Protocol of a multiphase study on telemedicine for older adults in primary care

INTRODUCTION: Telemedicine (TM) has been adopted by many health authorities to limit unnecessary exposure during COVID-19. Prior to the pandemic, TM was associated with improvement of quality of life of older patients, low hospital admissions and nursing home placement, and high overall patients’ satisfaction due to convenience. However, older adults may face challenges to access TM, such as hearing, visual and cognitive decline, and limited access to Internet and devices. Ongoing vaccination campaigns and sanitary measures are keeping the pandemic under control, but new variants threaten public safety. Specific recommendations on TM use in high-risk populations, such as older adults, are therefore required. METHODS AND ANALYSIS: To assess the challenges of TM use in the routine primary healthcare practice of older adults. The research objective is to examine the potential effect of TM; (1) to describe the evidence of TM, (2) to understand the patients, caregivers and clinicians’ experiences with TM use and (3) to develop practice-based and evidence-based recommendations on effective use of TM. Multiphase design: (1) systematic mixed studies review on the evidence of TM use, (2) qualitative descriptive study on the experiences of the patients, caregivers and healthcare professionals. Recommendations will be proposed based on the integration of both studies. In accordance with PRISMA statement, the systematic mixed studies review will be conducted through multiple databases search: MEDLINE, PsycINFO, EMBASE, CINAHL, AgeLine, Cochrane Library. Population studied: Community-dwelling 65 years and older adults using two-way synchronous TM by phone or video in a primary care setting. The qualitative descriptive study will include individual interviews with older adults from four McGill university affiliated primary care practices and focus groups with their healthcare professionals. ETHICS AND DISSEMINATION: Ethics approval has been received. Results will inform healthcare professionals and policy-makers on sustainable use of TM in primary care for older adults. PROSPERO REGISTRATION NUMBER: The review protocol has been recorded at the PROSPERO, CRD42021237686 (https://www.crd.york.ac.uk/prospero/.