| Popis: |
Introduction: The SARS-CoV-2 pandemic and its consequent decree of ASPO (Preventive and Compulsory Social Isolation) in Argentina, forced to rethink health intervention strategies and adapt them to virtuality. The aim of the study was to compare the detection and resolution of social health problems in a population of frail older adults in the virtual (2020) and home visit (2019).Methods: Quasi-experimental study with historical control. Inclusion criteria: adults over 65 years of age with frailty criteria from the Italian Hospital Health Plan. Exclusion criteria, refusal to participate and patients in agonic stage. Multifactorial intervention carried out by social-healthcare counselors trained in the detection and resolution of social and health problems (care network, medication reconciliation and adherence, falls, accessibility), by telephone (2020) and home visit (2019). We also added interventions in the current group related to care and prevention of SARS Cov 2. We analyzed data by intention-to-treat. The difference in problem solving between both groups (home visit and virtual) was compared. OpenEpi statistical software, version 3, was used. Results: A total of 1712 patients were included in the current group and 619 in the historical control. Mean age (84.4-85.2) female sex (76-74.4) mean barthel (50.8-53.1). In the current group a higher percentage of accessibility problems was detected versus the historical control (18.8 vs. 7.1%), lower percentage of insufficient care (14, 2 vs 27.4%), medication adherence (3.9 vs 7.7%) and falls (14.2 vs 30.5%), with no statistically significant differences in the problems found in inadequate care (6.2 vs 8%) and medication reconciliation (14 vs 15.3%). There were no significant differences in the total or partial resolution of the problems of accessibility (90.7 vs 84.6), insufficient care (65.8 vs 70.8), inadequate care (70.2 vs 64.1), medication reconciliation (76.2 vs 82.7) and adherence (66.2 vs 72).A total of 91.8% of the patients claimed to know the SARS Cov 2 infection prevention measures, and 89% applied them. At follow-up, 64.9% continued to apply the prevention measures, and 23.4% reinforced them. Conclusion: A higher percentage of accessibility problems was found in the virtual setting, a lower percentage of insufficient care and adherence, and a similar percentage of inadequate care and conciliation. The percentage of problem resolution in both groups (virtual and home visit) was similar, being able to sustain the standard of care in virtuality. Telephone intervention in the current context is a useful tool. A mixed intervention could be implemented in the future and work time could be optimized. Limitations: There were limitations in the completeness of the scales during the telephone intervention, due to the length of the assessment, including the limitations of the people, such as hearing loss and dementia. |
