Written by Priyanka Vandersman, Research Associate, Research Centre for Palliative Care, Death & Dying
By the year 2050, over a quarter of the population in high-income countries is expected to be over 65 years old. (1) The ageing population will inevitably put more pressure on the aged and health care sector with its increased need for supported living, and chronic illness care and management. In the last decade, digital technologies have been purported as a solution to meeting the health and care needs of the ageing population. (2) Indeed, appropriate integration of well-designed and tested technological solutions could result in improved health outcomes, increased efficiency, and ultimately, reduced healthcare expenditure. However, the area of digital health technology research is still in its infancy, with very little evidence of its efficacy or effectiveness. (3) While the promises of novel digital technologies are yet to be appropriately evaluated, these technologies are being increasingly adopted by the healthcare sector and older people alike. Given this reality, timely and robust body of research exploring the potential, and the risks associated with digital health technology is necessary to inform future health and aged care practices.
To contribute towards the above noted knowledge gap, my doctoral program of research aimed to explore the mobile technology aspect of digital health use in the context of chronic disease self-management. Using a mixed methods design, my PhD project (Enrolled: University of Notre Dame Australia, Sydney) evaluated the feasibility of using a publicly available pain self-management app in helping community dwelling older people better manage their arthritic pain. Integration of the data from the two reviews and three primary studies comprising my PhD revealed that meaningful and sustainable use of apps by older people for their arthritic pain self-management requires involvement of older people, clinicians, researchers and app developers in the design, development and integration process. The data also revealed the need for ongoing research activities to continually evaluate and refine these apps, while also assessing their impact and cost effectiveness. On a systems level, there seems to be opportunity to build synchronised and strategic approaches to promote, legislate and guide practices relating to use of pain self-management apps for arthritic pain self-management of older people.
While these findings that emerged from the study data are expected and valuable addition to the body of knowledge, the unexpected and indirect learnings of this PhD are similarly meaningful. My five year doctoral project encountered some challenges, which was partly expected, given the area of app use among older people is still evolving, and there is little shared knowledge on common pitfalls of app based studies. Experiences such as: recruiting older people from community organisations, helping older people download/use/troubleshoot the app, considering how to manage a third party owned intervention (the app), and involving primary and allied health clinicians in an interview; all contributed to the comprehensive learnings of the project. Having completed my PhD project, I am very excited to bring my knowledge and experience of digital health technology research across to the Research Centre for Palliative care, Death and Dying (RePaDD) at Flinders University. I am certain that RePaDD’s interest in Digital technology will positively contribute towards this important and growing area of research.
In my fulltime role as a Research Associate for the ‘End of Life Directions in Aged Care’ (ELDAC) project’s Digital Technology stream, I keep my weekdays busy liaising with the aged care IT industry sector: finding out ways to integrate new technological solutions into their existing systems, or developing study protocol to evaluate implementation of novel technologies in the aged care setting. My weekends are generally occupied with enjoying beauty of Adelaide, doing some recreational reading, or contemplating doing another systematic review. Overall, it has been a great experience being a Flinders staff, and a member of the RePaDD, and I am looking forward to opportunities of collaboration and joint exploration of the ways in which digital technologies can influence the experiences of people living with, and dying of chronic diseases.
1. United Nations. World Population Prospects 2019: Highlights. New York (US): United Nations Department for Economic and Social Affairs. 2019.
2. Hamine S, Gerth-Guyette E, Faulx D, Green BB, Ginsburg AS. Impact of Health chronic disease management on treatment adherence and patient outcomes: a systematic review. Journal of medical Internet research. 2015;17(2):e52.
3. Rahimi K. Digital health and the elusive quest for cost savings. The Lancet Digital Health. 2019 Jul 1;1(3):e108-9.