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Acceptability of a Novel Telemedication Review for Older Adults in Nursing Homes in France: A Qualitative Study

Authors Costa M, Correard F, Montaleytang M, Baumstarck K, Loubière S, Amichi K, Villani P, Honore S, Daumas A, Verger P

Received 25 September 2020

Accepted for publication 17 November 2020

Published 7 January 2021 Volume 2021:16 Pages 19—34


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Richard Walker

Marie Costa,1,2 Florian Correard,3,4 Maeva Montaleytang,3,4 Karine Baumstarck,5 Sandrine Loubière,5 Kahena Amichi,6 Patrick Villani,7 Stephane Honore,3,4,8 Aurélie Daumas,7 Pierre Verger1,2

1ORS PACA, Southeastern Health Regional Observatory, Marseille, France; 2Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, IHU-Méditerranée Infection, Marseille, France; 3AP-HM, Service Pharmacie, Hôpital de la Timone, Marseille 13385, France; 4Laboratoire de Pharmacie Clinique, faculté de pharmacie, Aix-Marseille Université, Marseille 13385, France; 5EA3279, Self-Perceived Health Assessment Research Unit, Aix-Marseille University, Marseille 13385, France; 6Direction de la Recherche Clinique et de l’Innovation (DRCI), AP-HM, Marseille 13354, France; 7Service de Médecine Interne Gériatrie et Thérapeutique, CHU Sainte Marguerite, Assistance Publique des Hôpitaux de Marseille (AP-HM), Marseille 13274, France; 8Service de Pharmacie Clinique, Faculté de Pharmacie Timone, Aix-Marseille Université, Marseille F-13000, France

Correspondence: Marie Costa Email

Purpose: In France, polypharmacy among older people living in nursing homes (NH) is a major public health concern. In this context, the randomized controlled trial TEM-EHPAD was recently launched in various NH in southern France to evaluate the impact of implementing a novel telemedication review (TMR) on hospital admission rates of NH residents at high risk of iatrogenic disease. A qualitative study was integrated into the main trial study to assess general practitioners’ (GP) and other NH healthcare professionals’ (HP) acceptability of the proposed TMR before its implementation.
Material and Methods: A qualitative study using face-to-face semi-structured interviews was conducted with 16 HP before the beginning of the intervention. A manual thematic analysis was performed on the transcribed interviews.
Results: Four main themes emerged from the thematic analysis: HP perceptions of the TMR, difficulties related to medication management for NH residents, HP perceptions of the roles of different professionals, and facilitators of good practices. Most participants were favorable to the TMR, but some GP expressed fears about loss of control over their prescription writing.
Conclusion: This study fulfilled its objective to assess pre-intervention acceptability by GP and other HP. Results provided important information about how to adapt the TMR intervention to make it more acceptable to HP who will be involved in TEM-EHPAD. One of the main recommendations is the importance of providing participating GP with the opportunity to take part in the process of reviewing prescriptions.

Keywords: qualitative study, telemedicine, older adults, telemedication review, nursing home, acceptability study, satisfaction assessment

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