Background & Aims
Despite a growing need for community based digital services to care for chronic pain among socially vulnerable older adults, the development and implementation of a publicly accessible digital healthcare system for older adults have been hindered by a lack of studies among older adult users and their community service providers in the ordinary living environments.
Using quasi-experimental design of a 6-week living lab trials with a group of older adults and the age-gender matched control, this study tested the efficacy of a digital health monitoring platform to inform older adult users and their community service providers day-to-day changes in pain, depressive symptoms, and health status. The platform was designed to link older adults with a publicly provided community senior care service via mobile apps and a website for older adults and their community service providers.
Methods
A quasi-experimental, non-randomized 6-week living lab trial for testing the efficacy of the digital health monitoring platform was conducted with socially vulnerable older adults (n = 35) and the age and gender matched control group (n = 38). The community service providers (n = 16) and a managerial social worker (n = 1) also participated. Pain status and depressive symptoms were assessed daily using VAS and PHQ-9 items via scripted verbal conversations using a mobile chatbot. Digital sensing of daily health status, including HRV, sleep, and physical activity, were assessed using a wearable sensor (Fitbit Sense), which was worn continuously, except charging time. Daily individualized feedback utilizing traffic signal signs on the health and emergency status was also displayed on the mobile application for the users and a web/app for their community caregiving service providers. Pre-post tests examined changes in pain and functional limitations, depressive symptoms, and sleep quality.
Results
Older adult participants in the living lab and the control group included 80% of women and have the mean age of 75.36 years (SD = 4.48, ranges from 66 to 88). They reported to have on average 4.2 different kinds of chronic disease conditions with 48.7% osteoarthritis, 32.1% diabetes, and 9.0% cancer. The average levels of pain and functional limitation were 29.06 (SD = 18.96) at baseline with no significant group differences. The pre-post test results showed the significant group by time effects on pain and functional limitations (F(1, 70) = 815.224, p = 0.022). Compared to the control group, older adults in the living lab showed a reduction in levels of pain and functional limitations from pre to post-test. The effects of using the platform on depressive symptoms and sleep quality were not significant. The usability was confirmed by daily usage of a platform by older adults and community caregivers.
Conclusions
The results suggest that receiving individualized health feedback using a digital platform and sharing it with their community caregivers to receive timely in-person caregiving services may help improve pain and functional health of older adults. However, the results indicate that additional and more specialized services may be needed to improve depressive symptoms and sleep problems of older adults (Registration: Clinicaltrials.gov NCT06270121, https://clinicaltrials.gov/study/NCT06270121).
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Presenting Author
Sunmi Song
Poster Authors
Topics
- Evidence, Clinical Trials, Systematic Review, Guidelines, and Implementation Science