{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:39:10Z","timestamp":1791923950458,"version":"4.3.4"},"reference-count":26,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Telemedicine offers promising solutions for improving access to care among older adults with chronic conditions, but there is limited evidence on how older patients navigate and engage with video telehealth in their home environments.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to assess older adults\u2019 acceptability, usability, comfort, and engagement with pharmacist-led telemedicine visits conducted at home using behavioral observation separate from the telehealth platform.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This descriptive mixed methods pilot study included a convenience sample of 20 older adult veterans (aged \u226565 years, \u22652 chronic conditions, and \u22655 medications) recruited from a Veterans Affairs (VA) health care system. A project manager observed and video-recorded participant preparation for and conduct during in-home telemedicine visits with a clinical pharmacist. Recordings were coded using structured protocols to assess verbal and nonverbal behavior, technological challenges, and environmental factors. Trained and reliable coders rated verbal and nonverbal comfort, frustration, and engagement during technology setup and the telemedicine appointment using Likert-type impression scales (intercoder reliability was good, Cohen \u03ba=0.81). Video data were also transcribed and coded for behavioral events (eg, troubleshooting, verbal expressions of age or technology ability, and nonverbal adaptation) and analyzed using rapid qualitative analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Participants expressed moderate engagement and comfort with technology overall. Verbal and nonverbal engagement significantly increased from setup to appointment (\n Z<\/jats:italic>\n =2.03,\n P<\/jats:italic>\n =.002). Technology-related challenges (eg, audio lag and troubleshooting) occurred in over half the visits but were often resolved through participant adaptation or support from the research staff. Participants displayed both frustration (eg, sighing and leaning away) and adaptability (eg, propping up tablets and retrieving medications). Verbal expressions reflected a mix of technology confidence and age-related limitations. Environmental distractions were present in some visits (eg, dogs barking or phones ringing), but also allowed for rich clinical engagement (eg, home tours and direct observation of medications).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In this small pilot sample of older veterans, participants generally remained engaged during in-home telemedicine visits despite technological and contextual barriers, suggesting that home-based telemedicine may be acceptable for some older adults when support is available. Addressing technical support, home environment considerations, and age-related perceptions of technology may increase telehealth usability and satisfaction among aging populations.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/86944","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T20:43:16Z","timestamp":1786048996000},"page":"e86944-e86944","source":"Crossref","is-referenced-by-count":1,"title":["Acceptability and Usability of Telemedicine for Older Veterans in a Pilot Sample: Mixed Methods Study"],"prefix":"10.2196","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8918-8932","authenticated-orcid":false,"given":"Mollie A","family":"Ruben","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5089-6523","authenticated-orcid":false,"given":"Atticus","family":"Carroll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2740-2267","authenticated-orcid":false,"given":"Maria D","family":"Venegas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6136-8189","authenticated-orcid":false,"given":"Chelsea E","family":"Hawley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3387-1967","authenticated-orcid":false,"given":"Megan B","family":"McCullough","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8283-3643","authenticated-orcid":false,"given":"William W","family":"Hung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2951-8674","authenticated-orcid":false,"given":"Lauren R","family":"Moo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-022-01834-5","article-title":"Survey of the patients\u2019 perspectives and preferences in adopting telepharmacy versus in-person visits to the pharmacy: a feasibility study during the COVID-19 pandemic","volume":"22","author":"Moulaei","journal-title":"BMC Med Inform Decis Mak"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.2147\/IPRP.S101685","article-title":"Telepharmacy: a pharmacist\u2019s perspective on the clinical benefits and challenges","volume":"5","author":"Poudel","journal-title":"Integr Pharm Res Pract"},{"issue":"Suppl 1","key":"R3","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1111\/1475-6773.14055","article-title":"Perceived benefits of geriatric specialty telemedicine among rural patients and caregivers","volume":"58 Suppl 1","author":"Dryden","journal-title":"Health Serv Res"},{"issue":"9","key":"R4","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.13451","article-title":"The urgent need for rigorous studies of telehealth for older adults who are homebound","volume":"4","author":"Moo","journal-title":"JAMA Netw Open"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.2196\/50205","article-title":"Findings from a national survey of older US adults on patient willingness to use telehealth services: cross-sectional survey","volume":"26","author":"Odebunmi","journal-title":"J Med Internet Res"},{"issue":"11","key":"R6","doi-asserted-by":"publisher","first-page":"2425","DOI":"10.1111\/jgs.16843","article-title":"Home video visits: two-dimensional view of the Geriatric 5 