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Randomized Controlled Trial Comparative Study
Utility of a Medical Alert Protection System compared to telephone follow-up only for home-alone elderly presenting to the Emergency Department - A randomized controlled trial.
- Nicholas Wei Rong Ong, Ho Andrew Fu Wah AFW Singhealth Emergency Medicine Residency, Singapore., Bibhas Chakraborty, Stephanie Fook-Chong, Pasupathi Yogeswary, Sherman Lian, Xiaohui Xin, Juliana Poh, Kelvin Koon Yeow Chiew, and Ong Marcus Eng Hock MEH Department of Emergency Medicine, Singapore General Hospital, Singapore; Health Services and Systems Research, Duke-NUS Medical School, Singapore..
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
- Am J Emerg Med. 2018 Apr 1; 36 (4): 594-601.
ObjectiveMedical Alert Protection Systems (MAPS) are a form of assistive technology designed to support independent living in the care of elderly patients in the community. We aimed to investigate the utility of using such a device (eAlert! System) in elderly patients presenting to an Emergency Department (ED).MethodsElderly patients presenting to an ED were randomized to receive MAPS or telephone follow-up only (control arm). All patients were followed up at one-week, one-month and six-month post-intervention. A confidence scale (at 1week, 1month and 6months) and EQ-5D score (at 6months) were also administered.Results106 and 91 participants enrolled in the MAPS and control arms respectively. Within both individual arms, there were significant reductions in the median number of ED visits and median number of admissions in the six month periods before, compared to after intervention (p<0.01 for both). However, the reductions were not significantly different between the two arms. Among participants who have had one or more admissions during the six months period post intervention, the MAPS arm had significantly lower median total length of stay (8days, Interquartile Range [IQR]=(4, 14)) compared to the control arm (15days, IQR=(3, 25), p=0.045). The median health state score for health state was significantly higher in the MAPS arm (70 IQR=(60,80) versus 60 IQR=(50,70), p=0.008).ConclusionIn this population of elderly ED patients, the use of a MAPS decreased length of stay for admissions and improved quality of life measures.Copyright © 2017 Elsevier Inc. All rights reserved.
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