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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

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...

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Autores principales: Wong, Arkers Kwan Ching, Wong, Frances Kam Yuet, Chow, Karen Kit Sum, Wong, Siu Man, Bayuo, Jonathan, Ho, Annie Ka Ying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9647479/
https://www.ncbi.nlm.nih.gov/pubmed/36350651
http://dx.doi.org/10.1001/jamanetworkopen.2022.41137
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author Wong, Arkers Kwan Ching
Wong, Frances Kam Yuet
Chow, Karen Kit Sum
Wong, Siu Man
Bayuo, Jonathan
Ho, Annie Ka Ying
author_facet Wong, Arkers Kwan Ching
Wong, Frances Kam Yuet
Chow, Karen Kit Sum
Wong, Siu Man
Bayuo, Jonathan
Ho, Annie Ka Ying
author_sort Wong, Arkers Kwan Ching
collection PubMed
description 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
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spelling pubmed-96474792022-11-28 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 Wong, Arkers Kwan Ching Wong, Frances Kam Yuet Chow, Karen Kit Sum Wong, Siu Man Bayuo, Jonathan Ho, Annie Ka Ying JAMA Netw Open Original Investigation 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 American Medical Association 2022-11-09 /pmc/articles/PMC9647479/ /pubmed/36350651 http://dx.doi.org/10.1001/jamanetworkopen.2022.41137 Text en Copyright 2022 Wong AKC et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Wong, Arkers Kwan Ching
Wong, Frances Kam Yuet
Chow, Karen Kit Sum
Wong, Siu Man
Bayuo, Jonathan
Ho, Annie Ka Ying
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
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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9647479/
https://www.ncbi.nlm.nih.gov/pubmed/36350651
http://dx.doi.org/10.1001/jamanetworkopen.2022.41137
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