Evidence map›Paper›PMID 33492349›Full record

Trial reportAge and ageing2021

The effectiveness and cost-effectiveness of assistive technology and telecare for independent living in dementia: a randomised controlled trial.

Robert Howard, Rebecca Gathercole, Rosie Bradley, Emma Harper, Lucy Davis, Lynn Pank, Natalie Lam, Emma Talbot, Emma Hooper, Rachel Winson and 18 more

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Age and ageing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 8 pooled it
11.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 8 syntheses or guidelines pooled it, 69 citations in OpenAlex.

  1. Pooled it
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  5. Cognitive rehabilitation for people with mild to moderate dementia.The Cochrane database of systematic reviews · 2023
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  19. Technology that CARES: Enhancing dementia care through everyday technologies.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors at 19 institutions in 2 countries.

Robert HowardUniversity College London, UK.
Rebecca GathercoleKing's College London, UK.
Rosie BradleyMedical Research Council Population Health Research Unit, UK.
Emma HarperMedical Research Council Population Health Research Unit, UK.
Lucy DavisMedical Research Council Population Health Research Unit, UK.
Lynn PankMedical Research Council Population Health Research Unit, UK.
Natalie LamMedical Research Council Population Health Research Unit, UK.
Emma TalbotNorfolk and Suffolk NHS Foundation Trust, UK.
Emma HooperLancashire Care NHS Foundation Trust and University of Manchester, UK.
Rachel WinsonCambridgeshire and Peterborough NHS Foundation Trust, UK.
Bethany ScuttKing's College London, UK.
Victoria Ordonez MontanoHertfordshire Community Services NHS Trust, UK.
Samantha NunnCambridgeshire Community Services NHS Trust, UK.
Grace LavelleKing's College London, UK.
Andrew BatemanUniversity of Essex, UK.
Peter BenthamBirmingham and Solihull Mental Health NHS Foundation Trust, UK.
Alistair BurnsUniversity of Manchester, UK.
Barbara DunkSouth London and Maudsley NHS Foundation Trust, UK.
Kirsty ForsythQueen Margaret University, UK.
Chris FoxUniversity of East Anglia, UK.
Fiona PolandUniversity of East Anglia, UK.
Iracema LeroiTrinity College Dublin, Ireland.
Stanton NewmanCity, University of London, UK.
John O'BrienUniversity of Cambridge, UK.
Catherine HendersonLondon School of Economics and Political Science, UK.
Martin KnappLondon School of Economics and Political Science, UK.
John WoolhamKing's College London, UK.
Richard GrayMedical Research Council Population Health Research Unit, UK.
King's College London · GBMedical Research Council · GBLondon School of Economics and Political Science · GBMRC Population Health Research UnitUniversity of East Anglia · GBBirmingham and Solihull Mental Health NHS Foundation Trust · GBCambridgeshire and Peterborough NHS Foundation Trust · GBCambridgeshire Community Services NHS Trust · GBCity, University of London · GBHertfordshire Community NHS Trust · GBLancashire Care NHS Foundation Trust · GBNorfolk and Suffolk NHS Foundation Trust · GBQueen Margaret University · GBSouth London and Maudsley NHS Foundation Trust · GBTrinity College Dublin · IEUniversity College London · GBUniversity of Cambridge · GBUniversity of Essex · GBUniversity of Manchester · GB

Funding

Department of Health 10/50/02
6 · The paper itself

Abstract

objectivesThe use of assistive technology and telecare (ATT) has been promoted to manage risks associated with independent living in people with dementia but with little evidence for effectiveness.

methodsParticipants were randomly assigned to receive an ATT assessment followed by installation of all appropriate ATT devices or limited control of appropriate ATT. The primary outcomes were time to institutionalisation and cost-effectiveness. Key secondary outcomes were number of incidents involving risks to safety, burden and stress in family caregivers and quality of life.

resultsParticipants were assigned to receive full ATT (248 participants) or the limited control (247 participants). After adjusting for baseline imbalance of activities of daily living score, HR for median pre-institutionalisation survival was 0.84; 95% CI, 0.63 to 1.12; P = 0.20. There were no significant differences between arms in health and social care (mean -£909; 95% CI, -£5,336 to £3,345, P = 0.678) and societal costs (mean -£3,545; 95% CI, -£13,914 to £6,581, P = 0.499). ATT group members had reduced participant-rated quality-adjusted life years (QALYs) at 104 weeks (mean - 0.105; 95% CI, -0.204 to -0.007, P = 0.037) but did not differ in QALYs derived from proxy-reported EQ-5D. DISCUSSION: Fidelity of the intervention was low in terms of matching ATT assessment, recommendations and installation. This, however, reflects current practice within adult social care in England.

conclusionsTime living independently outside a care home was not significantly longer in participants who received full ATT and ATT was not cost-effective. Participants with full ATT attained fewer QALYs based on participant-reported EQ-5D than controls at 104 weeks.

Indexed as

DementiaSelf-Help DevicesActivities of Daily LivingCost-Benefit AnalysisEnglandHumansIndependent LivingQuality-Adjusted Life YearsQuality of Lifeassistive technologydementiaindependent livingolder peoplesocial caretelecare

Identifiers

PMID33492349
PMCPMC8099012
OpenAlexW3111311122

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.