Utility of a Medical Alert Protection System compared to telephone follow-up only for home-alone elderly presenting to the ED - A randomized controlled trial

作者：Ong Nicholas Wei Rong^*; Ho Andrew Fu Wah; Chakraborty Bibhas; Fook Chong Stephanie; Yogeswary Pasupathi; Lian Sherman; Xin Xiaohui; Poh Juliana; Chiew Kelvin Koon Yeow; Hock Marcus Eng

来源：American Journal of Emergency Medicine, 2018, 36(4): 594-601.

DOI：10.1016/j.ajem.2017.09.027

• Medical Alert Protection System
• Geriatric emergency medicine
• Personal emergency response system
• Randomized controlled trial
• Personal alarm
• Social alarm

Objective: Medical 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).
Methods: Elderly 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 1 week, 1 month and 6 months) and EQ-5D score (at 6 months) were also administered.
Results: 106 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 (8 days, Interquartile Range [IQR] = (4, 14)) compared to the control arm (15 days, 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).
Conclusion: In this population of elderly ED patients, the use of a MAPS decreased length of stay for admissions and improved quality of life measures.