Telemedicine and Dementia Care: A Systematic Review of Barriers and Facilitators.
Julie S Yi, Corinne A Pittman, Carrie L Price and 2 others
PMID 33887231WHAT IT FOUND
Video dementia care was feasible and often acceptable, but home use relied on care partners, staff, and equipment; hearing and vision problems were common barriers, and no included study adapted technology for them.
Key findings
01All 14 studies that reported feasibility found video visits feasible, and all 7 that reported acceptability found them acceptable.
02In-home video visits depended on equipment, orientation, and care partner or staff support.
03Six of 17 studies reported participants had difficulty hearing the provider, and no study reported adapting equipment for hearing or vision problems.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
Most included studies were small pilots rather than full trials. The studies were too different to combine statistically, so there is no pooled effect estimate. Fourteen of 17 studies had at least one domain with high risk of bias. Satisfaction findings came from low response rates, so they may not represent all patients. Participants were often white, educated, and comfortable with technology, so results may not apply to people with fewer resources or different backgrounds. Five studies excluded participants with hearing or vision problems, and no included study reported adapting equipment for sensory impairment. Most telemedicine visits were between healthcare facilities, not in the home, so in-home barriers may be under-described. The review did not consider other barriers such as apraxia.
Declared interests
The supplied text lists NIH extramural research support but does not include a conflicts of interest statement.
The easy way to misread this
Do not read this review as proof that telemedicine improves dementia outcomes. Most included studies were small pilots, and the reported outcomes were feasibility, acceptability, and satisfaction rather than evidence of clinical benefit.