation service to improve care for behavioral and psychological symptoms of dementia: A pilot study.

Background Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent in major neurocognitive disorders and have considerable impacts. Many clinical settings struggle with insufficient knowledge, suboptimal management and excessive use of psychotropic medications. Research aim Giv...

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Publicado en:Gerontechnology Vol. 19; no. 1; pp. 42 - 54
Autores principales: Bruneau, Marie-Andrée, Bier, Nathalie, Daneau, Stéphanie, Dubé, Catherine, Villeneuve, Laurence, Ménard, Caroline, Bourbonnais, Anne
Formato: research tables/charts Journal Article
Publicado: International Society for Gerontechnology 2020
Acceso en línea:Ver este registro en EBSCOhost
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      pub: International Society for Gerontechnology
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        atl: A coaching tele-consultation service to improve care for behavioral and psychological symptoms of dementia: A pilot study.
      aug:
        au:
          Bruneau, Marie-Andrée
          Bier, Nathalie
          Daneau, Stéphanie
          Dubé, Catherine
          Villeneuve, Laurence
          Ménard, Caroline
          Bourbonnais, Anne
        affil: Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, Québec, Canada
      sug:
        subj:
          Dementia Therapy
          Behavioral Symptoms Therapy
          Remote Consultation Education
          Geriatricians Education
          Program Evaluation
          Human
          Quebec
          Pilot Studies
          Interviews
          Open-Ended Questionnaires
          Descriptive Statistics
          Gerontologic Care
          Neuropsychology Education
          Skill Acquisition
          Clinical Competence
          Patient Satisfaction
          Quality of Health Care
          Clinical Assessment Tools
      ab: Background Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent in major neurocognitive disorders and have considerable impacts. Many clinical settings struggle with insufficient knowledge, suboptimal management and excessive use of psychotropic medications. Research aim Given the low availability of specialized staff and the remoteness of some healthcare locations, our aim was to document the effects and the implementation process of a telehealth coaching service on BPSD care. Methods Geriatric specialists at the Institut universitaire de gériatrie de Montréal (IUGM) offered a structured training program to distant community care teams through tele-consultation. It involved setting up a BPSD team in each participating community to ensure acquired skills would be sustained. The program proposed a 2-day formal training followed by a monthly complex BPSD case tele-consultation. One of these clinical projects with the Magdalen Islands health centre (MIHC) included a mixed methods research component. We evaluated clinical benefits by comparing Neuropsychiatric Inventory (NPI-Q), Clinical Global Impression (CGI-I) and psychotropic intake at baseline and three months post tele-consultation, on clinical chart review with non-parametric Wilcoxon analysis. The implementation process was evaluated by open-ended interviews and satisfaction questionnaires. The qualitative data were analyzed using Miles and Huberman's approach. Results Twelve patients were evaluated by tele-consultation. Results showed clinical benefits (decrease of 35% NPI-Q (p=0.024), an improvement on CGI, as well as high satisfaction levels (caregivers and remote team). Eleven open interviews were completed (2 nurses, 3 psychosocial staff, 2 managers, 4 doctors). The project helped to define a better care trajectory for BPSD. Professionals felt a sense of competency and relief from helplessness and isolation. They also described improved patient care (systematic evaluations, individualized interventions integrating non-pharmacological aspects, more appropriate prescriptions). Conclusion These results suggest that tele-consultation is a good way to disseminate expertise concerning BPSD.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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