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Published in: BMC Medical Informatics and Decision Making 1/2019

Open Access 01-12-2019 | Research article

The use of technology in the context of frailty screening and management interventions: a study of stakeholders’ perspectives

Authors: Holly Gwyther, Lex van Velsen, Rachel L. Shaw, Barbara D’Avanzo, Maria Bujnowska-Fedak, Donata Kurpas, Katarzyna Szwamel, Jan-Willem van’t Klooster, Carol Holland

Published in: BMC Medical Informatics and Decision Making | Issue 1/2019

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Abstract

Background

Health and social care interventions show promise as a way of managing the progression of frailty in older adults. Information technology could improve the availability of interventions and services for older adults. The views of stakeholders on the acceptability of technological solutions for frailty screening and management have not been explored.

Methods

Focus groups were used to gather data from healthy and frail/pre-frail older adults, health and social care providers, and caregivers in three European countries – Italy, Poland and UK. Data were analysed using framework analysis in terms of facilitators or determinants of older adults’ adoption of technology.

Results

Our findings clustered around the perceived value; usability, affordability and accessibility; and emotional benefits of frailty screening and management technology to stakeholders. We also noted issues relating to social support, previous experience of technology and confidence of stakeholders.

Conclusions

Professionals and caregivers understand the benefits of technology to facilitate frailty care pathways but these views are tempered by concerns around social isolation. Frail older adults raised legitimate concerns about the accessibility and usability of technology, specifically around the potential for their personal information to be compromised. Solutions must be developed within a framework that addresses social contexts and avoids stigma around frailty and ageing.
Literature
1.
go back to reference Xue Q-L. The frailty syndrome: definition and natural history. Clin Geriatr Med. 2011;27(1):1–15.CrossRef Xue Q-L. The frailty syndrome: definition and natural history. Clin Geriatr Med. 2011;27(1):1–15.CrossRef
2.
go back to reference Lang PO, Michel JP, Zekry D. Frailty syndrome: a transitional state in a dynamic process. Gerontology. 2009;55:539–49.CrossRef Lang PO, Michel JP, Zekry D. Frailty syndrome: a transitional state in a dynamic process. Gerontology. 2009;55:539–49.CrossRef
3.
go back to reference Topinková E. Aging, disability and frailty. Ann Nutr Metab. 2008;52:6–11.CrossRef Topinková E. Aging, disability and frailty. Ann Nutr Metab. 2008;52:6–11.CrossRef
4.
go back to reference Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381:752–62.CrossRef Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381:752–62.CrossRef
5.
go back to reference Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59:255–63.CrossRef Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59:255–63.CrossRef
6.
go back to reference Fried LP, Tangen C, Walston J, Newman A, Hirsch C, Gottdiener J, Seeman T, Rl T, Kop W, Burke G, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–57.CrossRef Fried LP, Tangen C, Walston J, Newman A, Hirsch C, Gottdiener J, Seeman T, Rl T, Kop W, Burke G, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–57.CrossRef
7.
go back to reference Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. J Gerontol Ser A Biol Med Sci. 2007;62:722–7.CrossRef Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. J Gerontol Ser A Biol Med Sci. 2007;62:722–7.CrossRef
8.
go back to reference Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. Can Med Assoc J. 2005;173:489–95.CrossRef Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, Mitnitski A. A global clinical measure of fitness and frailty in elderly people. Can Med Assoc J. 2005;173:489–95.CrossRef
