ABSTRACT

Dementia affects one in ten adults over age 65. Paradoxically, dementia (e.g., Alzheimer’s disease and related dementias) is underdiagnosed, with approximately 50% of those with dementia lacking a formal diagnosis. This limits options for care, support and research engagement. To address this gap, we developed and implemented a telehealth-based ECHO (Extension for Community Healthcare Outcomes) program, “Dementia 360,” to provide education and support for clinicians and allied team members. We assessed the feasibility and acceptability of this telementoring educational offering and the effect it had on clinician confidence in diagnosing and treating dementia. Clinicians from across Oregon (n = 67) attended learning sessions via videoconferencing technology. The sessions, which focused on dementia diagnosis and treatment, included didactic information provided by experts, followed by case discussions. We assessed clinician acceptability using surveys, and confidence in identifying and treating those with dementia prior to and after Dementia 360 using paired t tests. Dementia 360 was acceptable to clinicians and significantly increased their comfort levels in identifying and treating those with dementia. The technology-based program provided support and instruction that was acceptable by clinicians, even those in frontier areas of the state.

摘要

65 岁以上的成年人中有十分之一患有痴呆症。自相矛盾的是，痴呆症（例如，阿尔茨海默氏病和相关痴呆症）诊断不足，大约 50% 的痴呆症患者缺乏正式诊断。这限制了护理、支持和研究参与的选择。为了解决这一差距，我们开发并实施了基于远程医疗的 ECHO（社区医疗保健结果扩展）计划“痴呆症 360”，为临床医生和相关团队成员提供教育和支持。我们评估了这种远程辅导教育产品的可行性和可接受性，以及它对临床医生诊断和治疗痴呆症信心的影响。来自俄勒冈州 (n = 67) 的临床医生通过视频会议技术参加了学习课程。这些会议的重点是痴呆症的诊断和治疗，包括专家提供的教学信息，然后是案例讨论。我们使用调查评估了临床医生的可接受性，以及使用配对在 Dementia 360 之前和之后识别和治疗痴呆症患者的信心t检验。痴呆症 360 为临床医生所接受，并显着提高了他们识别和治疗痴呆症患者的舒适度。基于技术的计划提供了临床医生可以接受的支持和指导，即使是在该州边境地区的医生也是如此。