Telehealth and telemedicine have become indispensable healthcare delivery tools during the COVID-19 pandemic. Older individuals with cirrhosis have complex medical needs that are currently unmet, due to growing disease burden and decreased access to care within Canada. Delivering timely specialist care virtually, to older adults with cirrhosis has the potential to improve patient care, whilst being acceptable to all; however, this has not yet been prospectively studied.
This interprovincial feasibility study looked to evaluate the virtual delivery of dual specialist care (hepatologist and geriatrician) for older Canadian adults in Nova Scotia, Canada, who are living with liver cirrhosis who are at high risk of geriatric syndromes, using a novel hepatology-geriatric referral pathway. Primary objectives include evaluating the impact of this approach on emergency care and inpatient utilization, and patient satisfaction.
81 participants aged 65 years or older, with a new diagnosis of liver cirrhosis, were enrolled into the study over three months (September to December 2022). Of these, 22 (27%) were found to have at least one geriatric syndrome, and were referred for a virtual geriatric assessment, with 16 participants undergoing a geriatric assessment by zoom (n=4) or by telephone. Telephone follow-up was arranged at 4 weeks, 3 and 6 months, along with assessment for emergency room visits and hospital admission status.
Data analysis is still ongoing, however, preliminary results reveal extremely positive patient feedback regarding their experience. We anticipate that the study will show reduced healthcare utilization, and will be acceptable to all.

Authors:
Frances Carr, University of Alberta, Canada
Julie Zhu, Dalhousie University, Canada
Michael Sun, Dalhousie University, Canada
Margo Macfarlane, Nova Scotia Health Authority, Canada
Farah Jafri, University of Alberta, Canada

About the Presenter(s)
Dr. Frances Carr is a Assistant Professor with the Division of Geriatric Medicine, University of Alberta. My research interests include Quality Improvement, benzodiazepine deprescribing, financial decision-making capacity and elder financial abuse.

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