[Telegeriatrics for chronic disease management through polypharmacy reduction in primary health careTelegeriatria para o controle de doenças crônicas por meio da redução da polifarmácia na atenção primária à saúde].

Abstract

Objective: To evaluate the effect of using asynchronous geriatric consultations to reduce polypharmacy and unscheduled consultations in older persons in Chile.

Methods: An asynchronous geriatric teleconsultation was introduced that enabled primary care teams to present clinical cases to a multidisciplinary geriatrics team, resulting in changes in chronic disease management and the optimization of pharmacological treatment. A total of 462 consultations between May 2022 and January 2024 were randomly analyzed. Descriptive analyses and hypothesis testing were used before and after the intervention, with follow-up at six months. The number of medications, potentially inappropriate medications, and unscheduled consultations were measured as outcome variables.

Results: The use of geriatric teleconsultations was associated with a statistically significant reduction in the total number of medications prescribed, potentially inappropriate medications, and the frequency of unscheduled consultations among older persons.

Conclusions: Telegeriatrics allows for multidisciplinary review of therapeutic regimens and has demonstrated a relevant clinical impact by suspending the prescription of pharmaceuticals and reducing unscheduled visits. It is a safe and effective tool for improving care and reducing health inequities in primary care.