Passive Remote Monitoring Technologies’ Influence on Home Care Clients’ Ability to Stay Home: Multiprovincial Randomized Controlled Trial

BackgroundResearchers in Nova Scotia and Ontario, Canada, implemented a passive remote monitoring (PRM) model of home care unique to their health system contexts. Each PRM model integrated tailored PRM devices (eg, motion sensors, cameras, and door alarms) into home care pati...

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Main Authors: Lorie Donelle, Bradley Hiebert, Grace Warner, Michael Reid, Jennifer Reid, Salimah Shariff, Emily Richard, Sandra Regan, Lori Weeks, Kathleen Ledoux
Format: Article
Language:English
Published: JMIR Publications 2025-03-01
Series:JMIR Aging
Online Access:https://aging.jmir.org/2025/1/e69107
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author Lorie Donelle
Bradley Hiebert
Grace Warner
Michael Reid
Jennifer Reid
Salimah Shariff
Emily Richard
Sandra Regan
Lori Weeks
Kathleen Ledoux
author_facet Lorie Donelle
Bradley Hiebert
Grace Warner
Michael Reid
Jennifer Reid
Salimah Shariff
Emily Richard
Sandra Regan
Lori Weeks
Kathleen Ledoux
author_sort Lorie Donelle
collection DOAJ
description BackgroundResearchers in Nova Scotia and Ontario, Canada, implemented a passive remote monitoring (PRM) model of home care unique to their health system contexts. Each PRM model integrated tailored PRM devices (eg, motion sensors, cameras, and door alarms) into home care patients’ residences with the aim of linking patients, family and friend caregivers, and health care providers to support older adults’ aging in place. ObjectiveThe purpose of this study was to examine the use of PRM technologies in the home to support older adults’ safe aging in place and avoidance or delay of higher levels of care. MethodsThis multiprovincial pragmatic randomized controlled trial examined how PRM technologies support older adults to safely remain in their home and avoid or delay admission to higher levels of care. Pairs of home care patients and their family and friend caregivers were recruited in Ontario and Nova Scotia. Participant pairs were randomly assigned to one of two conditions: (1) standard home care (ie, control) or (2) standard home care plus study-provided PRM (ie, intervention). Participants provided their provincial health insurance numbers to link with provincial health administrative databases and identify if patients were admitted to higher levels of care after 1 year. Cox proportional hazards models were used to evaluate the primary outcome in each province. ResultsIn total, 313 patient-caregiver pairs were recruited: 174 pairs in Ontario (intervention: n=60; control: n=114) and 139 pairs in Nova Scotia (intervention: n=45; control: n=94). Results indicate PRM was associated with a nonsignificant 30% reduction in risk of patients being admitted to higher levels of care in Ontario (hazard ratio 0.7, 95% CI 0.3-1.4) and no reduction in risk in Nova Scotia (hazard ratio 1.1, 95% CI 0.3-3.7). Adjusting for patient sex had no impact on model estimates for either province. ConclusionsLimitations related, in part, to the impact of the COVID-19 pandemic may have contributed to the effectiveness of the intervention. While our study did not yield statistically significant results (P=.30 and P=.90) regarding the effectiveness of the PRM model in prolonging home stays, the observed trends suggest that technology-assisted aging in place may be a valuable goal for older adults. Further study is required to understand if longer follow-up time allows more effects of PRM on patients’ avoidance of higher levels of care to be detected. Trial RegistrationISRCTN ISRCTN79884651; https://www.isrctn.com/ISRCTN79884651 International Registered Report Identifier (IRRID)RR2-10.2196/15027
