Telemedizinische Betreuung von Demenzerkrankten in der COVID-19 Pandemie

Zusammenfassung

In unserem multidisziplinären Gedächtniszentrum der Universitätsklinik Jena haben wir bereits zu Beginn der SARS-CoV2-Pandemie im Frühjahr 2020 mit der regulären Einführung einer Videosprechstunde für Patient*innen mit Risiko für eine Demenzentwicklung bzw. mit einer Demenzerkrankung und deren Angehörigen begonnen.

Über einen Zeitraum von 12 Monaten haben wir eine systematische Befragung zur Zufriedenheit bei Patient*innen im regulären Face-to-Face-Kontakt (F2F) und bei Videokonsultationen (VC) durchgeführt.

Ziel dieser Studie war eine Bewertung der Einsatzmöglichkeiten von Telemedizin bei älteren Menschen mit beginnenden kognitiven Defiziten im Rahmen einer Demenzerkrankung. Dabei wollten wir insbesondere die Patientenzufriedenheit und die Durchführbarkeit bewerten.

Ausgewertet wurden Erstvorstellungen in unserem Gedächtniszentrum bei Verdacht auf das Vorliegen einer demenziellen Erkrankung in einem standardisierten regulären Vorort-Setting (n=50) sowie in einer standardisierten Videokonsultation (n=40). In beiden Settings erfolgten aufeinanderfolgend eine neuropsychologische und eine ärztliche Vorstellung. Beide Gruppen waren bezüglich Alter und Geschlecht ähnlich verteilt (71.4 vs. 72.3 Jahre, 52 vs. 50% weiblich (F2F vs. VC)). Der kognitive Status war in der VC Gruppe leicht besser (ACE III signifikant, MMST nicht signifikant).

In der Befragung der Patient*innen anhand eines Inventars mit 12 Fragen (Patient*innenzufriedenheit, bewertet mit 1 bis 5) zeigte sich zwischen beiden Gruppen insgesamt kein signifikanter Unterschied. Tendenziell wurde hier allerdings der F2F in der Bewertung der Beratung etwas besser bewertet. Der technische Ablauf bei der VC wurde von Ärzt*innen und Neuropsycholog*innen zu über 80% als gut/sehr gut bewertet.

Eine allgemeine Einschätzung der kognitiven Defizite durch Ärzt*innen und Neuropsycholog*innen korrelierte im F2F und VC extrem hoch mit dem Ergebnis der anschließenden spezifischen Testung (MMST und ACE). Bei tendenziell besserer Übereinstimmung im VC war der Unterschied zwischen den Korrelationen nicht signifikant.

Insgesamt konnten wir keinen signifikanten Unterschiede bei der Patient*innenzufriedenheit zwischen VC und klassischer F2F Vorstellung finden. Technische Aspekte in der Vorbereitung einer VC und während einer VC waren weniger problematisch als initial antizipiert.

Abstract

In our multidisciplinary memory center at Jena University Hospital, we initiated a regular video consultation for patients at risk of developing dementia or with dementia disease and their relatives at the beginning of the SARS-CoV2 pandemic in spring 2020.

Over a 12-month period, we conducted a systematic survey of satisfaction among patients in regular face-to-face contact (F2F) and video consultations (VC).

The aim of this study was to evaluate the potential use of telemedicine in older people with incipient cognitive deficits in the context of dementia. In particular, we aimed to evaluate patient satisfaction and feasibility.

Initial presentations to our memory center for suspected dementia were evaluated in a standardized regular on-site setting (n=50) and in a standardized video consultation (n=40). In both settings, a neuropsychologist’s and a physician’s consultation were performed consecutively. Both groups were similarly distributed in terms of age and sex (71.4 vs. 72.3 years, 52 vs. 50% female (F2F vs. VC)). Cognitive status was slightly better in the VC group (ACE III significant, MMST not significant).

In the survey of the patients using a 12-question inventory (patient satisfaction, rated 1 to 5), there was no significant difference between the two groups overall. However, the F2F tended to be rated slightly better here in terms of advice. More than 80% of the physicians and neuropsychologists rated the technical process of VC as good/very good.

A general assessment of the cognitive deficits by physicians and neuropsychologists correlated extremely highly with the results of the subsequent specific testing (MMST and ACE) in F2F and VC. With a tendency to better agreement in VC, the difference between the correlations was not significant.

Overall, we could not find any significant differences in patients’ satisfaction between VC and classical F2F presentation. Technical aspects in the preparation of a VC and during a VC were less problematic than initially anticipated.

Schlüsselwörter

Telemedizin - Demenz - COVID-19 - Patientenzufriedenheit - Videosprechstunde

Key words

telemedicine - dementia - COVID-19 - patient satisfaction - video consultation

Publication History

Received: 20 July 2022

Accepted: 23 March 2023

Article published online:
12 July 2023

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