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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Short Communication

Admission Avoidance for Older Adults Facilitated by Telemedicine during the COVID-19 Pandemic

Author(s): Jemma Gregory*, Benjamin Noble, Donna Ward, Zoe Wyrko and Luca Laghi

Volume 23, Issue 8, 2023

Published on: 30 March, 2023

Page: [1014 - 1020] Pages: 7

DOI: 10.2174/1871530323666230201103920

Price: $65

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Abstract

Introduction: The coronavirus pandemic has disproportionately affected older adults and has provided an incentive to find alternatives to emergency department attendance to avoid unnecessary exposure to the SARS-CoV-2 virus. To address this issue, a specialist geriatric multidisciplinary team at Queen Elizabeth Hospital set up a novel telemedicine approach to the ambulance service with the aim of reducing unnecessary emergency department attendance for older adults. This study provides a service evaluation in its first year of use.

Methods: Service evaluation in the first year of the ‘Ask OPAL’ (older person Assessment and liaison) hotline for ambulance paramedics, run by a multidisciplinary acute geriatrics team at the Queen Elizabeth Hospital, Birmingham. Data on the number, patient demographics, intervention, and outcome of the calls, were recorded.

Results: During the study period, 2552 ‘Ask OPAL’ calls were conducted. Of the 2552 calls carried out, 1755 patients (69%) remained at home. Of the patients who remained at home, 76% received verbal advice only, while 24% were referred to community services in addition to receiving verbal advice.

Conclusion: In conclusion, the use of an integrated multidisciplinary team communicating with paramedics via telemedicine appears to be successful in preventing avoidable hospital admissions in complex patients.

Keywords: Telemedicine, geriatrics, admission avoidance, coronavirus, telehealth, community, paramedicine.

