General practitioners adherence to recommendations from geriatric assessments made during teleconsultations for the elderly living in nursing homes.
OBJECTIVE
To determine the factors associated with general practitioners adherence to recommendations from geriatric assessments made during teleconsultations for the elderly living in nursing homes.


METHODS
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).


METHODS
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.
Department of Geriatrics, Challans Hospital, 85300 Challans, France. Electronic address: e.georgeton@ch-lvo.fr.
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E
Georgeton
Department of Geriatrics, Nantes University Hospital, 44093 Nantes, France.
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L
Aubert
Department of Geriatrics, Challans Hospital, 85300 Challans, France.
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N
Pierrard
Department of Geriatrics, Challans Hospital, 85300 Challans, France.
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G
Gaborieau
Department of Geriatrics, Nantes University Hospital, 44093 Nantes, France.
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G
Berrut
Department of Geriatrics, Nantes University Hospital, 44093 Nantes, France. Electronic address: laure.dedecker@chu-nantes.fr.
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L
de Decker
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005602:France; D058005:General Practitioners; D015577:Geriatric Assessment; D019983:Guideline Adherence; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D019114:Remote Consultation / Q000592:standards*
Adherence; Geriatric assessment; Nursing home; Teleconsultation