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Geriatrics 2018, 3(3), 44; https://doi.org/10.3390/geriatrics3030044

Use of Clinical Video Telehealth as a Tool for Optimizing Medications for Rural Older Veterans with Dementia

1
Division of Geriatrics, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA
2
Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA
*
Author to whom correspondence should be addressed.
Received: 1 July 2018 / Revised: 20 July 2018 / Accepted: 21 July 2018 / Published: 30 July 2018
(This article belongs to the Special Issue Geriatric Care Models)
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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’ 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’ 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. View Full-Text
Keywords: telehealth; dementia; medications; rural; veterans; Beers list telehealth; dementia; medications; rural; veterans; Beers list
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Chang, W.; Homer, M.; Rossi, M.I. Use of Clinical Video Telehealth as a Tool for Optimizing Medications for Rural Older Veterans with Dementia. Geriatrics 2018, 3, 44.

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