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A102 INTERDISCIPLINARY TELEHEALTH REFERRAL PATHWAY AND CONSULTATIONS TO IMPROVE OUTCOMES AMONG CANADIAN OLDER ADULTS WITH LIVER CIRRHOSIS

BACKGROUND: Telehealth and telemedicine have become indispensable healthcare delivery tools during the COVID-19 pandemic. Older individuals with cirrhosis have complex medical needs that are currently unmet due to the growing disease burden and decreased access to care. Delivering timely specialist...

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Autores principales: Zhu, J, Carr, F, Tian, P, McLeod, M, MacFarlane, M, De Coutere, S, Sun, M, Peltekian, K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9991312/
http://dx.doi.org/10.1093/jcag/gwac036.102
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author Zhu, J
Carr, F
Tian, P
McLeod, M
MacFarlane, M
De Coutere, S
Sun, M
Peltekian, K
author_facet Zhu, J
Carr, F
Tian, P
McLeod, M
MacFarlane, M
De Coutere, S
Sun, M
Peltekian, K
author_sort Zhu, J
collection PubMed
description BACKGROUND: Telehealth and telemedicine have become indispensable healthcare delivery tools during the COVID-19 pandemic. Older individuals with cirrhosis have complex medical needs that are currently unmet due to the growing disease burden and decreased access to care. Delivering timely specialist care virtually to older adults with cirrhosis will likely be beneficial and acceptable to such patients; however, this has not yet been prospectively evaluated. PURPOSE: The primary goal is to pilot the delivery of dual specialist care from a hepatologist and geriatrician, delivered virtually, for older adults living with liver cirrhosis who are at high risk of geriatric syndromes (age >/= 65 with frailty, undifferentiated cognitive impairment from dementia or hepatic encephalopathy, recurrent falls, risk factors for polypharmacy and moderate to severe malnutrition). Care is delivered using a dedicated hepatology-geriatric referral pathway. Primary objectives include evaluating the impact of this approach on emergency care and inpatient utilization, along with patient attitude and satisfaction to the virtual interdisciplinary care delivery model. METHOD: This pilot quality improvement study was conducted in Halifax, Nova Scotia. Ethics approval was obtained from the Nova Scotia Health Research Ethics Board and the University of Alberta Research Ethics Board. Fifty to one hundred participants (age 65 years or older with at least one geriatric syndrome; diagnosis of liver cirrhosis by liver elastography or liver biopsy, or Fibrosis-4 Index for Liver Fibrosis greater than three and having radiological features of cirrhosis and/or portal hypertension) were recruited between September 2022 to December 2022 at the time of their hepatology consultation. After consent and screening, each patient underwent a telehealth appointment by zoom with a geriatrician within four weeks of their initial hepatology assessment. Follow-up by telephone using a standardized survey regarding ease of access and quality of their telehealth experience then occurred at 3-4 weeks, 3 months and 6 months for emergency room visits and hospital admission status. RESULT(S): Pending CONCLUSION(S): Pending PLEASE ACKNOWLEDGE ALL FUNDING AGENCIES BY CHECKING THE APPLICABLE BOXES BELOW: Other PLEASE INDICATE YOUR SOURCE OF FUNDING; Pfizer Canada DISCLOSURE OF INTEREST: J. Zhu Grant / Research support from: Pfizer Canada, F. Carr Grant / Research support from: Pfizer Canada, P. Tian: None Declared, M. McLeod: None Declared, M. MacFarlane: None Declared, S. De Coutere: None Declared, M. Sun: None Declared, K. Peltekian: None Declared
