Acceptability of a Novel Telemedication Review for Older Adults in Nursing Homes in France: A Qualitative Study

Clin Interv Aging. 2021 Jan 7:16:19-34. doi: 10.2147/CIA.S283496. eCollection 2021.


Purpose: In France, polypharmacy among older people living in nursing homes (NH) is a major public health concern. In this context, the randomized controlled trial TEM-EHPAD was recently launched in various NH in southern France to evaluate the impact of implementing a novel telemedication review (TMR) on hospital admission rates of NH residents at high risk of iatrogenic disease. A qualitative study was integrated into the main trial study to assess general practitioners' (GP) and other NH healthcare professionals' (HP) acceptability of the proposed TMR before its implementation.

Material and methods: A qualitative study using face-to-face semi-structured interviews was conducted with 16 HP before the beginning of the intervention. A manual thematic analysis was performed on the transcribed interviews.

Results: Four main themes emerged from the thematic analysis: HP perceptions of the TMR, difficulties related to medication management for NH residents, HP perceptions of the roles of different professionals, and facilitators of good practices. Most participants were favorable to the TMR, but some GP expressed fears about loss of control over their prescription writing.

Conclusion: This study fulfilled its objective to assess pre-intervention acceptability by GP and other HP. Results provided important information about how to adapt the TMR intervention to make it more acceptable to HP who will be involved in TEM-EHPAD. One of the main recommendations is the importance of providing participating GP with the opportunity to take part in the process of reviewing prescriptions.

Keywords: acceptability study; nursing home; older adults; qualitative study; satisfaction assessment; telemedication review; telemedicine.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • France
  • Humans
  • Male
  • Nursing Homes / organization & administration*
  • Polypharmacy*
  • Qualitative Research
  • Randomized Controlled Trials as Topic
  • Telemedicine / statistics & numerical data*

Grants and funding

This trial is being supported by the French Ministry of Health through institutional grants from the French 2017 National Programme for Clinical Research (Programme de Recherche sur la Performance du Système de Soins). The Assistance Publique-Hôpitaux de Marseille is the study promoter and is in charge of all administrative measures. The trial is registered at under the number NCT03640845.