Effectiveness of information and communication technology-based integrated care for older adults: a systematic review and meta-analysis

Background: Although integrated care has been proposed as a promising approach to actively responding to the global population aging, there is still no exploration of the meticulously integrated care model for older adults living at home. This study aimed to develop an Intelligent and Integrated Older Care Model (SMART System) and evaluate its usability among older individuals. Methods: The development of our SMART system was guided by the knowledge-based Clinical Decision Support System architecture and the principle of neural reflexes, which included 5 phases: (1) functional design; (2) architecture and database design; (3) security measures design; (4) user interface and visualization design; (5) prototypes development and iteratively testing. We then conducted a cross-sectional study to evaluate the usability of the SMART system among older individuals by using the Health Information Technology Usability Evaluation Scale (Health-ITUES). Results: The SMART system consisted of a Care Receiver App, a Professional Care Provider App, and a Cloud Platform. According to the assessment results and daily monitoring data, the SMART system can provide a comprehensive diagnosis of care problems and tailor interventions and implementation approaches to address the multifaceted care needs of older individuals. The interventions and implementation approaches generated by the SMART system, after being reviewed and adjusted by professional nurses, will be sent to the corresponding care providers to promote coordinated care services. The SMART system was perceived as useful and acceptable among older individuals with the mean scores for each item of the Health-ITUES (Older People Version) exceeding 3.00. Conclusions: This study developed the SMART system to facilitate integrated home-based older care. The SMART system was demonstrated to be satisfactory and useful among older individuals.

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Effectiveness of an Intelligent and Integrated Older Care Model on Quality of Life among Home-dwelling Older Adults: A Randomized Controlled Trial (Preprint)

Guo,

Zhang,

Yang

et al. 2024

Preprint

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BACKGROUND Integrated care facilitated by Information and Communication Technology offers a promising approach to actively responding to the global older care burden. However, its effectiveness remains unclear. OBJECTIVE This study aimed to evaluate the effectiveness of an intelligent and integrated older care model (SMART system) in improving the quality of life for older people living at home. METHODS A randomized controlled trial was conducted. After assessing eligibility, participants were randomly allocated in a 1:1 ratio to receive the personalized integrated care delivered by the SMART system or usual care for 3 months from November 1, 2020, to December 31, 2020. The primary endpoint was the percent change in quality of life from baseline to the 3-month follow-up, while secondary endpoints included functional status and percent changes in health self-management ability, social support, and confidence in avoiding falling of older individuals from baseline to the 3-month follow-up. All data analysis followed the intention-to-treat principle. A covariance model or logistic regression model was performed to estimate the effectiveness as appropriate. Subgroup and sensitivity analyses were also conducted to verify the robustness of our findings. RESULTS Of 94 participants included, 48 were assigned to the SMART Group. The SMART system demonstrated a statistically significant improvement in quality of life among home-dwelling older participants, with an estimated intervention difference of 11.97% (95% CI: 7.20%-16.74%, p<0.001). Similarly, it substantially enhanced health self-management ability and social support compared to the usual care (difference: 4.95%, p<0.05; difference: 6.75%, p<0.001). Furthermore, the SMART system significantly reduced instrumental activities of daily living (IADL) disability (OR: 0.34, 95%CI: 0.11-0.83, p=0.024), while no statistically significant reduction in activities of daily living (ADL) disability was observed. The subgroup and sensitivity analyses yielded identical results. CONCLUSIONS Personalized and integrated care provided via the SMART system significantly improved quality of life, health self-management ability, and social support among older individuals, while also reducing IADL disability. CLINICALTRIAL This study was prospectively registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR-IOR-17010368) on 12/01/2017.

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Effectiveness of information and communication technology-based integrated care for older adults: a systematic review and meta-analysis

Cited by 3 publications

References 64 publications

Effect of information and communication technology-based smart care services for physical and cognitive functions in older adults living alone: A quasi-experimental study

Effect of information and communication technology-based smart care services for physical and cognitive functions in older adults living alone: A quasi-experimental study

Development and Usability Testing of An Intelligent and Integrated Older Care Model (SMART System) to Promote Integrated Home-based Older Care

Effectiveness of an Intelligent and Integrated Older Care Model on Quality of Life among Home-dwelling Older Adults: A Randomized Controlled Trial (Preprint)

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