RT Journal Article
SR Electronic
T1 Evaluation of a Virtual Pre-Consultation Tool for Older Adults in Primary Care: Results from a Randomized Trial
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 3887
DO 10.1370/afm.21.s1.3887
VO 21
IS Supplement 1
A1 Sourial, Nadia
A1 Kaczorowski, Janusz
A1 Quesnel-Vallee, Amelie
A1 Lussier, Marie Therese
A1 Khanassov, Vladimir
A1 Breton, Mylaine
A1 Develay, Elise
A1 Layani, Geraldine
A1 Godard-Sebillotte, Claire
A1 Adams, Alayne
A1 Authier, Marie
A1 Beauchet, Olivier
A1 Motulsky, Aude
A1 Archambault, Patrick
YR 2023
UL http://www.annfammed.org/content/21/Supplement_1/3887.abstract
AB Context: Virtual pre-consultation screening of patient needs may offer opportunities to improve the care and health outcomes of older patients in primary care, especially those with multiple care needs.Objective: We sought to implement and evaluate the effectiveness of a multidimensional virtual pre-consultation tool in the primary care setting to support rapid and standardized needs assessment for older persons.Study Design and Analysis: Pragmatic, multi-center, 1:1 individually randomized trial design. Implementation was conducted using a participatory approach over a 3-month period. Baseline and 3-month follow-up data were collected through phone-based questionnaires. An intention-to-treat analysis was carried out.Setting: Four university-affiliated interprofessional primary care clinics, two clinics in one urban region (Montreal) and two in one rural region (Abitibi) in Quebec, Canada.Population Studied: Patients 65 years and older with a consultation with a primary care provider (physician, nurse, social worker, other) during the implementation period in one of the participating clinics.Intervention: A virtual pre-consultation tool, ESOGER, was administered as a phone-based questionnaire by a member of the clinic staff to eligible patients prior to their consultation with the primary care provider. The ESOGER tool provides a general assessment of the physical, social, mental and cognitive health needs of older adults and produces a summary report available to clinicians at the time of consultation.Outcome Measures: The primary endpoint consisted of the EQ-5D quality of life score at 3-month follow-up. Secondary endpoints were unplanned primary care visits, visits to the ED and hospital admissions in last 3 months.Results: Of the 659 eligible patients contacted to date, 345 (52.3%) agreed to participate and have been randomized. Follow-up assessments are ongoing with a loss to follow-up of 22.8% and will be completed by August 2022. Final results of the intention-to-treat analysis will be presented overall and stratified by urban and rural sites.Conclusions: Intended consequences of this intervention include an increased responsiveness of consultations for providers resulting in improved care of older patients. Overall, we hope results will support the implementation of evidence-based, multidimensional and virtual pre-consultation tools for older persons in the primary care setting.