M\u2019s","volume":"68","author":"Moo","journal-title":"J Am Geriatr Soc"},{"issue":"9","key":"R7","doi-asserted-by":"publisher","first-page":"2404","DOI":"10.1111\/jgs.17163","article-title":"Barriers to telehealth access among homebound older adults","volume":"69","author":"Kalicki","journal-title":"J Am Geriatr Soc"},{"issue":"8","key":"R8","doi-asserted-by":"publisher","DOI":"10.2196\/20359","article-title":"Utilization barriers and medical outcomes commensurate with the use of telehealth among older adults: systematic review","volume":"8","author":"Kruse","journal-title":"JMIR Med Inform"},{"issue":"4","key":"R9","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8407","article-title":"Understanding older people\u2019s readiness for receiving telehealth: mixed-method study","volume":"20","author":"van Houwelingen","journal-title":"J Med Internet Res"},{"issue":"12","key":"R10","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.37193","article-title":"Perceptions of telehealth vs in-person visits among older adults with advanced kidney disease, care partners, and clinicians","volume":"4","author":"Ladin","journal-title":"JAMA Netw Open"},{"key":"R11","doi-asserted-by":"crossref","unstructured":"Katz-Buonincontro J . Convergent mixed methods designs. In: How to Mix Methods: A Guide to Sequential, Convergent, and Experimental Research Designs. American Psychological Association; 2024:73-82. [doi: 10.1037\/0000404-005]","DOI":"10.1037\/0000404-005"},{"issue":"3","key":"R12","first-page":"481","volume":"12","author":"Larsen","journal-title":"J Fam Pract"},{"issue":"10","key":"R13","doi-asserted-by":"publisher","first-page":"2816","DOI":"10.1007\/s10461-019-02466-z","article-title":"Emotional communication in HIV care: an observational study of patients\u2019 expressed emotions and clinician response","volume":"23","author":"Park","journal-title":"AIDS Behav"},{"issue":"11","key":"R14","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1176\/ps.62.11.pss6211_1361","article-title":"Psychiatrist-patient verbal and nonverbal communications during split-treatment appointments","volume":"62","author":"Cruz","journal-title":"Psychiatr Serv"},{"issue":"12","key":"R15","doi-asserted-by":"publisher","first-page":"2209","DOI":"10.1016\/j.pec.2018.08.013","article-title":"Measuring nonverbal behavior in clinical interactions: a pragmatic guide","volume":"101","author":"Blanch-Hartigan","journal-title":"Patient Educ Couns"},{"issue":"38","key":"R16","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000026689","article-title":"Introducing clinical pharmacy specialists into interprofessional primary care teams: assessing pharmacists\u2019 team integration and access to care for rural patients","volume":"100","author":"McCullough","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3928\/19404921-20150522-01","article-title":"Adapting telemonitoring technology use for older adults: a pilot study","volume":"9","author":"Williams","journal-title":"Res Gerontol Nurs"},{"issue":"14","key":"R18","doi-asserted-by":"publisher","first-page":"2192","DOI":"10.1177\/1049732320951526","article-title":"Carrying out rapid qualitative research during a pandemic: emerging lessons from COVID-19","volume":"30","author":"Vindrola-Padros","journal-title":"Qual Health Res"},{"issue":"10","key":"R19","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019993","article-title":"Can rapid approaches to qualitative analysis deliver timely, valid findings to clinical leaders? A mixed methods study comparing rapid and thematic analysis","volume":"8","author":"Taylor","journal-title":"BMJ Open"},{"key":"R20","unstructured":"Hamilton A . Rapid qualitative analysis: updates\/developments. VA Health Services Research. Sep 29, 2020. URL: https:\/\/www.hsrd.research.va.gov\/for_researchers\/cyber_seminars\/archives\/video_archive.cfm?SessionID=3846 [Accessed 10-03-2022]"},{"issue":"6","key":"R21","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1177\/104973230201200611","article-title":"Matrix analysis as a complementary analytic strategy in qualitative inquiry","volume":"12","author":"Averill","journal-title":"Qual Health Res"},{"issue":"12","key":"R22","doi-asserted-by":"publisher","first-page":"3480","DOI":"10.1111\/jgs.18035","article-title":"Older adults\u2019 perspectives on primary care telemedicine during the COVID-19 pandemic","volume":"70","author":"Bhatia","journal-title":"J Am Geriatr Soc"},{"issue":"1","key":"R23","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-022-00960-w","article-title":"Factors affecting medication adherence among older adults using tele-pharmacy services: a scoping review","volume":"80","author":"Emadi","journal-title":"Arch Public Health"},{"issue":"1","key":"R24","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1177\/1539449219859935","article-title":"Feasibility of telehealth-delivered home safety evaluations for caregivers of clients with dementia","volume":"40","author":"Gately","journal-title":"OTJR (Thorofare N J)"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1080\/02701960.2013.870902","article-title":"A multisite geriatric education program for rural providers in the Veteran Health Care System (GRECC-Connect)","volume":"35","author":"Hung","journal-title":"Gerontol Geriatr Educ"},{"issue":"Suppl 1","key":"R26","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s11606-024-08617-w","article-title":"20 years of telehealth in the Veterans Health Administration: taking stock of our past and charting our future","volume":"39","author":"Heyworth","journal-title":"J Gen Intern Med"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T20:43:18Z","timestamp":1786048998000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2026\/1\/e86944"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":26,"URL":"https:\/\/doi.org\/10.2196\/86944","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"article-number":"v10i1e86944"}}