General practitioners adherence to recommendations from geriatric assessments made during teleconsultations for the elderly living in nursing homes
General practitioners adherence to recommendations from geriatric assessments made during teleconsultations for the elderly living in nursing homes
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DOI：
10.1016/j.maturitas.2015.06.038
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发表时间：
2015-10-01
期刊：
影响因子：
4.9
通讯作者：
de Decker, L.
中科院分区：
文献类型：
--
作者：
Georgeton, E.;Aubert, L.;de Decker, L.
目的：为了确定相关因素与全科医生坚持老年评估的建议，在远程会诊的老年人生活在nursings.Study设计：前瞻性队列研究在三个养老院在旺代，法国，从沙朗医院远程会诊。老年医学评估的建议，由老年医学专家（n = 69）。主要结果测量：参与者被分为两组的基础上，全科医生坚持建议30天后远程会诊的证据。他们的坚持已被定义的应用程序由自己支持老年人的处方或组织的所有建议由老年医学专家在远程会诊。建议的类型包括药物和非药物治疗以及专家医疗建议。记录的数据包括远程咨询的主要原因，年龄，性别，痴呆诊断，多病量表，身体质量指数，日常生活能力量表，老年抑郁四项量表，跌倒的存在，和神经精神量表。Logistic回归分析进行检查的相关因素与全科医生坚持的建议，从老年人assessment.Results：全科医生坚持的建议，为58个远程会诊（86.3%）。一个充分调整的逻辑回归显示，全科医生遵守建议与抑郁综合征的风险相关（OR= 8.00，P = 0.040）和专家建议（OR= 17.97，P = 0.040）。全科医生坚持老年评估的建议，在远程会诊的老年人生活在养老院与抑郁综合征的存在风险及专家的医嘱建议。(C)2015爱思唯尔爱尔兰有限公司版权所有。
Objectives: To determine the factors associated with general practitioners adherence to recommendations from geriatric assessments made during teleconsultations for the elderly living in nursing homes.Study design: Prospective cohort study in three nursing homes in Vendee, France, with access to teleconsultations from Challans Hospital. Teleconsultations with geriatric assessment for which recommendations were made by a geriatrician (n = 69).Main outcome measurements: Participants were separated into two groups based on the evidence of general practitioners adherence to recommendations 30 days after teleconsultation. Their adherence has been defined by the application by themselves supporting the elderly of prescription or organization of all recommendations made by the geriatrician during the teleconsultation. The type of recommendations was pharmacological and non-pharmacological treatments, and expert medical advice. The recorded data included the main reason of teleconsultation's request, age, sex, dementia diagnosis, multimorbidities scale, body mass index, Activities of Daily Living Scale, 4-items Geriatric Depression Scale, existence of a fall, and the Neuropsychiatric Inventory. Logistic regressions were performed to examine the factors associated with general practitioners adherence to recommendations from the geriatric assessment.Results: General practitioners adherence to recommendations was made for 58 teleconsultations (86.3%). A fully adjusted logistic regression showed that general practitioners adherence to recommendations was associated with risk of depressive syndrome (OR= 8.00,P= 0.040) and expert medical advice's recommendations (OR= 17.97, P= 0.040).Conclusions: General practitioners adherence to recommendations from the geriatric assessment made during teleconsultations for elderly living in nursing homes is associated with the risk of depressive syndrome's existence and the expert medical advice recommendations. (C) 2015 Elsevier Ireland Ltd. All rights reserved.