Effect of an eHealth intervention on older adults' quality of life and health-related outcomes: a randomized clinical trial.

ABSTRACT:

Background

By 2030, the number of US adults age ≥65 will exceed 70 million. Their quality of life has been declared a national priority by the US government.

Objective

Assess effects of an eHealth intervention for older adults on quality of life, independence, and related outcomes.

Design

Multi-site, 2-arm (1:1), non-blinded randomized clinical trial. Recruitment November 2013 to May 2015; data collection through November 2016.

Setting

Three Wisconsin communities (urban, suburban, and rural).

Participants

Purposive community-based sample, 390 adults age ≥65 with health challenges.

Exclusions

long-term care, inability to get out of bed/chair unassisted.

Intervention

Access (vs. no access) to interactive website (ElderTree) designed to improve quality of life, social connection, and independence.

Measures

Primary outcome: quality of life (PROMIS Global Health). Secondary: independence (Instrumental Activities of Daily Living); social support (MOS Social Support); depression (Patient Health Questionnaire-8); falls prevention (Falls Behavioral Scale). Moderation: healthcare use (Medical Services Utilization). Both groups completed all measures at baseline, 6, and 12 months.

Results

Three hundred ten participants (79%) completed the 12-month survey. There were no main effects of ElderTree over time. Moderation analyses indicated that among participants with high primary care use, ElderTree (vs. control) led to better trajectories for mental quality of life (OR=0.32, 95% CI 0.10-0.54, P=0.005), social support received (OR=0.17, 95% CI 0.05-0.29, P=0.007), social support provided (OR=0.29, 95% CI 0.13-0.45, P<0.001), and depression (OR= -0.20, 95% CI -0.39 to -0.01, P=0.034). Supplemental analyses suggested ElderTree may be more effective among people with multiple (vs. 0 or 1) chronic conditions.

Limitations

Once randomized, participants were not blind to the condition; self-reports may be subject to memory bias.

Conclusion

Interventions like ET may help improve quality of life and socio-emotional outcomes among older adults with more illness burden. Our next study focuses on this population.

Trial registration

ClinicalTrials.gov ; registration ID number: NCT02128789.

SUBMITTER: Gustafson DH 

PROVIDER: S-EPMC8183591 | biostudies-literature |

REPOSITORIES: biostudies-literature