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spelling pubmed-99913122023-03-08 A102 INTERDISCIPLINARY TELEHEALTH REFERRAL PATHWAY AND CONSULTATIONS TO IMPROVE OUTCOMES AMONG CANADIAN OLDER ADULTS WITH LIVER CIRRHOSIS Zhu, J Carr, F Tian, P McLeod, M MacFarlane, M De Coutere, S Sun, M Peltekian, K J Can Assoc Gastroenterol Poster Presentations BACKGROUND: Telehealth and telemedicine have become indispensable healthcare delivery tools during the COVID-19 pandemic. Older individuals with cirrhosis have complex medical needs that are currently unmet due to the growing disease burden and decreased access to care. Delivering timely specialist care virtually to older adults with cirrhosis will likely be beneficial and acceptable to such patients; however, this has not yet been prospectively evaluated. PURPOSE: The primary goal is to pilot the delivery of dual specialist care from a hepatologist and geriatrician, delivered virtually, for older adults living with liver cirrhosis who are at high risk of geriatric syndromes (age >/= 65 with frailty, undifferentiated cognitive impairment from dementia or hepatic encephalopathy, recurrent falls, risk factors for polypharmacy and moderate to severe malnutrition). Care is delivered using a dedicated hepatology-geriatric referral pathway. Primary objectives include evaluating the impact of this approach on emergency care and inpatient utilization, along with patient attitude and satisfaction to the virtual interdisciplinary care delivery model. METHOD: This pilot quality improvement study was conducted in Halifax, Nova Scotia. Ethics approval was obtained from the Nova Scotia Health Research Ethics Board and the University of Alberta Research Ethics Board. Fifty to one hundred participants (age 65 years or older with at least one geriatric syndrome; diagnosis of liver cirrhosis by liver elastography or liver biopsy, or Fibrosis-4 Index for Liver Fibrosis greater than three and having radiological features of cirrhosis and/or portal hypertension) were recruited between September 2022 to December 2022 at the time of their hepatology consultation. After consent and screening, each patient underwent a telehealth appointment by zoom with a geriatrician within four weeks of their initial hepatology assessment. Follow-up by telephone using a standardized survey regarding ease of access and quality of their telehealth experience then occurred at 3-4 weeks, 3 months and 6 months for emergency room visits and hospital admission status. RESULT(S): Pending CONCLUSION(S): Pending PLEASE ACKNOWLEDGE ALL FUNDING AGENCIES BY CHECKING THE APPLICABLE BOXES BELOW: Other PLEASE INDICATE YOUR SOURCE OF FUNDING; Pfizer Canada DISCLOSURE OF INTEREST: J. Zhu Grant / Research support from: Pfizer Canada, F. Carr Grant / Research support from: Pfizer Canada, P. Tian: None Declared, M. McLeod: None Declared, M. MacFarlane: None Declared, S. De Coutere: None Declared, M. Sun: None Declared, K. Peltekian: None Declared Oxford University Press 2023-03-07 /pmc/articles/PMC9991312/ http://dx.doi.org/10.1093/jcag/gwac036.102 Text en ڣ The Author(s) 2023. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Poster Presentations
Zhu, J
Carr, F
Tian, P
McLeod, M
MacFarlane, M
De Coutere, S
Sun, M
Peltekian, K
A102 INTERDISCIPLINARY TELEHEALTH REFERRAL PATHWAY AND CONSULTATIONS TO IMPROVE OUTCOMES AMONG CANADIAN OLDER ADULTS WITH LIVER CIRRHOSIS
title A102 INTERDISCIPLINARY TELEHEALTH REFERRAL PATHWAY AND CONSULTATIONS TO IMPROVE OUTCOMES AMONG CANADIAN OLDER ADULTS WITH LIVER CIRRHOSIS
title_full A102 INTERDISCIPLINARY TELEHEALTH REFERRAL PATHWAY AND CONSULTATIONS TO IMPROVE OUTCOMES AMONG CANADIAN OLDER ADULTS WITH LIVER CIRRHOSIS
title_fullStr A102 INTERDISCIPLINARY TELEHEALTH REFERRAL PATHWAY AND CONSULTATIONS TO IMPROVE OUTCOMES AMONG CANADIAN OLDER ADULTS WITH LIVER CIRRHOSIS
title_full_unstemmed A102 INTERDISCIPLINARY TELEHEALTH REFERRAL PATHWAY AND CONSULTATIONS TO IMPROVE OUTCOMES AMONG CANADIAN OLDER ADULTS WITH LIVER CIRRHOSIS
title_short A102 INTERDISCIPLINARY TELEHEALTH REFERRAL PATHWAY AND CONSULTATIONS TO IMPROVE OUTCOMES AMONG CANADIAN OLDER ADULTS WITH LIVER CIRRHOSIS
title_sort a102 interdisciplinary telehealth referral pathway and consultations to improve outcomes among canadian older adults with liver cirrhosis
topic Poster Presentations
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9991312/
http://dx.doi.org/10.1093/jcag/gwac036.102
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