TY - JOUR PY - 2023// TI - Virtual fall program assessment for frail Canadian community-dwelling older adults: Examining equitable accessibility JO - Digital health A1 - Weiss, Sophie M. A1 - Castelo, Matthew A1 - Liu, Barbara A1 - Norris, Mireille SP - e20552076231178410 EP - e20552076231178410 VL - 9 IS - N2 - OBJECTIVE: In response to COVID-19, the fall prevention program (FPP) at Sunnybrook Health Sciences Centre was modified to be delivered virtually. We compared patient populations assessed for the FPP virtually versus in-person to explore equitable accessibility.

METHODS: A retrospective chart review was performed. All patients assessed virtually from the beginning of the COVID-19 pandemic until the end of abstraction (April 25, 2022) were compared to a historic sample of patients assessed in-person beginning in January 2019. Demographics, measures of frailty, co-morbidity, and cognition were abstracted. Wilcoxon Rank Sum tests and Fisher's Exact tests were used for continuous and categorical variables, respectively.

RESULTS: Thirty patients were assessed virtually and compared to 30 in-person historic controls. Median age was 80 years (interquartile range 75-85), 82% were female, 70% were university educated, the median Clinical Frailty Score was 5 out of 9, and 87% used >5 medications. Once normalized, frailty scores showed no difference (p  =  0.446). The virtual cohort showed significantly higher outdoor walking aid use (p  =  0.015), reduced accuracy with clock drawing (p  =  0.020), and nonsignificant trends toward using >10 medications, requiring assistance with >3 instrumental activities of daily living (IADLs), and higher treatment attendance. No significant differences were seen for time-to-treat (p  =  0.423).

CONCLUSION: Patients assessed virtually were similarly frail as the in-person controls but had increased use of walking aids, medications, IADL assistance, and cognitive impairment. In a Canadian context, frail and high socioeconomic status older adults continued to access treatment through virtual FPP assessments during the COVID-19 pandemic highlighting both the benefits of virtual care and potential inequity.

Language: en

LA - en SN - 2055-2076 UR - http://dx.doi.org/10.1177/20552076231178410 ID - ref1 ER -