Preventing frailty with the support of a home-monitoring and communication platform among older adults—a study protocol for a randomised-controlled pilot study in Sweden

Abstract

Background POSITIVE (i.e. maintaining and imPrOving the intrinSIc capaciTy Involving primary care and caregiVErs) is a new intervention program consisting of home-monitoring equipment and a communication platform to support treatment of frailty symptoms initially in primary care and prevent disability in older adults. Methods The primary objectives are to estimate the potential efficacy of the POSITIVE system on improving frailty in at least one point in Fried’s criteria and five points in Frailty Trait Scale. The secondary objectives are to (A) assess the recruitment, retention, drop-out rates, compliance with the intervention and the intervention mechanisms of impact; (B) evaluate the usability and acceptance of the POSITIVE system, and to get estimations on; (C) the potential efficacy of the intervention on improving the participants’ physical performance, cognitive functions, mood, independency level in activities in daily living, the impact on quality of life and number of falls during the follow-up period; (D) the impact on the caregiver quality of life and caregiver burden; and (E) on the consumption of health care resources, participants’ perception of health and level of care received, and healthcare professionals’ workload and satisfaction. A randomised controlled, assessor-blinded pilot study design recruiting from a primary care centre in Stockholm Region will be conducted. Fifty older adults identified as pre-frail or frail will be randomised into a control or an intervention group. Both groups will receive a medical review, nutritional recommendations and Vivifrail physical exercise program. The intervention group will receive the POSITIVE-system including a tablet, the POSITIVE application and portable measurement devices. The participants receiving the POSITIVE program will be monitored remotely by a primary care nurse during a 6-month follow-up. Data will be collected at baseline, 3 and 6 months into the intervention though the platform, standardised assessments and surveys. A process evaluation as per Medical Research Council guidance will be conducted after the 6-month follow-up period. Discussion The implications of the study are to provide estimations on the potential efficacy of the POSITIVE system in improving frailty among older adults and to provide relevant data to inform powered studies of potential efficacy and effectiveness, as well as to inform about the feasibility of the current study design. Trial registration ClinicalTrials.gov. Registration number: NCT04592146. October 19, 2020.

Combined extended reality and reinforcement learning to promote healthcare and reduce social anxiety in fragile X syndrome: a new assessment tool and a rehabilitative strategy

“…The integration and combination of different technologies have been recently postulated and suggested by Stasolla et al ( 2022 , 2023a , b ). Next to the positive outcomes for the participant, one may reasonably argue on the reduction of both caregivers' and families' burdens (Lopez-Vargas et al, 2019 ; Stasolla et al, 2021 ; Teriö et al, 2022 ). The innovative characteristic may be emphasized by the combined integration of both technologies, whose application and implementation may be adopted for both assessment and rehabilitative objectives in the early stages of social anxiety among FXS individuals.…”

POSITIVE: experiences of an intervention aiming for reversing and preventing frailty using a home monitoring and communication platform within primary health care

“…The POSITIVE system (i.e., maintaining and imPrOving the intrinSIc capaciTy Involving primary care and caregiVErs) is a prevention program that includes an intervention and support that consists of home-monitoring equipment with mobile measurement tools and a communication platform connected with primary health care [ 26 ]. The intervention was built on exercises from the Vivifrail program [ 27 ], allowing for individual adjustments of levels depending on frailty, functional capacity, and risk of falls.…”

“…There are a total of six program levels [ 27 ], and these can be adjusted along with participation in the program. A more detailed description can be found in a published study protocol [ 26 ].…”