9.
go back to reference Apóstolo J, Cooke R, Bobrowicz-Campos E, Santana S, Marcucci M, Cano A, Vollenbroek-Hutten M, Germini F, D’Avanzo B, Gwyther H, et al. Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: a systematic review. JBI Database System Rev Implement Rep. 2018;16:140–232.CrossRef Apóstolo J, Cooke R, Bobrowicz-Campos E, Santana S, Marcucci M, Cano A, Vollenbroek-Hutten M, Germini F, D’Avanzo B, Gwyther H, et al. Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: a systematic review. JBI Database System Rev Implement Rep. 2018;16:140–232.CrossRef
10.
go back to reference Gwyther H, Bobrowicz-Campos E, Apóstolo JLA, Marcucci M, Cano A, Holland C. A realist review to understand the efficacy and outcomes of interventions designed to minimise, reverse or prevent the progression of frailty. Health Psychol Rev. 2018:12(4):382–404CrossRef Gwyther H, Bobrowicz-Campos E, Apóstolo JLA, Marcucci M, Cano A, Holland C. A realist review to understand the efficacy and outcomes of interventions designed to minimise, reverse or prevent the progression of frailty. Health Psychol Rev. 2018:12(4):382–404CrossRef
11.
go back to reference Galvin KT, Todres L. Kinds of well-being: a conceptual framework that provides direction for caring. Int J Qual Stud Health Well-being. 2011;6:10362.CrossRef Galvin KT, Todres L. Kinds of well-being: a conceptual framework that provides direction for caring. Int J Qual Stud Health Well-being. 2011;6:10362.CrossRef
12.
go back to reference Cherniack EP, Flores HJ, Troen BR. Emerging therapies to treat frailty syndrome in the elderly. Altern Med Rev. 2007;12(3):246–58.PubMed Cherniack EP, Flores HJ, Troen BR. Emerging therapies to treat frailty syndrome in the elderly. Altern Med Rev. 2007;12(3):246–58.PubMed
13.
go back to reference Shaw RL, Gwyther H, Holland C, Bujinowska-Fedak M, Kurpas D, Cano A, Marcucci M, Riva S, DA B. Understanding frailty: meanings and beliefs about screening and prevention across key stakeholder groups in Europe. Ageing Soc. 2018;38(6):1223–1252. Shaw RL, Gwyther H, Holland C, Bujinowska-Fedak M, Kurpas D, Cano A, Marcucci M, Riva S, DA B. Understanding frailty: meanings and beliefs about screening and prevention across key stakeholder groups in Europe. Ageing Soc. 2018;38(6):1223–1252.
15.
go back to reference Marschollek M, Mix S, Wolf K-H, Effertz B, Haux R, Steinhagen-Thiessen E. ICT-based health information services for elderly people: past experiences, current trends, and future strategies. Med Inform Internet Med. 2007;32(4):251–61.CrossRef Marschollek M, Mix S, Wolf K-H, Effertz B, Haux R, Steinhagen-Thiessen E. ICT-based health information services for elderly people: past experiences, current trends, and future strategies. Med Inform Internet Med. 2007;32(4):251–61.CrossRef
16.
go back to reference Free C, Phillips G, Watson L, Galli L, Felix L, Edwards P, Patel V, Haines A. The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med. 2013;10(1):e1001363.CrossRef Free C, Phillips G, Watson L, Galli L, Felix L, Edwards P, Patel V, Haines A. The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Med. 2013;10(1):e1001363.CrossRef
17.
go back to reference Heart T, Kalderon E. Older adults: are they ready to adopt health-related ICT? Int J Med Inform. 2013;82(11):e209–31.CrossRef Heart T, Kalderon E. Older adults: are they ready to adopt health-related ICT? Int J Med Inform. 2013;82(11):e209–31.CrossRef
18.
go back to reference Vorrink SNW, Antonietti AMGEF, Kort HSM, Troosters T, Zanen P, J-WJ L. Technology use by older adults in the Netherlands and its associations with demographics and health outcomes. Assist Technol. 2017;29(4):188–96.CrossRef Vorrink SNW, Antonietti AMGEF, Kort HSM, Troosters T, Zanen P, J-WJ L. Technology use by older adults in the Netherlands and its associations with demographics and health outcomes. Assist Technol. 2017;29(4):188–96.CrossRef
