Abstract
Background
This study investigates the use of an information and communication technology (Elder Tree) designed for older adults and their informal caregivers to improve older adult quality of life and address challenges older adults face in maintaining their independence (for example, loneliness and isolation, falling, managing medications, driving and transportation).
Methods/Design
This study, an unblinded randomized controlled trial, will evaluate the effectiveness and cost of Elder Tree. Older adults who are at risk for losing their independence - along with their informal caregivers, if they name them - are randomized to two groups. The intervention group has access to their usual sources of information and communication as well as to Elder Tree for 18 months while the control group uses only their usual sources of information and communication. The primary outcome of the study is older adult quality of life. Secondary outcomes are cost per Quality-Adjusted Life Year and the impact of the technology on independence, loneliness, falls, medication management, driving and transportation, and caregiver appraisal and mastery. We will also examine the mediating effect of self-determination theory. We will evaluate the effectiveness of Elder Tree by comparing intervention- and control-group participants at baseline and months 6, 12, and 18. We will use mixed-effect models to evaluate the primary and secondary outcomes, where pretest score functions as a covariate, treatment condition is a between-subjects factor, and the multivariate outcome reflects scores for a given assessment at the three time points. Separate analyses will be conducted for each outcome. Cost per Quality-Adjusted Life Year will be compared between the intervention and control groups. Additional analyses will examine the mediating effect of self-determination theory on each outcome.
Discussion
Elder Tree is a multifaceted intervention, making it a challenge to assess which services or combinations of services account for outcomes in which subsets of older adults. If Elder Tree can improve quality of life and reduce healthcare costs among older adults, it could suggest a promising way to ease the burden that advancing age can place on older adults, their families, and the healthcare system.
Trial registration
ClinicalTrials.govNCT02128789. Registered on 26 March 2014.
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Details
1 University of Wisconsin-Madison, Center for Health Enhancement Systems Studies, Madison, USA (GRID:grid.14003.36) (ISNI:0000000121673675)
2 Wisconsin Institute for Health Aging, Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health and Executive Director, Madison, USA (GRID:grid.14003.36) (ISNI:0000 0001 2167 3675)
3 University of Wisconsin-Madison, Department of Industrial and Systems Engineering, Madison, USA (GRID:grid.14003.36) (ISNI:0000000121673675)
4 University of Wisconsin-Madison, College of Engineering and School of Business and Executive Director, University of Wisconsin E-Business Institute, Madison, USA (GRID:grid.14003.36) (ISNI:0000000121673675)
5 University of Sydney, Aging, Work & Health Research Group, Faculty of Health Sciences, Sydney, Australia (GRID:grid.1013.3) (ISNI:000000041936834X)
6 University of Wisconsin-Madison, Mass Communication Research Center, School of Journalism and Mass Communication, Madison, USA (GRID:grid.14003.36) (ISNI:0000000121673675)