Video consultations provide boost to SNF dementia care

Study senior author Lewis Lipsitz, M.D., says the program could decrease the use of antipsychotics, falls and other adverse events.
Study senior author Lewis Lipsitz, M.D., says the program could decrease the use of antipsychotics, falls and other adverse events.

When aggressive behavior occurs among dementia patients, nursing home staff often must resort to using physical restraints or prescribing powerful antipsychotic medications to reduce it. 

Now, a new study by researchers at Beth Israel Deaconess Medical Center (BIDMC) and Hebrew Senior- Life in Boston suggests that using video consultation technology to link nursing home staff with experts in dementia care can significantly reduce the use of those potent sedatives. 

Investigators used videoconferencing software to facilitate biweekly conversations at 11 nursing homes in Massachusetts and Maine between frontline nursing home staff and a team of clinical experts at BIDMC. During each 120-minute videoconference, a team of experts — including a geriatrician facilitator, geropsychiatrist, behavioral neurologist and social worker — discussed concerns and recommendations for patient cases. 

Published in the May issue of the JAMDA, the study showed that within the first three months of videoconferencing, antipsychotic use dropped by 12.5%, compared to a 4% increase at nursing homes that did not use videoconferencing. 

Over the course of the 18-month study, researchers found that residents in the facilities taking part in the program were 75% less likely to be physically restrained and 17% less likely to be prescribed antipsychotics. 

The study's senior author, Lewis A. Lipsitz, M.D., chief of the Division of Gerontology at BIDMC and director of the Institute for Aging Research at Hebrew SeniorLife, also noted that the reductions in restraint and antipsychotic use imply a potential decrease in adverse events such as falls, fractures and hospitalizations. 

“As a result, further study of [this program] is warranted for the continued improvement of geriatric care management,” Lipsitz wrote.