Videoconferences between doctors, nursing home help with dementia

NEW YORK, June 6 (UPI) — Greater communication between doctors and nursing home employees about the condition and treatment of dementia patients allowed specialists to participate in care, improving patients’ health, according to a recent study.

Researchers at Beth Israel Deaconess Medical Center and Hebrew SeniorLife found collaboration between care providers significantly reduced the use of physical restraints and antipsychotic medication, both of which pose health risks to older patients.

The study compared nursing homes participating in Project ECHO-AGE, a program Beth Israel researchers installed to work with patients going from the hospital to community-based nursing homes to test its efficacy, later bringing it to other nursing homes to compare its results to standard methods of care.

The program is based on the Extension for Community Healthcare Outcomes Project, conducted by researchers at the University of New Mexico to manage hepatitis C patients in rural parts of the state.

“We found that nursing home facilities that participated in Project ECHO-AGE saw a significant reduction in the use of physical restraints and antipsychotic medication among patients with dementia,” Dr. Lewis Lipsitz, chief of the gerontology division at Beth Israel Deaconess Medical Center, said in a press release. “These significant reductions also imply a potential decrease in adverse events such as falls, fractures and hospitalizations. As a result, further study of ECHO-AGE is warranted for the continued improvement of geriatric care management and lower health care costs.”

For the study, published in the Journal of the American Medical Directors Association, the researchers worked with 11 nursing homes in Massachusetts and Maine, installing Project ECHO-AGE at two-thirds of them for 18 months to test the program’s ability to reduce physical restraint and antipsychotic drug treatment with dementia patients.

As part of the program, nursing home staff met via videoconference with hospital-based teams of geriatricians, geropsychiatrists, a social worker and a neurologist, who discussed anonymized residents of the homes who had dementia.

The conferences were conducted biweekly, and included specific case discussions, as well as overall sessions on the management of dementia and other behavior disorders among elderly patients.

Patients at facilities with the program were 75 percent less likely to be physically restrained during the study, and 17 percent less likely to be prescribed antipsychotic medications, while all other outcomes were not significantly different, the researchers report.

“There is a two-pronged issue facing nursing homes in the United States: shortages of geriatricians, behavioral neurologists and geriatric psychiatrists and a lack of proximity of community nursing homes to larger medical facilities with specialists,” Dr. Stephen Gordon, a geriatrician in the gerontology division at BIDMC. “Video conference technology can bring academic medical center specialists and nursing home staff together in a collaborative effort to care for patients with dementia.”

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