Telecare may boost homebound seniors’ medication adherence according to JAMA study

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Homebound older adults who participated in a telecare program for three months had improved medication adherence and quality of life, according to a study published in JAMA Network Open

TOPLINE DATA

Researchers found study participants who received a telecare program had better medication adherence and quality of life scores compared with a control group.

However, there wasn’t a statistically significant difference between the telecare group and the control group in self-efficacy, or a person’s belief in their ability to achieve a goal. Scores in self-efficacy in both groups improved over time.

HOW IT WAS DONE

The study divided 68 adults in Hong Kong who were 60 years old or older, homebound and owned a smartphone into two groups. Homebound was defined as going outside less than once per week in the previous six months. 

Participants in the telecare group were paired with a nurse who was supported by a social service team. They received weekly phone calls and video messages about self-care for three months between May and July 2020. The control group only received monthly social calls. 

Researchers collected data on self-efficacy, daily living skills such as grooming, medication adherence, depression and use of healthcare services during screening for the study and one week after completion.

THE BACKGROUND

Around 1.6 million adults ages 65 and older are homebound, which can present healthcare delivery challenges, according to an estimate by HHS’ Office of the Assistant Secretary for Planning and Evaluation in April. 

Telehealth and virtual care soared during the COVID-19 pandemic as patients and providers avoided in-person interactions. Although telehealth utilization is falling now, the telehealth share of medical claim lines increased 3,552% from August 2019 to August 2020, according to FAIR Health

Although telehealth programs could be useful for homebound older adults, there are some barriers to adoption.

“Telecare particularly benefits older adults who are homebound and have limited access to customary healthcare services owing to physical disability and face a worsened situation during the pandemic,” wrote the study’s authors. 

“However, the utilization rate of these telehealth programs among older adults who are homebound was low, with reported challenges that included technical compatibility issues and the high cost of installation and maintenance of home health monitoring services.”

CONCLUSION

The study’s authors conceded that their trial was small and could be limited because it was reliant on self-reporting. It also focused on outcomes, not care coordination, and it could benefit from further study.

They also noted that their definition of homebound could be affected by the COVID-19 pandemic, since many people staying at home due to pandemic restrictions may have had fewer health issues than the general homebound population.

“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,” the authors wrote. 

“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.”

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