Abstract:
OBJECTIVES:This document offers guidance to clinicians and facilities on the use of telemedicine to deliver medically necessary evaluation and management of change of condition for nursing home residents. SETTINGS AND PARTICIPANTS:Members of the telemedicine workgroup of AMDA-The Society for Post-Acute Long-Term Medicine-developed this guideline through both telephonic and face-to-face meetings between April 2017 and September 2018. The guideline is based on the currently available research, experience, and expertise of the workgroup's members, including a summary of a recently completed systematic mixed studies literature review to determine evidence for telemedicine to reduce emergency department visits or hospitalizations of nursing home residents. RESULTS:Research and experience to date support the use of telemedicine as a tool in change of condition assessment and management as a means of reducing unnecessary emergency department visits and hospitalization. Telemedicine-delivered care should be integrated into the primary care of the resident and delivered by providers with competency in post-acute long-term care. The development and sustainability of telemedicine programs is heavily dependent on financial implications. Quality measures should be defined for telemedicine programs in nursing homes. CONCLUSIONS/IMPLICATIONS:Telemedicine programs in nursing homes can contribute to the delivery of timely, high quality medical care, which reduces unnecessary hospitalization. Reimbursement for telemedicine-driven care should be based upon medical necessity of visits to care and the maintenance of quality standards. More studies are needed to understand which telemedicine tools and processes are most effective in improving outcomes for nursing home residents.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Gillespie SM,Moser AL,Gokula M,Edmondson T,Rees J,Nelson D,Handler SMdoi
10.1016/j.jamda.2018.11.022subject
Has Abstractpub_date
2019-02-01 00:00:00pages
115-122issue
2eissn
1525-8610issn
1538-9375pii
S1525-8610(18)30671-6journal_volume
20pub_type
杂志文章,评审abstract:OBJECTIVE:In nursing homes (NHs), psychoactive medication use has received notable attention, but less is known about prescribing in assisted living (AL). This study examined how antipsychotic and antianxiety medication prescribing in AL compares with NHs. DESIGN:Observational, cross-sectional AL data linked to public...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.11.037
更新日期:2020-12-28 00:00:00
abstract:OBJECTIVE:Identifying patients at risk for delirium allows prompt application of prevention, diagnostic, and treatment strategies; but is rarely done. Once delirium develops, patients are more likely to need posthospitalization skilled care. This study developed an a priori electronic prediction rule using independent ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.10.020
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Discussions about advance directives should be offered to all nursing home residents. Managed Medicare programs for nursing home residents allow for the development of performance improvement initiatives to ensure that these discussions occur and are documented. PURPOSE:To assess the effectiveness of an int...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:To identify the differences of incidence of disability between frail older persons with and without slow walking speed. DESIGN:Prospective cohort study. SETTING:Japanese community. PARTICIPANTS:A total of l4,081 older adults aged ≥65 years living in the community, participated in a baseline assessment and ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.03.019
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To assess all-cause mortality patients with dementia treated with typical and atypical antipsychotic drugs (APDs). DESIGN:Registry-based cohort study. SETTING AND PARTICIPANTS:A total of 58,412 patients diagnosed with dementia and registered in the Swedish Dementia Registry were included in the study. Of th...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.12.019
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:To define the prevalence of dysphagia and its associated factors and to investigate the influence of dysphagia and nutritional therapies performed in dysphagic subjects on clinical outcomes, including nutritional status, pressure ulcers, hospitalization, and mortality. DESIGN:A prospective observational stu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.07.023
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:The purpose of the study was to develop and validate a simple caregiver-rated questionnaire to screen for chronic obstructive pulmonary disease (COPD) in nursing home residents. DESIGN:Part 1: Identification of screening parameters by the Delphi process using geriatric and pulmonary experts. Part 2: Retrosp...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.11.007
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:To assess the 30-day mortality predictive markers in the oldest patients with Clostridioides difficile infection (CDI) and to analyze the accuracy of the European severity risk markers in this population. DESIGN:Observational prospective multicenter cohort study conducted by the French Infectious Diseases S...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.07.002
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVES:To explore next-of-kin's (NOK's) perceptions of end-of-life (EOL) care in the nursing home setting and to compare these perceptions for residents receiving hospice care plus usual care versus usual care only. DESIGN:Mailed survey. SETTING:Three nursing homes in central Massachusetts. PARTICIPANTS:Nursing ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.07.017
更新日期:2011-02-01 00:00:00
abstract::Internists and family physicians are trained in evidence-based medicine (EBM). The philosophy of incorporating clinical research "evidence" into medical practice is taught at the undergraduate and graduate levels of medical training. Practicing physicians incorporate EBM into their practices in variable degrees depend...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Cognitive impairment is common in people living with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF); however, accurate estimates of prevalence are lacking. To date, there are no meta-analyses that have specifically investigated prevalence of mild cognitive impairment (MCI) in th...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jamda.2017.01.014
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings. DESIGN:Systematic review and meta-analysis. SETTING AND P...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2019.09.017
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:Long-term care (LTC) is an important setting for goals of care (GoC) discussions. Understanding clinician barriers to GoC discussions could identify opportunities for LTC-specific interventions to improve quantity and quality of GoC discussions in the context of serious illness. DESIGN:A multicenter, cross-...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.08.022
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:To investigate whether depression and/or antidepressants can be a potential risk factor for the development of dementia and mild cognitive impairment (MCI). DESIGN:Systematic review and meta-analysis of longitudinal studies. SETTING AND PARTICIPANTS:Community or clinical settings. Participants included pati...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,meta分析
doi:10.1016/j.jamda.2018.12.004
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:An estimated 1.5 million residents of nursing homes (NH) in the United States were prescribed an average of 7 to 8 medications each month. However, it is unknown which of these prescribed drugs and nutritional supplements have been tested for use among NH residents who often have distinct and complex needs c...
