Old-age mental telehealth services at primary healthcare centers in low- resource areas in Greece: design, iterative development and single-site pilot study findings

BMC Health Services Research

Research

Dimitrios Kiosses¹  Konstantinos Tsimpanis²  Evaggelia Kontogianni³  Rigas Filippos Soldatos³  Kostas Siarkos³  Antonios Politis⁴  Theofanis Vorvolakos⁵  Iracema Leroi⁶  Kim-Huong Nguyen⁷  Eleni-Zacharoula (Eliza) Georgiou⁸  Panagiotis Alexopoulos⁹  Anna Petrou^1,10  Eleutheria Aggeletaki^1,10  Apostolos Efkarpidis^1,10  Maria Alexaki^1,11  Kalliopi Savvopoulou^1,12  Vasileios Stamos^1,12  Vassiliki Naziri^1,13  Maria Delatola^1,14  Antonis Delatolas^1,14  Maria Gkampra^1,15  Konstantinos Kostoulas^1,16  Elissavet Thanopoulou^1,16 

[1] Cognition, and Psychotherapy Lab, Department of Psychiatry, Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, 315 East 62nd Street, 5th Floor, 10065, New York, NY, USA;Department of Informatics and Telecommunications, National and Kapodistrian University of Athens, 15784, Panepistimiopolis, Athens, Ilissia, Greece;Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Vasilissis Sophias 72, 11528, Athens, Greece;Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Vasilissis Sophias 72, 11528, Athens, Greece;Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry, Johns Hopkins Medical School, 600 N. Wolfe Street Meyer Building, 21287, Baltimore, MD, USA;Department of Psychiatry, School of Health Sciences, University General Hospital of Alexandroupolis, Democritus University of Thrace, University Campus, 68100, Dragana, Alexandroupolis, Greece;Global Brain Health Institute, School of Medicine, Trinity College Dublin, The University of Dublin, Lloyd Building Trinity College Dublin, Dublin 2, Dublin, Republic of Ireland;Global Brain Health Institute, School of Medicine, Trinity College Dublin, The University of Dublin, Lloyd Building Trinity College Dublin, Dublin 2, Dublin, Republic of Ireland;Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital campus, 4102, Woolloongabba, QLD, Australia;Mental Health Services, University General Hospital of Patras, Department of Medicine, School of Health Sciences, University of Patras, 26504, Rion, Patras, Greece;Mental Health Services, University General Hospital of Patras, Department of Medicine, School of Health Sciences, University of Patras, 26504, Rion, Patras, Greece;Global Brain Health Institute, School of Medicine, Trinity College Dublin, The University of Dublin, Lloyd Building Trinity College Dublin, Dublin 2, Dublin, Republic of Ireland;Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany;Nursing Services Department, General Hospital of Syros “Vardakeio and Proio”, Geor. Papandreou 2, 84100, Ermoupolis, Greece;Primary Healthcare Center of Andros, 84500, Chora, Andros, Greece;Primary Healthcare Center of Erymanthia, 25015, Erymanthia Achaea, Greece;Primary Healthcare Center of Soufli, 68400, Soufli Evros, Greece;Primary Healthcare Center of Tinos, Mark. Krikeli 18, 84200, Tinos, Greece;Primary Healthcare Center of Xanthi, Andrea Dimitriou 1, 67133, Xanthi, Greece;Primary Heathcare Center of Chalandritsa, 25008, Chalandritsa Achaea, Greece;

关键词: Telemedicine;    Dementia;    Mild cognitive impairment;    Old-age depression;    Remote areas;   

DOI  :  10.1186/s12913-023-09583-5

 received in 2023-02-10, accepted in 2023-05-19,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundEven though communities in low-resource areas across the globe are aging, older adult mental and cognitive health services remain mainly embedded in tertiary- or secondary hospital settings, and thus not easily accessible by older adults living in such communities. Here, the iterative development of INTegRated InterveNtion of pSychogerIatric Care (INTRINSIC) services addressing the mental and cognitive healthcare needs of older adults residing in low-resource areas of Greece is depicted.MethodsINTRINSIC was developed and piloted in three iterative phases: (i) INTRINSIC initial version conceptualization; (ii) A 5-year field testing in Andros island; and (iii) Extending the services. The INTRINSIC initial version relied on a digital platform enabling videoconferencing, a flexible battery of diagnostic tools, pharmacological treatment and psychosocial support and the active involvement of local communities in service shaping.ResultsΙn 61% of the 119 participants of the pilot study, new diagnoses of mental and/or neurocognitive disorders were established. INTRINSIC resulted in a significant reduction in the distance travelled and time spent to visit mental and cognitive healthcare services. Participation was prematurely terminated due to dissatisfaction, lack of interest or insight in 13 cases (11%). Based on feedback and gained experiences, a new digital platform, facilitating e-training of healthcare professionals and public awareness raising, and a risk factor surveillance system were created, while INTRINSIC services were extended to incorporate a standardized sensory assessment and the modified problem adaptation therapy.ConclusionThe INTRINSIC model may be a pragmatic strategy to improve access of older adults with mental and cognitive disorders living in low-resource areas to healthcare services.

【 授权许可】

CC BY   
© The Author(s) 2023

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