Telehealth improves quality of life for dementia patients, caregivers
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The quality of life of patients with dementia and their caregivers can be improved through a collaborative telehealth care intervention that provides support over the phone and online, according to study results published in JAMA Internal Medicine.
“Effective care can be delivered through telehealth and offers the advantage of being often more convenient for busy caregivers,” Katherine L. Possin, PhD, associate professor of neurology in the Memory and Aging Center at the UCSF Weill Institute for Neurosciences, told Healio Primary Care. “This is especially important in dementia because families may live a long distance from dementia specialists, or the patient with dementia may have difficulty traveling to provider appointments due to their disease.”
The study builds on previous findings, which show that the severity of behavioral symptoms in patients with dementia predicted depressive symptoms in their caregivers and that providing dementia care at home improved caregiver burden and dementia symptoms.
Researchers conducted the study at two hubs in California and Nebraska and included patients from those states and Iowa. Participants with a dementia diagnosis and a caregiver who agreed to co-enroll were randomly assigned to receive usual care or the Care Ecosystem intervention. Those assigned to intervention received monthly calls and emails from care team navigators who addressed the caregivers’ concerns. Dementia care experts were available for consultation on medical issues, legal and financial circumstances and safety concerns.
A total of 780 pairs of patients with dementia (mean age = 78.1 years) and caregivers (mean age = 64.7 years) were include in the study.
Researchers found that patients with dementia who received the intervention had improved scores on the Quality of Life in Alzheimer’s Disease survey (unstandardized beta = 0.53; 95% CI, 0.25-1.3) and fewer ED visits (unstandardized beta = 0.14; 95% CI, 0.29 to 0.01) compared with patients who received usual care.
Between baseline and 12 months, researchers found reductions in caregiver burden (unstandardized beta = 1.9; 95% CI, 3.89 to 0.08) and depression (unstandardized beta = 1.14; 95% CI, 2.15 to 0.13) among those in the intervention group compared with the usual care group.
Among caregivers who received the intervention, 97% reported that they would recommend the intervention to other caregivers. In addition, 45.5% reported that they were very satisfied with the intervention and 32.9% reported that they were satisfied.
“Possin and colleagues have provided evidence that achieving the goals of the triple aim of improving care, health outcomes, and reducing cost can be met by providing dementia training to clinically supervised, unlicensed [care team navigators] in a scalable way,” Jennifer Tjia, MD, MSCE, associate professor at the University of Massachusetts Medical School, wrote in commentary published alongside the study. – by Erin Michael
Disclosures: Possin reports receiving grants from CMS, Global Brain Health Institute, the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, and the University of California, San Francisco during the conduct of the study, as well as personal fees from Clear View Healthcare Partners outside the submitted work. Please see study for all other authors’ relevant financial disclosures. Tjia reports receiving grants from the Cambia Health Foundation and the NIH, personal fees from the Donaghue Foundation, and personal fees and nonfinancial support from CVS Health outside the submitted work.