Back to Browse Journals » International Journal of General Medicine » Volume 6

Effects of home telemonitoring on transitions between frailty states and death for older adults: a randomized controlled trial

Authors Upatising B, Hanson GJ, Kim YL, Cha SS, Yih Y, Takahashi PY

Published Date March 2013 Volume 2013:6 Pages 145—151

DOI http://dx.doi.org/10.2147/IJGM.S40576

Received 30 November 1999, Accepted 4 January 2013, Published 14 March 2013

Benjavan Upatising,1 Gregory J Hanson,2 Young L Kim,3 Stephen S Cha,4 Yuehwern Yih,1 Paul Y Takahashi2

1School of Industrial Engineering, Purdue University, West Lafayette, IN, USA; 2Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA; 3School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; 4Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

Background: Two primary objectives when caring for older adults are to slow the decline to a worsened frailty state and to prevent disability. Telemedicine may be one method of improving care in this population. We conducted a secondary analysis of the Tele-ERA study to evaluate the effect of home telemonitoring in reducing the rate of deterioration into a frailty state and death in older adults with comorbid health problems.
Methods: This trial involved 205 adults over the age of 60 years with a high risk of hospitalization and emergency department visits. For 12 months, the intervention group received usual medical care and telemonitoring case management, and the control group received usual care alone. The primary outcome was frailty, which was based on five criteria, ie, weight loss, weakness, exhaustion, low activity, and slow gait speed. Participants were classified as frail if they met three or more criteria; prefrail if they met 1–2 criteria; and not frail if they met no criteria. Both groups were assessed for frailty at baseline, and at 6 and 12 months. Frailty transition analyses were performed using a multiple logistic regression method. Kaplan–Meier and Cox proportional hazards methods were used to evaluate each frailty criteria for mortality and to compute unadjusted hazard ratios associated with being telemonitored, respectively. A retrospective power analysis was computed.
Results: During the first 6 months, 19 (25%) telemonitoring participants declined in frailty status or died, compared with 17 (19%) in usual care (odds ratio 1.41, 95% confidence interval [CI] 0.65–3.06, P = 0.38). In the subsequent 6 months, there was no transition to a frailty state, but seven (7%) participants from the telemonitoring and one (1%) from usual care group died (odds ratio 5.94, 95% CI 0.52–68.48, P = 0.15). Gait speed (hazards ratio 3.49, 95% CI 1.42–8.58) and low activity (hazards ratio 3.10, 95% CI 1.25–7.71) were shown to predict mortality.
Conclusion: This study did not provide sufficient evidence to show that the telemonitoring group did better than usual care in reducing the decline of frailty states and death. Transitions occurred primarily in the first 6 months.

Keywords: telemedicine, high-risk elderly persons, frailty transition, functional decline

A Letter to the Editor has been received and published for this article.

Download Article [PDF] View Full Text [HTML] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Pharmacokinetics and pharmacodynamics of acetylsalicylic acid after intravenous and oral administration to healthy volunteers

Nagelschmitz J, Blunck M, Kraetzschmar J, Ludwig M, Wensing G, Hohlfeld T

Clinical Pharmacology: Advances and Applications 2014, 6:51-59

Published Date: 19 March 2014

Population pharmacokinetics of olprinone in healthy male volunteers

Kunisawa T, Kasai H, Suda M, Yoshimura M, Sugawara A, Izumi Y, Iida T, Kurosawa A, Iwasaki H

Clinical Pharmacology: Advances and Applications 2014, 6:43-50

Published Date: 4 March 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Detemir as a once-daily basal insulin in type 2 diabetes

Nelson SE

Clinical Pharmacology: Advances and Applications 2011, 3:27-37

Published Date: 18 August 2011

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010