Viabilidad de un sistema de telemedicina de soporte para el diagnóstico de demencia en atención primaria / Feasibility of a telemedicine support system for diagnosing dementia in primary care

Introducción. El Sistema Informatizado de Soporte al Diagnóstico de Demencia en Atención Primaria (SISDDAP) es un programa de telemedicina asincrónico que, mediante la protocolización del cribado y diagnóstico de demencia, tiene como objetivo el diagnóstico compartido de demencia entre profesionales de atención primaria (AP) y atención especializada (AE). Objetivos. Determinar la viabilidad y grado de implementación de un programa de telemedicina asincrónico y evaluar el grado de concordancia de las medidas cognitivas y funcionales entre los profesionales de dos niveles asistenciales distintos. Pacientes y métodos. Se analiza la utilización del programa SISDDAP por parte de los profesionales de cuatro áreas básicas de salud (ABS) en las que se introdujo el programa voluntariamente. Se calculó la frecuencia absoluta y relativa de utilización del programa SISDDAP y del número de variables registradas, y se calculó el coeficiente de correlación intraclase entre las puntuaciones obtenidas por los profesionales de AP y AE en los diversos instrumentos psicométricos que incluye el módulo de diagnóstico del SISDDAP (Mini-Mental State Examination, Blessed Dementia Rating Scale y Patient Health Questionnaire 9). Resultados. Las cuatro ABS que incorporaron el SISDDAP remitieron 215 (45,3%) solicitudes mediante el programa de telemedicina, y el 82,2% de estas solicitudes tenía dos o menos datos faltantes. El coeficiente de correlación intraclase fue superior a 0,70 entre todos los instrumentos evaluados. Conclusiones. El SISDDAP es un programa de telemedicina asincrónico que tiene una buena acogida entre los profesionales de AP. Tras una formación adecuada, el grado de concordancia de los instrumentos psicométricos es aceptable (AU)

Introduction. The Computerised Support System for the Diagnosis of Dementia in Primary Care (SISDDAP, in Spanish) is an asynchronous telemedicine programme that establishes protocols for the screening and diagnosis of dementia, thereby enabling primary care (PC) and specialised care (SC) professionals to reach shared diagnoses of dementia. Aims. To determine the feasibility and degree of implementation of an asynchronous telemedicine programme and to evaluate the rate of agreement between the cognitive and functional measures taken by professionals from two different levels of healthcare. Patients and methods. The study examines the use of the SISDDAP programme by professionals from four basic areas of healthcare (BAH) in which the programme was introduced on a voluntary basis. The absolute and relative frequency of use of the SISDDAP programme and the number of variables registered were calculated, together with the intra-class correlation coefficient among the scores obtained by PC and SC professionals on the different psychometric instruments, including the SISDDAP diagnostic module (Mini-Mental State Examination, Blessed Dementia Rating Scale and Patient Health Questionnaire 9). Results. The four BAH that incorporated the SISDDAP referred 215 (45.3%) applications via the telemedicine programme, and 82.2% of these applications had a maximum of two data items missing. The intra-class correlation coefficient was above 0.70 among all the instruments evaluated. Conclusions. The SISDDAP is an asynchronous telemedicine programme that is well accepted among PC professionals. After suitable training, the level of agreement among the psychometric instruments is acceptable (AU)

[Feasibility of a telemedicine support system for diagnosing dementia in primary care]. / Viabilidad de un sistema de telemedicina de soporte para el diagnóstico de demencia en atención primaria.

INTRODUCTION: The Computerised Support System for the Diagnosis of Dementia in Primary Care (SISDDAP, in Spanish) is an asynchronous telemedicine programme that establishes protocols for the screening and diagnosis of dementia, thereby enabling primary care (PC) and specialised care (SC) professionals to reach shared diagnoses of dementia. AIMS: To determine the feasibility and degree of implementation of an asynchronous telemedicine programme and to evaluate the rate of agreement between the cognitive and functional measures taken by professionals from two different levels of healthcare. PATIENTS AND METHODS: The study examines the use of the SISDDAP programme by professionals from four basic areas of healthcare (BAH) in which the programme was introduced on a voluntary basis. The absolute and relative frequency of use of the SISDDAP programme and the number of variables registered were calculated, together with the intra-class correlation coefficient among the scores obtained by PC and SC professionals on the different psychometric instruments, including the SISDDAP diagnostic module (Mini-Mental State Examination, Blessed Dementia Rating Scale and Patient Health Questionnaire 9). RESULTS: The four BAH that incorporated the SISDDAP referred 215 (45.3%) applications via the telemedicine programme, and 82.2% of these applications had a maximum of two data items missing. The intra-class correlation coefficient was above 0.70 among all the instruments evaluated. CONCLUSIONS: The SISDDAP is an asynchronous telemedicine programme that is well accepted among PC professionals. After suitable training, the level of agreement among the psychometric instruments is acceptable.