title: The effect of telecare on the quality of life and psychological well-being of elderly recipients of social care over a 12-month period: the Whole Systems Demonstrator cluster randomised trial.
abstract: BACKGROUND
  home-based telecare (TC) is utilised to manage risks of independent living and provide prompt emergency responses. This study examined the effect of TC on health-related quality of life (HRQoL), anxiety and depressive symptoms over 12 months in patients receiving social care.
  
  
  METHODS
  a study of participant-reported outcomes [the Whole Systems Demonstrator (WSD) Telecare Questionnaire Study; baseline n = 1,189] was nested in a pragmatic cluster-randomised trial of TC (the WSD Telecare trial), held across three English Local Authorities. General practice (GP) was the unit of randomisation and TC was compared with usual care (UC).
  
  
  METHODS
  participant-reported outcome measures were collected at baseline, short-term (4 months) and long-term (12 months) follow-up, assessing generic HRQoL, anxiety and depressive symptoms. Primary intention-to-treat analyses tested treatment effectiveness and were conducted using multilevel models to control for GP clustering and covariates for participants who completed questionnaire measures at baseline assessment plus at least one other assessment (n = 873).
  
  
  RESULTS
  analyses found significant differences between TC and UC on Short Form-12 mental component scores (P < 0.05), with parameter estimates indicating being a member of the TC trial-arm increases mental component scores (UC-adjusted mean = 40.52; TC-adjusted mean = 43.69). Additional significant analyses revealed, time effects on EQ5D (decreasing over time) and depressive symptoms (increasing over time).
  
  
  CONCLUSIONS
  TC potentially contributes to the amelioration in the decline in users' mental HRQoL over a 12-month period. TC may not transform the lives of its users, but it may afford small relative benefits on some psychological and HRQOL outcomes relative to users who only receive UC. International Standard Randomised Controlled Trial Number Register: ISRCTN 43002091.
authors: School of Health Sciences, City University London, London, UK.
authors: Shashivadan Parbat
authors: SP
authors: Hirani
authors: Michelle
authors: M
authors: Beynon
authors: Martin
authors: M
authors: Cartwright
authors: Lorna
authors: L
authors: Rixon
authors: Helen
authors: H
authors: Doll
authors: Catherine
authors: C
authors: Henderson
authors: Martin
authors: M
authors: Bardsley
authors: Adam
authors: A
authors: Steventon
authors: Martin
authors: M
authors: Knapp
authors: Anne
authors: A
authors: Rogers
authors: Peter
authors: P
authors: Bower
authors: Caroline
authors: C
authors: Sanders
authors: Ray
authors: R
authors: Fitzpatrick
authors: Jane
authors: J
authors: Hendy
authors: Stanton Peter
authors: SP
authors: Newman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D056902:Clinical Alarms; D003362:Cost-Benefit Analysis; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D004630:Emergencies / Q000523:psychology*; D004632:Emergency Medical Services / Q000379:methods*; D005194:Family Practice / Q000379:methods; D005260:Female; D015577:Geriatric Assessment; D006699:Home Care Services; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011788:Quality of Life / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods / Q000458:organization & administration; D006113:United Kingdom
keywords: assistive technology; cluster-randomised trial; older people; quality of life; telecare