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- Title
Effect of a Mobile Health Application With Nurse Support on Quality of Life Among Community-Dwelling Older Adults in Hong Kong: A Randomized Clinical Trial.
- Authors
Wong, Arkers Kwan Ching; Wong, Frances Kam Yuet; Chow, Karen Kit Sum; Wong, Siu Man; Bayuo, Jonathan; Ho, Annie Ka Ying
- Abstract
Key Points: Question: Can a mobile health (mHealth) smartphone app delivered by a nurse case manager supported by a health-social partnership team improve quality of life among community-dwelling older adults in Hong Kong? Findings: In this randomized clinical trial with 221 participants, the mHealth program with the proactive support of a nurse case manager and the health-social partnership team was not significantly more effective than either the mHealth program alone or the usual care control in enhancing quality of life among community-dwelling older adults. Meaning: This randomized clinical trial found that the implementation of an interactive mHealth program with the support of a health-social partnership did not enable older adults to better manage their health in the community. This randomized clinical trial evaluates the efficacy of a nurse-supported interactive mobile health smartphone app on quality of life among community-dwelling older adults in Hong Kong. Importance: Mobile health (mHealth) smartphone apps are becoming increasingly popular among older adults, although the reactive care approach of these apps has limited their usability. Objective: To evaluate the effects of an interactive mHealth program supported by a health-social partnership team on quality of life (QOL) among community-dwelling older adults in Hong Kong. Design, Setting, and Participants: This was a 3-group, randomized clinical trial conducted in 5 community centers in Hong Kong from December 1, 2020, to April 30, 2022, with a last follow-up date of January 31, 2022. Participants included older adults aged at least 60 years who were living within the service area, used a smartphone, and had at least 1 of the following problems: chronic pain, hypertension, or diabetes. Data were analyzed from May 1 to 10, 2022. Interventions: Participants were randomly assigned to the mHealth with interactivity (mHealth+I) group, mHealth group, or control group. Participants in the mHealth+I group received the mHealth app and nurse case management supported by a health-social partnership team. The mHealth group received the mHealth app only. The control group received no mHealth app or health-social care services. Main Outcomes and Measures: The primary outcome was the change in QOL from baseline to 3 months after completion of the intervention. Results: Among 221 participants (mean [SD] age 76.6 [8.0] years; 185 [83.7%] women), 76 were randomized to the control group, 71 were randomized to the mHealth group, and 74 were randomized to the mHealth+I group. The most common chronic diseases or problems were hypertension (147 participants [66.5%]), pain (144 participants [65.2%]), cataracts (72 participants [32.6%]), and diabetes (61 participants [27.6%]). At 3 months after the intervention and compared with the intervention group, there were no statistically significant differences in either the physical component summary (mHealth+I: β = −1.01 [95% CI, −4.13 to 2.11]; P =.53; mHealth: β = 0.22 [95% CI, −3.07 to 3.50]; P =.90) or the mental component summary (mHealth+I: β = −0.87 [95% CI, −4.42 to 2.69]; P =.63; mHealth: β = 1.73 [95% CI, −1.89 to 5.34]; P =.35) QOL scores. Only secondary outcomes, including self-efficacy (β = −2.31 [95% CI, −4.26 to −0.36]; P =.02), systolic blood pressure (β = −2.30 [95% CI, −5.00 to −0.13]; P =.04), pain levels (β = 1.18 [95% CI, 0.52 to 2.00]; P =.02), and health services utilization (β = 0.98 [95% CI, 0.32 to 2.09]; P =.048) improved in the mHealth+I group compared with the control group. Conclusions and Relevance: This randomized clinical trial found no difference in the primary outcome between the mHealth+I group and the control group confirming that there were no incremental benefits to adding interactivity in mHealth programs for older adults with chronic diseases. Trial Registration: Clinicaltrials.gov Identifier: NCT03878212
- Subjects
HONG Kong (China); EVALUATION of human services programs; SOCIAL support; MOBILE apps; SELF-management (Psychology); SMARTPHONES; MEDICAL care; RANDOMIZED controlled trials; MEDICAL care use; INTERPROFESSIONAL relations; QUALITY of life; INDEPENDENT living; DESCRIPTIVE statistics; RESEARCH funding; INTEGRATED health care delivery; SOCIAL services; STATISTICAL sampling; TELEMEDICINE
- Publication
JAMA Network Open, 2022, Vol 5, Issue 11, pe2241137
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2022.41137