Barriers and facilitators of telehealth for caregivers and older adults with dementia

Abstract Introduction: Telehealth programmes have become an alternative to the social isolation imposed by the pandemic. However, few studies analyze existing barriers and facilitators on programmes for caregivers and older people with dementia. Purpose: To analyze the barriers and facilitators of a telehealth program for caregivers of older people with dementia during the COVID-19 pandemic. Methods: This quantitative-qualitative study took place online, from 2021 to 2022. 41 caregivers and 41 older people with dementia participated in an online intervention consisting of psychoeducation and barriers management techniques, a 12 week physical exercise programme and participants meetings. Barriers and facilitators were measured in 6 time-points throughout the intervention by questionnaire. After intervention, a focus group was applied with the caregivers. Descriptive and comparative analysis between the six time-points were carried out by generalized estimating equations. Qualitative data were analyzed and categorized through Bardin's content analysis. Results: From a total of 254 barriers, 24.4% were related to the caregiver; 49.2% to the older person and 26.4% to other aspects. The facilitators were the offered programme being online, flexible schedules, the high quality of services provided, a self-explanatory platform and the quality of the materials available. The number of barriers were higher in the first time-point compared to the fourth time point (p=0.023). Modifiable barriers (n=69) were different between the six time-points with superior values from the first to the third and fourth time-point (p=0.003). Conclusion: This study highlights the importance of analyzing conditions and factors that can hinder or contribute to the functioning and adherence to telehealth programs. Future similar programs to be offered may benefit from the results of this investigation. Trial Registration Number: Research Ethics Committee on Human Beings at the Federal University of São Carlos-SP (CAAE: 34696620.0.0000.5504/CEP: 6.428.315) Study registration: Registered in the Brazilian Registry of Clinical Trials (accession number RBR-825p57). Date of Registration: 10/08/2020.