19.
go back to reference Favela J, Castro LA, Franco-Marina F, Sánchez-García S, Juárez-Cedillo T, Bermudez CE, Mora-Altamirano J, Rodriguez MD, García-Peña C. Nurse home visits with or without alert buttons versus usual care in the frail elderly: a randomized controlled trial. Clin Interv Aging. 2013;8:85–95.PubMedPubMedCentral Favela J, Castro LA, Franco-Marina F, Sánchez-García S, Juárez-Cedillo T, Bermudez CE, Mora-Altamirano J, Rodriguez MD, García-Peña C. Nurse home visits with or without alert buttons versus usual care in the frail elderly: a randomized controlled trial. Clin Interv Aging. 2013;8:85–95.PubMedPubMedCentral
20.
go back to reference van Velsen L, Illario M, Jansen-Kosterink S, Crola C, Di Somma C, Colao A, Vollenbroek-Hutten M. A community-based, technology-supported health Service for Detecting and Preventing Frailty among older adults: a participatory design development process. J Aging Res. 2015;2015:9. van Velsen L, Illario M, Jansen-Kosterink S, Crola C, Di Somma C, Colao A, Vollenbroek-Hutten M. A community-based, technology-supported health Service for Detecting and Preventing Frailty among older adults: a participatory design development process. J Aging Res. 2015;2015:9.
21.
go back to reference Dekker-van Weering M, Jansen-Kosterink S, Frazer S, Vollenbroek-Hutten M. User experience, actual use, and effectiveness of an information communication technology-supported home exercise program for pre-frail older adults. Front Med. 2017;4:208. Dekker-van Weering M, Jansen-Kosterink S, Frazer S, Vollenbroek-Hutten M. User experience, actual use, and effectiveness of an information communication technology-supported home exercise program for pre-frail older adults. Front Med. 2017;4:208.
22.
go back to reference van Velsen L, Frazer S, N'dja A, Ammour N, Del SS, Zia G, Hermens H. The reliability of using tablet Technology for Screening the health of older adults. Stud Health Technol Inform. 2018;247:651–5.PubMed van Velsen L, Frazer S, N'dja A, Ammour N, Del SS, Zia G, Hermens H. The reliability of using tablet Technology for Screening the health of older adults. Stud Health Technol Inform. 2018;247:651–5.PubMed
23.
go back to reference Robbins TD, Lim Choi Keung SN, Arvanitis TN. E-health for active ageing; a systematic review. Maturitas. 2018;114:34–40.CrossRef Robbins TD, Lim Choi Keung SN, Arvanitis TN. E-health for active ageing; a systematic review. Maturitas. 2018;114:34–40.CrossRef
24.
go back to reference Olson KE, O’Brien MA, Rogers WA, Charness N. Diffusion of technology: frequency of use for younger and older adults. Ageing Int. 2011;36(1):123–45.CrossRef Olson KE, O’Brien MA, Rogers WA, Charness N. Diffusion of technology: frequency of use for younger and older adults. Ageing Int. 2011;36(1):123–45.CrossRef
25.
go back to reference Bujnowska-Fedak MM, Mastalerz-Migas A. Usage of medical internet and e-health services by the elderly. In: Environment exposure to pollutants. Cham: Springer; 2014. p. 75–80. Bujnowska-Fedak MM, Mastalerz-Migas A. Usage of medical internet and e-health services by the elderly. In: Environment exposure to pollutants. Cham: Springer; 2014. p. 75–80.
26.
go back to reference König R, Seifert A, Doh M. Internet use among older Europeans: an analysis based on SHARE data. Univ Access Inf Soc. 2018;17(3):621–33.CrossRef König R, Seifert A, Doh M. Internet use among older Europeans: an analysis based on SHARE data. Univ Access Inf Soc. 2018;17(3):621–33.CrossRef
27.
go back to reference Selwyn N, Gorard S, Furlong J, Madden L. Older adults’ use of information and communications technology in everyday life. Ageing Soc. 2003;23(5):561–82.CrossRef Selwyn N, Gorard S, Furlong J, Madden L. Older adults’ use of information and communications technology in everyday life. Ageing Soc. 2003;23(5):561–82.CrossRef
