The University of Southampton
University of Southampton Institutional Repository

Effect of a telecare case management program for older adults who are homebound during the COVID-19 pandemic: a pilot randomized clinical trial

Effect of a telecare case management program for older adults who are homebound during the COVID-19 pandemic: a pilot randomized clinical trial
Effect of a telecare case management program for older adults who are homebound during the COVID-19 pandemic: a pilot randomized clinical trial
Importance: Older adults who are homebound can be difficult to reach owing to their functional limitations and social distancing during the COVID-19 pandemic, leaving their health needs unrecognized at an earlier stage.
Objective: To determine the effectiveness of a telecare case management program for older adults who are homebound during the COVID-19 pandemic. Design, Setting, and Participants: This randomized clinical trial was conducted among 68 older adults in Hong Kong from May 21 to July 20, 2020, with a last follow-up date of October 20, 2020. Inclusion criteria were being 60 years or older, owning a smartphone, and going outside less than once a week in the previous 6 months. Interventions: Participants in the telecare group received weekly case management from a nurse supported by a social service team via telephone call and weekly video messages covering self-care topics delivered via smartphone for 3 months. Participants in the control group received monthly social telephone calls.
Main Outcomes and Measures: The primary outcome was the change in general self-efficacy from before the intervention to after the intervention at 3 months. Self-efficacy was measured by the Chinese version of the 10-item, 4-point General Self-efficacy Scale, with higher scores representing higher self-efficacy levels. Analysis was performed on an intention-to-treat basis.
Results: A total of 68 participants who fulfilled the criteria were enrolled (34 in the control group and 34 in the intervention group; 56 [82.4%] were women; and mean [SD] age, 71.8 [6.1] years). At 3 months, there was no statistical difference in self-efficacy between the telecare group and the control group. Scores for self-efficacy improved in both groups (β = 1.68; 95% CI, -0.68 to 4.03; P =.16). No significant differences were found in basic and instrumental activities of daily living, depression, and use of health care services. However, the telecare group showed statistically significant interactions of group and time effects on medication adherence (β = -8.30; 95% CI, -13.14 to -3.47; P =.001) and quality of life (physical component score: β = 4.99; 95% CI, 0.29-9.69; P =.04). Conclusions and Relevance: In this randomized clinical trial, participants who received the telecare program were statistically no different from the control group with respect to changes in self-efficacy, although scores in both groups improved. After the intervention, the telecare group had better medication adherence and quality of life than the control group, although the small sample size may limit generalizability. A large-scale study is needed to confirm these results. Trial Registration: ClinicalTrials.gov Identifier: NCT04304989.
Wong, Arkers Kwan Ching
584328ce-8848-4177-b38d-4d49f796f8a0
Wong, Frances Kam Yuet
16ef04f5-c554-4606-9b2f-7f604b2495c3
Chow, Karen Kit Sum
91fed928-89c9-456d-bf12-5b2be34cd3c1
Wong, Siu Man
fdb42fa8-fda6-4d0f-afd2-8a940442cadf
Lee, Paul Hong
02620eab-ae7f-4a1c-bad1-8a50e7e48951
Wong, Arkers Kwan Ching
584328ce-8848-4177-b38d-4d49f796f8a0
Wong, Frances Kam Yuet
16ef04f5-c554-4606-9b2f-7f604b2495c3
Chow, Karen Kit Sum
91fed928-89c9-456d-bf12-5b2be34cd3c1
Wong, Siu Man
fdb42fa8-fda6-4d0f-afd2-8a940442cadf
Lee, Paul Hong
02620eab-ae7f-4a1c-bad1-8a50e7e48951

Wong, Arkers Kwan Ching, Wong, Frances Kam Yuet, Chow, Karen Kit Sum, Wong, Siu Man and Lee, Paul Hong (2021) Effect of a telecare case management program for older adults who are homebound during the COVID-19 pandemic: a pilot randomized clinical trial. JAMA Network Open, 4 (9), [e2123453]. (doi:10.1001/jamanetworkopen.2021.23453).

Record type: Article

Abstract

Importance: Older adults who are homebound can be difficult to reach owing to their functional limitations and social distancing during the COVID-19 pandemic, leaving their health needs unrecognized at an earlier stage.
Objective: To determine the effectiveness of a telecare case management program for older adults who are homebound during the COVID-19 pandemic. Design, Setting, and Participants: This randomized clinical trial was conducted among 68 older adults in Hong Kong from May 21 to July 20, 2020, with a last follow-up date of October 20, 2020. Inclusion criteria were being 60 years or older, owning a smartphone, and going outside less than once a week in the previous 6 months. Interventions: Participants in the telecare group received weekly case management from a nurse supported by a social service team via telephone call and weekly video messages covering self-care topics delivered via smartphone for 3 months. Participants in the control group received monthly social telephone calls.
Main Outcomes and Measures: The primary outcome was the change in general self-efficacy from before the intervention to after the intervention at 3 months. Self-efficacy was measured by the Chinese version of the 10-item, 4-point General Self-efficacy Scale, with higher scores representing higher self-efficacy levels. Analysis was performed on an intention-to-treat basis.
Results: A total of 68 participants who fulfilled the criteria were enrolled (34 in the control group and 34 in the intervention group; 56 [82.4%] were women; and mean [SD] age, 71.8 [6.1] years). At 3 months, there was no statistical difference in self-efficacy between the telecare group and the control group. Scores for self-efficacy improved in both groups (β = 1.68; 95% CI, -0.68 to 4.03; P =.16). No significant differences were found in basic and instrumental activities of daily living, depression, and use of health care services. However, the telecare group showed statistically significant interactions of group and time effects on medication adherence (β = -8.30; 95% CI, -13.14 to -3.47; P =.001) and quality of life (physical component score: β = 4.99; 95% CI, 0.29-9.69; P =.04). Conclusions and Relevance: In this randomized clinical trial, participants who received the telecare program were statistically no different from the control group with respect to changes in self-efficacy, although scores in both groups improved. After the intervention, the telecare group had better medication adherence and quality of life than the control group, although the small sample size may limit generalizability. A large-scale study is needed to confirm these results. Trial Registration: ClinicalTrials.gov Identifier: NCT04304989.

This record has no associated files available for download.

More information

Published date: 9 September 2021
Additional Information: Funding/Support: This work was supported by grant P0031004 from the NICHE (Dr A. K. C. Wong). Publisher Copyright: © 2021 American Society of Civil Engineers (ASCE). All rights reserved.

Identifiers

Local EPrints ID: 474964
URI: http://eprints.soton.ac.uk/id/eprint/474964
PURE UUID: 7afd7f73-8baf-48a7-b27b-116005e6f948
ORCID for Paul Hong Lee: ORCID iD orcid.org/0000-0002-5729-6450

Catalogue record

Date deposited: 07 Mar 2023 17:48
Last modified: 06 Jun 2024 02:15

Export record

Altmetrics

Contributors

Author: Arkers Kwan Ching Wong
Author: Frances Kam Yuet Wong
Author: Karen Kit Sum Chow
Author: Siu Man Wong
Author: Paul Hong Lee ORCID iD

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×