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spelling doaj-art-9d8a8b21b7894a5aadb602b9aa76a5d42025-08-20T03:39:45ZengJMIR PublicationsJMIR Aging2561-76052025-03-018e6910710.2196/69107Passive Remote Monitoring Technologies’ Influence on Home Care Clients’ Ability to Stay Home: Multiprovincial Randomized Controlled TrialLorie Donellehttps://orcid.org/0000-0001-9276-8639Bradley Hieberthttps://orcid.org/0000-0003-0361-7156Grace Warnerhttps://orcid.org/0000-0001-9865-865XMichael Reidhttps://orcid.org/0000-0002-5564-4060Jennifer Reidhttps://orcid.org/0009-0001-9591-2285Salimah Shariffhttps://orcid.org/0000-0002-1219-6763Emily Richardhttps://orcid.org/0000-0002-5023-5559Sandra Reganhttps://orcid.org/0000-0002-9675-0054Lori Weekshttps://orcid.org/0000-0001-5334-3320Kathleen Ledouxhttps://orcid.org/0000-0001-5694-7058 BackgroundResearchers in Nova Scotia and Ontario, Canada, implemented a passive remote monitoring (PRM) model of home care unique to their health system contexts. Each PRM model integrated tailored PRM devices (eg, motion sensors, cameras, and door alarms) into home care patients’ residences with the aim of linking patients, family and friend caregivers, and health care providers to support older adults’ aging in place. ObjectiveThe purpose of this study was to examine the use of PRM technologies in the home to support older adults’ safe aging in place and avoidance or delay of higher levels of care. MethodsThis multiprovincial pragmatic randomized controlled trial examined how PRM technologies support older adults to safely remain in their home and avoid or delay admission to higher levels of care. Pairs of home care patients and their family and friend caregivers were recruited in Ontario and Nova Scotia. Participant pairs were randomly assigned to one of two conditions: (1) standard home care (ie, control) or (2) standard home care plus study-provided PRM (ie, intervention). Participants provided their provincial health insurance numbers to link with provincial health administrative databases and identify if patients were admitted to higher levels of care after 1 year. Cox proportional hazards models were used to evaluate the primary outcome in each province. ResultsIn total, 313 patient-caregiver pairs were recruited: 174 pairs in Ontario (intervention: n=60; control: n=114) and 139 pairs in Nova Scotia (intervention: n=45; control: n=94). Results indicate PRM was associated with a nonsignificant 30% reduction in risk of patients being admitted to higher levels of care in Ontario (hazard ratio 0.7, 95% CI 0.3-1.4) and no reduction in risk in Nova Scotia (hazard ratio 1.1, 95% CI 0.3-3.7). Adjusting for patient sex had no impact on model estimates for either province. ConclusionsLimitations related, in part, to the impact of the COVID-19 pandemic may have contributed to the effectiveness of the intervention. While our study did not yield statistically significant results (P=.30 and P=.90) regarding the effectiveness of the PRM model in prolonging home stays, the observed trends suggest that technology-assisted aging in place may be a valuable goal for older adults. Further study is required to understand if longer follow-up time allows more effects of PRM on patients’ avoidance of higher levels of care to be detected. Trial RegistrationISRCTN ISRCTN79884651; https://www.isrctn.com/ISRCTN79884651 International Registered Report Identifier (IRRID)RR2-10.2196/15027https://aging.jmir.org/2025/1/e69107
spellingShingle Lorie Donelle
Bradley Hiebert
Grace Warner
Michael Reid
Jennifer Reid
Salimah Shariff
Emily Richard
Sandra Regan
Lori Weeks
Kathleen Ledoux
Passive Remote Monitoring Technologies’ Influence on Home Care Clients’ Ability to Stay Home: Multiprovincial Randomized Controlled Trial
JMIR Aging
title Passive Remote Monitoring Technologies’ Influence on Home Care Clients’ Ability to Stay Home: Multiprovincial Randomized Controlled Trial
title_full Passive Remote Monitoring Technologies’ Influence on Home Care Clients’ Ability to Stay Home: Multiprovincial Randomized Controlled Trial
title_fullStr Passive Remote Monitoring Technologies’ Influence on Home Care Clients’ Ability to Stay Home: Multiprovincial Randomized Controlled Trial
title_full_unstemmed Passive Remote Monitoring Technologies’ Influence on Home Care Clients’ Ability to Stay Home: Multiprovincial Randomized Controlled Trial
title_short Passive Remote Monitoring Technologies’ Influence on Home Care Clients’ Ability to Stay Home: Multiprovincial Randomized Controlled Trial
title_sort passive remote monitoring technologies influence on home care clients ability to stay home multiprovincial randomized controlled trial
url https://aging.jmir.org/2025/1/e69107
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