Abstract
BackgroundOlder people suffering from frailty often receive fragmented chronic care from multiple professionals. According to the literature, there is an urgent need for coordination of care.ObjectiveThe objective of this study was to investigate the effectiveness of an online health community (OHC) intervention for older people with frailty aimed at facilitating multidisciplinary communication.MethodsThe design was a controlled before-after study with 12 months follow-up in 11 family practices in the eastern part of the Netherlands. Participants consisted of frail older people living in the community requiring multidisciplinary (long-term) care. The intervention used was the health and welfare portal (ZWIP): an OHC for frail elderly patients, their informal caregivers and professionals. ZWIP contains a secure messaging system supplemented by a shared electronic health record. Primary outcomes were scores on the Instrumental Activities of Daily Living scale (IADL), mental health, and social activity limitations.ResultsThere were 290 patients in the intervention group and 392 in the control group. Of these, 76/290 (26.2%) in the intervention group actively used ZWIP. After 12 months follow-up, we observed no significant improvement on primary patient outcomes. ADL improved in the intervention group with a standardized score of 0.21 (P=.27); IADL improved with 0.50 points, P=.64.ConclusionsOnly a small percentage of frail elderly people in the study intensively used ZWIP, our newly developed and innovative eHealth tool. The use of this OHC did not significantly improve patient outcomes. This was most likely due to the limited use of the OHC, and a relatively short follow-up time. Increasing actual use of eHealth intervention seems a precondition for large-scale evaluation, and earlier adoption before frailty develops may improve later use and effectiveness of ZWIP.
Highlights
Chronic care for frail older people is fragmented, with involvement from a large and constantly changing group of professionals who are frequently unaware that they provide care to the same patient [1]
Increasing actual use of eHealth intervention seems a precondition for large-scale evaluation, and earlier adoption before frailty develops may improve later use and effectiveness of Health and Welfare portal (ZWIP). (J Med Internet Res 2014;16(6):e156) doi:10.2196/jmir
Participants in the intervention group were more likely to have completed primary education only, have more informal caregivers, and have higher complexity of care compared to the participants in the control group
Summary
Chronic care for frail older people is fragmented, with involvement from a large and constantly changing group of professionals who are frequently unaware that they provide care to the same patient [1]. Online health communities (OHCs) have been recognized as an effective mechanism for supporting continuous care for frail older people [4], allowing better coordination and more efficient communication with patients and among professionals. OHCs are suited for improving the coordination of care for frail elderly who have multiple professional caregivers. For this purpose, we developed and evaluated the Health and Welfare Information Portal (Zorg en Welzijns Informatie Portaal, ZWIP, in Dutch) [1,6] on its effectiveness. There is an urgent need for coordination of care
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