28.
go back to reference Vroman KG, Arthanat S, Lysack C. “Who over 65 is online?” older adults’ dispositions toward information communication technology. Comput Hum Behav. 2015;43:156–66.CrossRef Vroman KG, Arthanat S, Lysack C. Who over 65 is online?” older adults’ dispositions toward information communication technology. Comput Hum Behav. 2015;43:156–66.CrossRef
29.
go back to reference ONS statistical bulletin: ONS statistical bulletin 2017. 2017. ONS statistical bulletin: ONS statistical bulletin 2017. 2017.
30.
go back to reference Bernhardt JM. Health education and the digital divide: building bridges and filling chasms: Oxford University Press; 2000. Bernhardt JM. Health education and the digital divide: building bridges and filling chasms: Oxford University Press; 2000.
31.
go back to reference Jimison H, Gorman P, Woods S, Nygren, P.,, Walker, M., , Norris S, Hersh W: Barriers and drivers of health information technology use for the elderly, chronically III, and underserved. In: Evidence Reports/Technology Assessments, No 175. Agency for Healthcare Research and Quality (US); 2008. Jimison H, Gorman P, Woods S, Nygren, P.,, Walker, M., , Norris S, Hersh W: Barriers and drivers of health information technology use for the elderly, chronically III, and underserved. In: Evidence Reports/Technology Assessments, No 175. Agency for Healthcare Research and Quality (US); 2008.
32.
go back to reference Lee C, Coughlin JF. Perspective: older Adults’ adoption of technology: an integrated approach to identifying determinants and barriers. J Prod Innov Manag. 2015;32(5):747–59.CrossRef Lee C, Coughlin JF. Perspective: older Adults’ adoption of technology: an integrated approach to identifying determinants and barriers. J Prod Innov Manag. 2015;32(5):747–59.CrossRef
33.
go back to reference Peek S, Luijkx K, Vrijhoef H, Nieboer M, Aarts S, Voort C, Rijnaard M, Wouters E. Origins and consequences of technology acquirement by independent-living seniors: towards an integrative model. BMC Geriatr. 2017;17(1):189.CrossRef Peek S, Luijkx K, Vrijhoef H, Nieboer M, Aarts S, Voort C, Rijnaard M, Wouters E. Origins and consequences of technology acquirement by independent-living seniors: towards an integrative model. BMC Geriatr. 2017;17(1):189.CrossRef
35.
go back to reference Glasgow RE, Phillips SM, Sanchez MA. Implementation science approaches for integrating eHealth research into practice and policy. Int J Med Inform. 2014;83(7):e1–e11.CrossRef Glasgow RE, Phillips SM, Sanchez MA. Implementation science approaches for integrating eHealth research into practice and policy. Int J Med Inform. 2014;83(7):e1–e11.CrossRef
36.
go back to reference Stanimirović D, Vintar M. Development of eHealth at a national level–comparative aspects and mapping of general success factors. Inform Health Soc Care. 2014;39(2):140–60.CrossRef Stanimirović D, Vintar M. Development of eHealth at a national level–comparative aspects and mapping of general success factors. Inform Health Soc Care. 2014;39(2):140–60.CrossRef
37.
go back to reference Cano A, Kurpas D, Bujnowska-Fedak M, Santana S, Holland C, Marcucci M, Gonzalez-Segura A, Vollenbroek-Hutten M, D'Avanzo B, Nobili A, et al. FOCUS: frailty management optimisation through EIPAHA commitments and utilisation of stakeholders’ input – an innovative European project in elderly care. Fam Med Prim Care Rev. 2016;18:373–6.CrossRef Cano A, Kurpas D, Bujnowska-Fedak M, Santana S, Holland C, Marcucci M, Gonzalez-Segura A, Vollenbroek-Hutten M, D'Avanzo B, Nobili A, et al. FOCUS: frailty management optimisation through EIPAHA commitments and utilisation of stakeholders’ input – an innovative European project in elderly care. Fam Med Prim Care Rev. 2016;18:373–6.CrossRef
