Implementation of a Telemedicine Tool in Primary Care for Older Adults

NCT05102890 | Completed

• 2 other identifiers: MP-02-2022-101602022-IMPV-309559
• Study Type: interventional
• Target: 452
• Locations: 1 country
• Sites: 1

Brief Summary

The pandemic has served a major catalyst propelling telehealth to the frontline of health care. For older adults who often live many chronic health problems, telehealth, which means to give medical check-ups by phone, email or by video conferencing, has become a lifeline to accessing a doctor when they need one. Even without the pandemic, telehealth can help ease access to care, especially for those living in rural areas who often need to travel long distances to see a doctor. However, there is a lack of telehealth tools that have been adapted for older patients. For example, only a few studies have looked at how well they work in improving outcomes for older patients like their quality of life, autonomy and use of health services. Telehealth could also lead to unfair differences between urban and rural patients who don't have the same access to technology. All these factors can make it difficult for family doctors to feel confident about using telehealth for their older patients. With telehealth likely to become mainstream for family doctors and older patients even after the pandemic, it is important to support the growing use of telehealth through tools that are adapted for older patients, fair and based on reliable evidence. This project aims to support the shift to telehealth in caring for older people living in the community by implementing and evaluating ESOGER, a telehealth support tool, in family medicine clinics. The ESOGER tool provides s a quick and reliable evaluation of the health and social needs of older patients. It can be done by phone making it accessible for everyone. This tool is expected to give family doctors a standardized and feasible way to determine the health and social needs of their older patients using telehealth which will help improve patients' autonomy, quality of life and health service use. The tool will be tested in four clinics in both urban and rural regions of Quebec to find out if it helped doctors better address their patients' needs and helped patients to live well at home. The study investigators will also study any differences in improvement between urban and rural older patients. They will discuss the results with the clinics and patient-partners to learn from their experiences and make the telehealth tool and the way to use it be as optimal as possible for family doctors to help maintain the health, quality of life and autonomy of older patients living at home.

Conditions

Aging

Outcome Measures

Primary Outcomes (1)

• Change from baseline quality of life score at 3 months

  The Euro-Qol 5D (EQ-5D), a highly validated quality of life questionnaire, will be used to measure the primary outcome. The EQ-5D score ranges from 0 (indicating worst health) to 1 (best health). The change in quality of life score will be measured as the difference in the EQ-5D score at 3 months minus the EQ-5D score at baseline.

  The EQ-5D will be measured at study entry (time 0) and at study follow-up (3 months) for both the intervention and control group.

Study Arms (2)

Intervention group

EXPERIMENTAL

Patients 65 years old and older will receive a pre-consultation screening questionnaire by phone prior to their virtual or in-person visit. A summary report based on the results of the questionnaire will be placed in the patient electronic chart for use by the clinician at the time of visit.

Other: ESOGER

Control Group

NO INTERVENTION

Usual care in the primary care clinic

Interventions

ESOGER OTHER

For patients in the intervention group, ESOGER will be administered by phone by a member of the clinic team prior to their virtual or in-persons consultation with their primary care provider. ESOGER is already available on an online platform for data entry. Based on feedback our team obtained from interviews with current users of ESOGER, administration of the tool is expected to take between 5 and 10 minutes. A report summarizing the health and social status of the patient along with flagged potential vulnerabilities will be generated automatically by the online ESOGER platform. This report will then be uploaded to the patient's electronic chart by a member of the clinic and made available for the primary care provider at the time of the consultation.

Intervention group

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)

You may qualify if:

• years old and older
• Patient of the participating primary care clinic with upcoming virtual or in-person primary care visit

You may not qualify if:

• unable to provide informed consent in English or French

Sponsors & Collaborators

• Centre hospitalier de l'Université de Montréal (CHUM): lead

Study Sites (1)

School of Public Health

Montreal, Quebec, H3N1X9, Canada

Location

Study Officials

• Nadia Sourial, PhD

  Université de Montréal

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SCREENING
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Telemedicine tool as a pre-consultation assessment for older patients in the primary care setting

Study Record Dates

• First Submitted: October 20, 2021
• First Posted: November 2, 2021
• Study Start: November 22, 2021
• Primary Completion: November 1, 2022
• Study Completion: November 1, 2022
• Last Updated: November 14, 2022

Record last verified: 2022-11

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)