Department of Neurology, Aiginition University Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece.
Medical Physics and Digital Innovation Lab, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Medicina (Kaunas). 2022 Nov 22;58(12):1705. doi: 10.3390/medicina58121705.
: Dementia affects more than 55 million patients worldwide, with a significant societal, economic, and psychological impact. However, many patients with Alzheimer's disease (AD) and other related dementias have limited access to effective and individualized treatment. Care provision for dementia is often unequal, fragmented, and inefficient. The COVID-19 pandemic accelerated telemedicine use, which holds promising potential for addressing this important gap. In this narrative review, we aim to analyze and discuss how telemedicine can improve the quality of healthcare for AD and related dementias in a structured manner, based on the seven dimensions of healthcare quality defined by the World Health Organization (WHO), 2018: effectiveness, safety, people-centeredness, timeliness, equitability, integrated care, and efficiency. : MEDLINE and Scopus databases were searched for peer-reviewed articles investigating the role of telemedicine in the quality of care for patients with dementia. A narrative synthesis was based on the seven WHO dimensions. : Most studies indicate that telemedicine is a valuable tool for AD and related dementias: it can improve effectiveness (better access to specialized care, accurate diagnosis, evidence-based treatment, avoidance of preventable hospitalizations), timeliness (reduction of waiting times and unnecessary transportation), patient-centeredness (personalized care for needs and values), safety (appropriate treatment, reduction of infection risk),integrated care (interdisciplinary approach through several dementia-related services), efficiency (mainly cost-effectiveness) and equitability (overcoming geographical barriers, cultural diversities). However, digital illiteracy, legal and organizational issues, as well as limited awareness, are significant potential barriers. : Telemedicine may significantly improve all aspects of the quality of care for patients with dementia. However, future longitudinal studies with control groups including participants of a wide educational level spectrum will aid in our deeper understanding of the real impact of telemedicine in quality care for this population.
: 全球有超过 5500 万名痴呆症患者，这给社会、经济和心理带来了重大影响。然而，许多阿尔茨海默病 (AD) 和其他相关痴呆症患者获得有效和个性化治疗的机会有限。痴呆症的护理往往不平等、碎片化且效率低下。COVID-19 大流行加速了远程医疗的使用，这为解决这一重要差距带来了巨大的潜力。在本叙述性综述中，我们旨在根据世界卫生组织 (WHO) 2018 年定义的医疗质量的七个维度（有效性、安全性、以患者为中心、及时性、公平性、综合护理和效率），以结构化的方式分析和讨论远程医疗如何提高 AD 和相关痴呆症患者的医疗质量。 : 我们在 MEDLINE 和 Scopus 数据库中搜索了调查远程医疗在痴呆症患者护理质量中作用的同行评议文章。基于 WHO 的七个维度进行了叙述性综合分析。 : 大多数研究表明，远程医疗是 AD 和相关痴呆症的宝贵工具：它可以提高有效性（更好地获得专业护理、准确诊断、基于证据的治疗、避免可预防的住院）、及时性（减少等待时间和不必要的运输）、以患者为中心（个性化满足需求和价值观）、安全性（适当的治疗、降低感染风险）、综合护理（通过多个与痴呆症相关的服务进行跨学科方法）、效率（主要是成本效益）和公平性（克服地理障碍、文化多样性）。然而，数字文盲、法律和组织问题以及有限的认识，是重大的潜在障碍。 : 远程医疗可能会显著改善痴呆症患者护理质量的各个方面。然而，未来的纵向研究需要包括具有广泛教育水平的参与者的对照组，这将有助于我们更深入地了解远程医疗在该人群的高质量护理中的实际影响。