39.
go back to reference Kurpas D, Gwyther H, Szwamel K, Shaw RL, D’Avanzo B, Holland C, Bujnowska-Fedak MM. Patient-centred access to health care: a framework analysis of the care interface for frail older adults. BMC Geriatr. 2018;18(1):273.CrossRef Kurpas D, Gwyther H, Szwamel K, Shaw RL, D’Avanzo B, Holland C, Bujnowska-Fedak MM. Patient-centred access to health care: a framework analysis of the care interface for frail older adults. BMC Geriatr. 2018;18(1):273.CrossRef
40.
go back to reference Ritchie J, Spencer L, O’Connor W. Carrying out qualitative analysis. In: Qualitative research practice: a guide for social science students and researchers. London: Sage; 2003. Ritchie J, Spencer L, O’Connor W. Carrying out qualitative analysis. In: Qualitative research practice: a guide for social science students and researchers. London: Sage; 2003.
41.
go back to reference Van Campen C, editor. Frail older persons in the Netherlands. The Hague: The Netherlands Institue for social research SCP; 2011. Van Campen C, editor. Frail older persons in the Netherlands. The Hague: The Netherlands Institue for social research SCP; 2011.
42.
go back to reference Tanaka T, Takahashi K, Suthutvoravut U, Yoshizawa Y, Fujisaki M, Akishita M, Iijima K. Social frailty: a most important risk factor of frailty and sarcopenia in community-dwelling elderly. Innov Aging. 2017;1(suppl_1):381–2.CrossRef Tanaka T, Takahashi K, Suthutvoravut U, Yoshizawa Y, Fujisaki M, Akishita M, Iijima K. Social frailty: a most important risk factor of frailty and sarcopenia in community-dwelling elderly. Innov Aging. 2017;1(suppl_1):381–2.CrossRef
43.
go back to reference Chang SS, Weiss CO, Xue Q-L, Fried LP. Patterns of comorbid inflammatory diseases in frail older women: the Women’s health and aging studies I and II. J Gerontol A. 2010;65A(4):407–13.CrossRef Chang SS, Weiss CO, Xue Q-L, Fried LP. Patterns of comorbid inflammatory diseases in frail older women: the Women’s health and aging studies I and II. J Gerontol A. 2010;65A(4):407–13.CrossRef
44.
go back to reference Seeman T, Chen X. Risk and protective factors for physical functioning in older adults with and without chronic conditions MacArthur studies of successful aging. J Gerontol B. 2002;57(3):S135–44.CrossRef Seeman T, Chen X. Risk and protective factors for physical functioning in older adults with and without chronic conditions MacArthur studies of successful aging. J Gerontol B. 2002;57(3):S135–44.CrossRef
45.
go back to reference Beukema S, van Velsen L, Jansen-Kosterink S, Karreman J. “There is something we need to tell you…”: communicating health-screening results to older adults via the internet. Telemed E-health. 2017;23(9):741–6.CrossRef Beukema S, van Velsen L, Jansen-Kosterink S, Karreman J. There is something we need to tell you…”: communicating health-screening results to older adults via the internet. Telemed E-health. 2017;23(9):741–6.CrossRef
46.
go back to reference Bouwens S, Mares M, Neven L. Vitality in spite of frailty – a study of Dutch people aged 75+. In: British Society of Gerontology, 47th annual conference. Manchester; 2018. Book Printing UK, Peterborough. Bouwens S, Mares M, Neven L. Vitality in spite of frailty – a study of Dutch people aged 75+. In: British Society of Gerontology, 47th annual conference. Manchester; 2018. Book Printing UK, Peterborough. 
Metadata
Title
The use of technology in the context of frailty screening and management interventions: a study of stakeholders’ perspectives
Authors
Holly Gwyther
Lex van Velsen
Rachel L. Shaw
Barbara D’Avanzo
Maria Bujnowska-Fedak
Donata Kurpas
Katarzyna Szwamel
Jan-Willem van’t Klooster
Carol Holland
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2019
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-019-0828-6

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