journal_title:Journal of the American Medical Directors Association
pub_type: 历史文章,杂志文章
doi:10.1016/j.jamda.2008.06.005
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Previous studies have demonstrated the polymorphisms of insulinlike growth factor-1 (IGF-1) and its binding protein-3 (IGFBP3) genes could affect the circulating IGF-1 level. Moreover, the serum IGF-1 level was correlated with muscle size. OBJECTIVES:This study aimed to explore the effect of polymorphisms o...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.11.015
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVES:To evaluate the effects of humor therapy assessed using observational methods on agitation, engagement, positive behaviors, affect, and contentment. DESIGN:Single-blind cluster randomized controlled trial. SETTING:A total of 35 Sydney nursing homes. PARTICIPANTS:All eligible residents within geographicall...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamda.2014.03.017
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVES:Pulmonary infections are common in children with quadriplegic cerebral palsy. High frequency chest wall oscillation with the vest therapy (VT) is used to promote pulmonary clearance and to prevent pneumonias in cystic fibrosis patients. The purpose of this study was to ascertain the effectiveness of VT in pa...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1097/01.JAM.0000028225.84012.3B
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVES:We examined the dose-response relationships of body composition indices with mortality and identified the best predictor. DESIGN AND SETTING:Kusatsu Longitudinal Study and Hatoyama Cohort Study, Japan. PARTICIPANTS:In total, 1977 community-dwelling Japanese adults age ≥65 years (966 men and 1011 women) par...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.11.018
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:Sex-specific impact of frailty on all-cause mortality in older age population remains controversial. This meta-analysis aimed to evaluate the association between frailty and all-cause mortality in older age women vs men from the general population. DESIGN:Meta-analysis. SETTING AND PARTICIPANTS:PubMed and E...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.05.059
更新日期:2020-07-15 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the effect of sarcopenic obesity on activities of daily living and home discharge rates in adults undergoing convalescent rehabilitation. In addition, we evaluated diagnostic criteria for sarcopenic obesity to predict outcomes. DESIGN:A retrospective cohort study. SETTI...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.03.029
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:To examine the independent associations between atrial fibrillation (AF) and objectively measured mobility in a nationally representative cohort. DESIGN:Wave 1 of The Irish Longitudinal Study on Ageing (TILDA), a population-based study assessing health, economic, and social aspects of ageing. SETTING:Commu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.08.005
更新日期:2014-12-01 00:00:00
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journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.10.009
更新日期:2010-06-01 00:00:00
abstract::Nursing homes can be ideal clinical teaching and learning environments for acquiring geriatric specialty and interdisciplinary team skills, particularly those regarding assessment, care planning, management, monitoring, and collaborating in an interdisciplinary milieu. Little is known as to how geriatric specialty tra...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2008.11.002
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVES:Immigrants often face many unique cultural and logistical challenges in their health care that differ from nonimmigrants. We sought to describe and compare characteristics and the time to placement between recent immigrants and long-standing residents waiting for long-term care (LTC). DESIGN:Population-base...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.07.018
更新日期:2020-08-25 00:00:00
abstract:PURPOSE:Urinary incontinence (UI) is common but inadequately assessed and treated in nursing facility (NF) residents. The purpose of this study is two-fold: (1) to determine perceptions about the importance of UI and its management in the NF setting compared with other geriatric syndromes and (2) to compare barriers to...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2007.08.003
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:There is a lack of studies disentangling whether changes in frailty are associated with subsequent changes in depressive symptoms or vice versa among the oldest old. Consequently, we aimed to disentangle this link. DESIGN:Three waves [follow-up (FU) wave 7 to FU wave 9; n = 423 individuals in the analytical ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.10.008
更新日期:2020-11-19 00:00:00
abstract:OBJECTIVES:Dysphagia is a major healthcare problem as it increases the risk of malnutrition, dehydration, aspiration pneumonia, and death. The aims of this analysis of data from nursing homes (NHs) worldwide were to examine prevalence rates of dysphagia, to identify characteristics of residents with dysphagia, and to d...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamda.2017.08.015
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:To determine the effects of dopaminergic medication withdrawal in an elderly, demented and minimally ambulatory nursing home population with parkinsonism in New York City. METHODS:In our double-blind, randomized study, 11 patients (7 males, 4 females) were randomized into 2 groups: one group underwent levodo...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamda.2008.07.001
更新日期:2008-11-01 00:00:00
abstract::The aging population in China is growing rapidly and by the middle of this century will peak. In addition, in 2000, elderly people aged 80 and older accounted for 18% of the world's population of oldest old. We identify here ways to begin addressing China's unique aging population needs. Through improving geriatric an...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.06.007
更新日期:2009-09-01 00:00:00