Feasibility of a telemedicine support system for diagnosing dementia in primary care

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.