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Graphical Abstract

[1]
Wootton, R. Telemedicine. BMJ, 2001, 323
[2]
Giebel, C.; Harvey, D.; Akpan, A.; Chamberlain, P. Reducing hospital admissions in older care home residents: a 4-year evaluation of the care home innovation programme (CHIP). BMC Health Serv. Res., 2020, 20(1), 94.
[3]
Parke, B.; Hunter, K.F.; Strain, L.A.; Marck, P.B.; Waugh, E.H.; McClelland, A.J. Facilitators and barriers to safe emergency department transitions for community dwelling older people with dementia and their caregivers: A social ecological study. Int. J. Nurs. Stud., 2013, 50(9), 1206-1218.
[http://dx.doi.org/10.1016/j.ijnurstu.2012.11.005] [PMID: 23219329]
[4]
LaCalle, E.; Rabin, E. Frequent users of emergency departments: The myths, the data, and the policy implications. Ann. Emerg. Med., 2010, 56(1), 42-48.
[http://dx.doi.org/10.1016/j.annemergmed.2010.01.032] [PMID: 20346540]
[5]
Ackroyd-Stolarz, S.; Guernsey, J.; MacKinnon, N.; Kovacs, G. Impact of adverse events on hospital disposition in community-dwelling seniors admitted to acute care. Healthc. Q., 2009, 12(sp), 34-39.
[http://dx.doi.org/10.12927/hcq.2009.20964] [PMID: 19667775]
[6]
Jay, S.; Whittaker, P.; Mcintosh, J.; Hadden, N. Can consultant geriatrician led comprehensive geriatric assessment in the emergency department reduce hospital admission rates? A systematic review. Age Ageing, 2017, 46(3), 366-372.
[PMID: 27940568]
[7]
NHS Digital. Hospital accident and emergency activity 2020-2021.
[8]
Huntley, A.L.; Chalder, M.; Shaw, A.R.G.; Hollingworth, W.; Metcalfe, C.; Benger, J.R.; Purdy, S. A systematic review to identify and assess the effectiveness of alternatives for people over the age of 65 who are at risk of potentially avoidable hospital admission. BMJ Open, 2017, 7(7), e016236.
[http://dx.doi.org/10.1136/bmjopen-2017-016236] [PMID: 28765132]
[9]
Doraiswamy, S.; Jithesh, A.; Mamtani, R.; Abraham, A.; Cheema, S. Telehealth use in geriatrics care during the COVID-19 pandemic- a scoping review and evidence synthesis. Int. J. Environ. Res. Public Health, 2021, 18(4), 1755.
[http://dx.doi.org/10.3390/ijerph18041755] [PMID: 33670270]
[10]
Martins Van, J.G. The effects of COVID-19 among the elderly population: A case for closing the digital divide. Front. Psychiatry, 2020, 11, 577427.
[http://dx.doi.org/10.3389/fpsyt.2020.577427] [PMID: 33304283]
[11]
Office for National Statistics. Deaths due to COVID-19, registered in England and Wales:2020. 2021.
[12]
Sepúlveda-Loyola, W.; Rodríguez-Sánchez, I.; Pérez-Rodríguez, P.; Ganz, F.; Torralba, R.; Oliveira, D.V.; Rodríguez-Mañas, L. Impact of social isolation due to COVID-19 on health in older people: Mental and physical effects and recommendations. J. Nutr. Health Aging, 2020, 24(9), 938-947.
[http://dx.doi.org/10.1007/s12603-020-1500-7] [PMID: 33155618]
[13]
Lam, K.; Lu, A.D.; Shi, Y.; Covinsky, K.E. Assessing telemedicine unreadiness amongst older adults in the United States during the COVID-19 pandemic. JAMA Intern. Med., 2020, 180(10), 1389-1391.
[http://dx.doi.org/10.1001/jamainternmed.2020.2671] [PMID: 32744593]
[14]
Pritchard, C.; Ness, A.; Symonds, N.; Siarkowski, M.; Broadfoot, M.; McBrien, K.A.; Lang, E.; Holroyd-Leduc, J.; Ronksley, P.E. Effectiveness of hospital avoidance interventions among elderly patients: A systematic review. CJEM, 2020, 22(4), 504-513.
[http://dx.doi.org/10.1017/cem.2020.4] [PMID: 32216860]
[15]
McNeely, K. Planning to safely reduce avoidable conveyance: Ambulance improvement programme. NHS England and NHS Improvement. 2019. Available from: https://www.england.nhs.uk/wp-content/uploads/2019/09/planning-to-safetly-reduce-avoidable-conveyance-v4.0.pdf
[16]
Walsh, B.; Lattimer, V.; Wintrup, J.; Brailsford, S. Professional perspectives on systemic barriers to admission avoidance: learning from a system dynamics study of older people’s admission pathways. Int. J. Older People Nurs., 2015, 10(2), 105-114.
[http://dx.doi.org/10.1111/opn.12056] [PMID: 24849205]
[17]
Huntley, A.L.; Davies, B.R.; Jones, N. Determining when a hospital admission of an older person can be avoided in a subacute setting: a systematic review and concept analysis. J. Health Serv. Res. Policy, 2019, 25(4), 252-264.
[http://dx.doi.org/10.1177/1355819619886885] [PMID: 31805793]
[18]
Brignell, M.; Wootton, R.; Gray, L. The application of telemedicine to geriatric medicine. Age Ageing, 2007, 36(4), 369-374.
[http://dx.doi.org/10.1093/ageing/afm045] [PMID: 17449535]
[19]
van Vuuren, J.; Thomas, B.; Agarwal, G.; MacDermott, S.; Kinsman, L.; O’Meara, P.; Spelten, E. Reshaping healthcare delivery for elderly patients: the role of community paramedicine; a systematic review. BMC Health Serv. Res., 2021, 21(1), 29.
[http://dx.doi.org/10.1186/s12913-020-06037-0] [PMID: 33407406]
[20]
Khoujah, D.; Cimino-Fiallos, N. The geriatric emergency literature 2020: COVID and beyond. Am. J. Emerg. Med., 2021, 44, 177-183.
[http://dx.doi.org/10.1016/j.ajem.2021.04.034] [PMID: 33905980]
[21]
Abrashkin, K.A.; Washko, J.; Zhang, J.; Poku, A.; Kim, H.; Smith, K.L. Providing acute care at home: Community paramedics enhance an advanced illness management program – preliminary data. J. Am. Geriatr. Soc., 2016, 64(12), 2572-2576.
[http://dx.doi.org/10.1111/jgs.14484] [PMID: 27575363]
[22]
Jensen, J.L.; Travers, A.H.; Marshall, E.G.; Leadlay, S.; Carter, A.J.E.; Carter, A.J. Insights into the implementation and operation of a novel paramedic long-term care program. Prehosp. Emerg. Care, 2014, 18(1), 86-91.
[http://dx.doi.org/10.3109/10903127.2013.831506] [PMID: 24116961]

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