Older Adults Want Telemedicine to Remain an Option Alongside In-person Care

Journal of the American Geriatrics Society Research Summary

Today the Journal of the American Geriatrics Society published a study about older adults’ views on receiving their primary care through telemedicine. Researchers asked adults over the age of 65 what they thought about the telemedicine care they received during the COVID-19 pandemic. The researchers wanted to understand if telemedicine should remain an option for patients on a permanent basis.

Why does this matter?

We all want to have access to good quality care that helps us stay healthy as we age. Policy makers are making big decisions about what kind of care older adults should receive and whether insurance will cover it. A current law, the Coronavirus Aid, Relief, and Economic Security (CARES) Act, allows telemedicine to be covered by insurance. However, it will expire on October 13, 2022. Researchers wanted to find out if people were happy with receiving primary care through telemedicine. They also identified barriers that make receiving care through telemedicine difficult for some people, so changes can be made to improve the patient experience.

What Was Learned from thisStudy?

Most adults over the age of 65 who participated in the study reported being satisfied with the primary care telemedicine they received during the pandemic. Participating older adults also expressed their hopes that telemedicine would remain available as an option, even as social distance orders begin to lift. Study participants reported that telemedicine was easier:

  • In bad weather.
  • During pandemics.
  • When they weren’t feeling well.
  • When they had mobility issues.

They also liked that it was easy to include family and caregivers during telemedicine visits.

Even though older adults clearly appreciate the benefits of telemedicine, most respondents still preferred in-person care because:

  • They want to have a physical examination.
  • It is easier to have a good relationship with their healthcare provider.
  • They had technical difficulties using video.

How Researchers Conducted this Study

The study participants included 208 adults over the age of 65 who had completed a phone-only and/or video telemedicine primary care visit with their primary care provider (PCP) since March 2020. The survey took place by phone and through an online questionnaire with multiple choice and open-ended questions.

Researchers asked participants to compare telemedicine to in-person visits and to rate their experience on a scale from 1-7. Open-ended questions gave participants an opportunity to share more detailed thoughts on their preference and what might improve telemedicine.

What are the Study’s Limitations?

The researchers concluded that having a choice between telemedicine and in-person care was preferred by the study participants. However, the findings were limited to one health system in Massachusetts and included mostly non-Hispanic white, highly educated participants. These people may be more likely to choose telemedicine than people from other backgrounds. Some participants reported that telemedicine was their only option, so they were not given a choice.

What this Study Means for You

The researchers found that adults over 65 want to continue to have a choice of seeing their PCP in person or through a telemedicine visit. Their findings will support efforts to have insurance companies cover telemedicine for older adults after the October deadline.

This summary is from “Older Adults’ Perspectives on Primary Care Telemedicine during the COVID-19 Pandemic.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study’s authors are Roma Bhatia, MD, MPH; Elizabeth Gilliam, MA; Gianna Aliberti, MD; Adlin Pinheiro, MS; Maria Karamourtopoulos, BA; Roger B. Davis, ScD; Laura DesRochers, MD, MPH; and Mara A. Schonberg, MD, MPH.

Psychological Resilience May Increase Healthy Aging for Older Adults with Type 2 Diabetes

Journal of the American Geriatrics Society Research Summary

The Journal of the American Geriatrics Society recently published a study about healthy aging for older adults with type 2 diabetes. The researchers looked into the role of psychological resilience in helping people with diabetes stay healthy as they get older. Psychological resilience is the attitudes and behaviors that help us adapt to stress and avoid its negative impact. In general, researchers are eager to find ways to support people in healthy aging, instead of focusing only on problems that can occur as people get older. This study highlights opportunities to promote ways for older adults with type 2 diabetes to age better.

Why Does this Matter?

We all hope to have a positive and healthy experience as we age. Researchers and clinicians are evaluating different ways we can enhance people’s later years of life. Existing research suggests that among older adults, higher psychological resilience has been linked to better well-being, a healthier lifestyle, and a reduced risk of death.

People with type 2 diabetes face many challenges, including the risk of developing other chronic conditions and declines in cognitive and physical function. Because of these challenges, this study looks at how psychological resilience impacts these older adults specifically.

How is Psychological Resilience Measured?

Participants in the study were evaluated using the Brief Resilience Scale (BRS). The BRS is a 6-question survey that asks people to report how well they think they adapt to or avoid the negative outcomes of stress. A higher score means the person has greater resilience.

What Was Learned from this Study?

The study found that older people with a history of type 2 diabetes who had higher scores of psychological resilience experience better health as they age compared to those who had lower scores.

Those with higher resilience had many positive health outcomes compared to people with lower resilience. The researchers found that the study participants with higher resilience had the following positive outcomes:

  • They were hospitalized less frequently over the past year
  • They had better physical functioning
  • They reported having fewer disabilities
  • They showed fewer depressive symptoms
  • They had a better mental and physical quality of life
  • They were less likely to have frailty (feeling weak, having less energy, and difficulty performing daily activities)

These results suggest that resilience may help an individual do better during a medical challenge, or that individuals may view themselves as more resilient when they face a medical challenge. Understanding how resilience provides helpful health benefits will help researchers find out what interventions can help improve aging.

How the Researchers Conducted the Study

The study included 3,199 older adults with type 2 diabetes who were enrolled in a program called Look AHEAD. Look AHEAD was a clinical trial that took place at multiple sites and assigned participants to random study groups. The study compared lifestyle interventions with education and whether those changes helped a patient to lose weight. After the Look AHEAD trial finished, the researchers continued to follow the participants for ten years. An assessment was carried out after approximately 14 years.

Researchers analyzed the participants’ information such as basic demographics, diabetes status, number of overnight hospitalizations, BRS score, quality of life, depressive symptoms, disability, physical function, and frailty.

What are the Study’s Limitations?

It is possible that some connections between resilience and health may be different, depending on a person’s race or ethnicity. Because these differences have not been fully studied yet, the authors stress that it is important to conduct additional research.

Previously published research also suggests that greater psychological resilience also may protect against the onset of diabetes and help improve management of the disease. However, further studies are needed to fully understand this connection.

What the Study Means for You

The researchers believe that being psychologically resilient may provide many benefits to older adults with type 2 diabetes. With further research, they believe interventions and support to promote better aging could be developed.

This summary is from “Psychological resilience in older adults with type 2 diabetes from the Look AHEAD Trial.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study’s authors are KayLoni L. Olson, PhD; Marjorie Howard, MS; Jeanne M. McCaffery, PhD; Gareth R. Dutton, PhD; Mark A. Espeland, PhD; Felicia R. Simpson, PhD; Karen C. Johnson, MD, MPH; Medha Munshi, MD; Thomas A. Wadden, PhD; Rena R. Wing, PhD; and the Look AHEAD Research Group.