Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 29, 2024
Date Accepted: Nov 11, 2024
Date Submitted to PubMed: Nov 28, 2024
Impact of the Smarter Safer Homes Solution on Quality of Life and Health Outcomes in Older People Living in Their Own Homes: Randomized Controlled Trial
ABSTRACT
Background:
An increasing aging population, accompanied by a shortage of residential aged care homes and workforce, and consumer feedback, has driven a growing interest in supporting older people to age in place in home-based settings. In this context, smart home technologies for health monitoring have gained popularity in supporting older people to live in their own homes through remote monitoring. However, there is limited evidence in the literature regarding the impact of smart home monitoring on this population.
Objective:
This study aimed to investigate the impact of smart home monitoring on the Adult Social Care Outcomes Toolkit (ASCOT), EuroQol-5 Dimensions-5 Levels (EQ-5D-5L), Katz Index of Independence in Activities of Daily Living (Katz ADL), Lawton Instrumental Activities of Daily Living Scale (IADL), and Geriatric Depression Scale (GDS) among older people living in their own homes over a 12-month period. The study adheres to the previously published protocol that employs the Smarter Safer Home (SSH) platform introduced in the same manuscript.
Methods:
A total of 195 participants were randomized into control (n=97) and intervention (n=98) groups. The control group continued to receive their existing care from aged care service providers (ACSPs). Meanwhile the intervention group, in addition to receiving their usual aged care services, had the SSH platform installed in their homes, with their ACSPs regularly monitoring them through the SSH. Surveys were conducted at baseline, 6 and 12 months from baseline. Linear mixed effect models were used to compare the difference between the intervention and control groups, with the ASCOT as the primary outcome measure.
Results:
In comparison to the control group, the intervention group had a higher ASCOT score at the 6-month assessment (mean difference: 0.045; 95% CI: 0.001 to 0.089; Cohen d: 0.377). However, the difference in ASCOT scores did not persist at the 12-month assessment (mean difference: 0.031; 95% CI: -0.014 to 0.076; Cohen d: 0.259). There were no significant differences in EQ-5D-5L, Katz ADL, IADL, and GDS observed between the intervention and control groups at the 6-month and 12-month assessments.
Conclusions:
A smart home monitoring platform that provides daily updates on an individual's activities of daily living can be effective in promoting the social care-related quality of life for older individuals living in their own homes. The long-term effect of this technology requires further validation, considering the challenges posed by the COVID-19 pandemic and public health restrictions during the later stage of this randomized controlled trial. Further investigation with a larger sample size is required to validate the impact of SSH on EQ-5D-5L, Katz ADL, IADL, and GDS. Clinical Trial: Australian New Zealand Clinical Trials Registry ACTRN12618000829213; https://tinyurl.com/2n6a75em
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