Brodoehl Stefan, Wagner Franziska, Klingner Carsten, Srowig Annie, Finke Kathrin
Neurologie, Jena University Hospital, Jena, Germany.
Gedächtniszentrum/Neurologie, Jena University Hospital, Jena, Germany.
Fortschr Neurol Psychiatr. 2023 Nov;91(11):444-454. doi: 10.1055/a-2073-3947. Epub 2023 Jul 12.
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.
2020年春季新冠疫情刚开始时，我们在耶拿大学医院的多学科记忆中心，为有患痴呆症风险或患有痴呆症的患者及其亲属开展了定期视频会诊。在12个月的时间里，我们对定期面对面会诊（F2F）和视频会诊（VC）的患者满意度进行了系统调查。本研究的目的是评估远程医疗在早期认知功能有缺陷的老年痴呆症患者中的潜在应用。特别是，我们旨在评估患者满意度和可行性。对疑似痴呆症患者首次到我们记忆中心就诊的情况，在标准化的常规现场环境（n = 50）和标准化的视频会诊（n = 40）中进行了评估。在这两种环境下，均依次进行了神经心理学家和医生的会诊。两组在年龄和性别方面分布相似（71.4岁对72.3岁，女性分别为52%对50%（面对面会诊对视频会诊））。视频会诊组的认知状态稍好（ACE III有显著差异，MMST无显著差异）。在使用12个问题的问卷（患者满意度，评分1至5）对患者进行的调查中，两组总体上没有显著差异。然而，在建议方面，面对面会诊在此处的评分往往略高。超过80%的医生和神经心理学家将视频会诊的技术流程评为良好/非常好。医生和神经心理学家对认知缺陷的总体评估与后续在面对面会诊和视频会诊中特定测试（MMST和ACE）的结果高度相关。视频会诊中的一致性有更好的趋势，相关性之间的差异不显著。总体而言，我们未发现视频会诊和传统面对面会诊在患者满意度上有任何显著差异。视频会诊准备阶段和会诊期间的技术问题比最初预期的要少。
