Healthcare Technology and Falls


Healthcare technology addresses different problems and makes solutions more accessible. Technological interventions exist for fall prevention (Bernocchi et al., 2019). Falls disproportionately affect certain populations, and falls in older adults with arthritis are very common because of the associated balance impairment (Manlapaz, Sole, Jayakaran, & Chapple, 2019; Quach & Burr, 2018). In this paper, the population of older adults with arthritis will be illustrated through the case of an older man who was diagnosed with knee osteoarthritis. Here, primary care settings are reviewed; the patient visits a physician regularly, and his complaints include having near-falls. This paper shows that it is possible to prevent falls in older people with arthritis through the application of telehealth in primary care.

A Synthesized Literature Review with Explanations

A literature review on the topic helps to explain how people with arthritis may need fall prevention technologies. Arthritis is generally associated with falls (Manlapaz et al., 2019; Quach & Burr, 2018; Brenton-Rule, Dalbeth, Bassett, Menz, & Rome, 2015). The evidence may conflict when it comes to particular types of arthritis (Brenton-Rule et al., 2015; Quach & Burr, 2018), but osteoarthritis appears to be connected to falls (Quach & Burr, 2018), including knee osteoarthritis (Manlapaz et al., 2019). A recent systematic review by Manlapaz et al. (2019) shows that risk factors for falls with this condition include comorbidities, greater numbers of affected joints, and balance impairment.

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The recent research on technology-assisted fall prevention in people with arthritis and its specific forms is not very extensive. One of the non-invasive approaches to alleviating the problems associated with arthritis is exercise (Bennell et al., 2016). Its communication technology versions are suggested to be effective in reducing falls (Anderson et al., 2019), although more research may be required for conclusive statements about their general effectiveness (Allen et al., 2018). Still, a new telehealth program, which incorporated exercise instruction and nurse monitoring, was shown to be effective in its ability to decrease fall rates in older adults with significant risks (Bernocchi et al., 2019). In addition, technology-assisted exercise, training, and monitoring are mentioned in a recent overview of the solutions to balance and gait problems in aging adults (Khanuja, Joki, Bachmann, & Cuccurullo, 2018), as well as a systematic review of the use of technology to prevent falls (Hamm, Money, Atwal, & Paraskevopoulos, 2016). In summary, there is sufficient ground to imply that telehealth-based programs which focus on exercise and monitoring could assist patients with significant risks of falls, which includes people with arthritis.

Description of the Situation

The illustrative real-life situation is the case of an older man who was diagnosed with knee osteoarthritis. He has reported near-fall experiences, and he is worried about the possibility of a fall. This concern is reasonable because of his balance problems, which are a risk for patients with arthritis (Manlapaz et al., 2019). The patient has been participating in an exercise-focused program to manage the effects of arthritis, especially pain and balance problems. This intervention is also evidence-based (Bennell et al., 2016). The patient used to be motivated but now expresses less willingness to participate in exercises. He has also reported disliking travels because he has to ask his son to drive him or use public transport, which he usually avoids.

Technology as a Solution: Description and Application

The patient finds it difficult to travel to different destinations, and the treatment which he uses can be carried out at home with the help of telehealth. A recently tested telehealth-assisted exercise program is capable of reducing falls in high-risk populations (Bernocchi et al., 2019). The synchronicity of this method is especially important since it allows for some interaction between the patient and providers (Hamm et al., 2016). The program also offers the opportunity to communicate with the primary care physician or nurse (Bernocchi et al., 2019). Thus, the solution helps to deliver primary and ongoing care, including treatment and monitoring, at home.

The option would be proposed to the patient by his primary care provider, and its advantages and disadvantages would be discussed. This solution would facilitate the monitoring of the patient and his communication with care providers while making the treatment more convenient for him. It would also remove the barrier of distance, and it might help to motivate the patient. The disadvantages include the need for appropriately trained specialists, sufficient equipment, and the patient’s ability and willingness to use it. The latter gap can be resolved through education, but the rest of them require training and funding. The patient would be the one to make the decision, and the primary care specialists would be responsible for adjusting the program to the patient’s needs and monitoring its effectiveness (through patient feedback and objectively measured outcomes) while exploiting the solution’s benefits.

Case Summary

The case focuses on a man with knee osteoarthritis who attends exercise therapy and prefers to avoid traveling because of limited access to transport. As a person with arthritis, he runs an increased risk of falls (Manlapaz et al., 2019). Given the barriers to treatment that he has, telehealth could make his exercise program more accessible while facilitating his communication with and monitoring by his primary care professionals.

Conclusion

People with arthritis, especially some of its types, are more likely to experience falls. Therefore, preventative fall interventions are in order. In the described case, a patient with knee osteoarthritis reports limited access to transport, which is a barrier to his care. His current treatment and communication with primary care providers can be facilitated through telehealth. Some evidence indicates that a telehealth-assisted exercise and monitoring program can reduce falls in similar populations. Therefore, the solution would assist the patient discussed here and can be used with other older adults with comparable conditions.

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References

Allen, K. D., Arbeeva, L., Callahan, L. F., Golightly, Y. M., Goode, A. P., Heiderscheit, B. C.,… Schwartz, T. A. (2018). Physical therapy vs Internet-based exercise training for patients with knee osteoarthritis: Results of a randomized controlled trial. Osteoarthritis and Cartilage, 26(3), 383-396. Web.

Anderson, M. L., Allen, K. D., Golightly, Y. M., Arbeeva, L. S., Goode, A., Huffman, K. M.,… Hill, C. H. (2019). Fall risk and utilization of balance training for adults with symptomatic knee osteoarthritis. Journal of Geriatric Physical Therapy, 42(2), E39-E44. Web.

Bennell, K. L., Ahamed, Y., Jull, G., Bryant, C., Hunt, M. A., Forbes, A. B.,… Egerton, T. (2016). Physical therapist-delivered pain coping skills training and exercise for knee osteoarthritis: Randomized controlled trial. Arthritis Care & Research, 68(5), 590-602. Web.

Bernocchi, P., Giordano, A., Pintavalle, G., Galli, T., Ballini Spoglia, E., Baratti, D., & Scalvini, S. (2019). Feasibility and clinical efficacy of a multidisciplinary home-telehealth program to prevent falls in older adults: A randomized controlled trial. Journal of the American Medical Directors Association, 20(3), 340-346. Web.

Brenton-Rule, A., Dalbeth, N., Bassett, S., Menz, H., & Rome, K. (2015). The incidence and risk factors for falls in adults with rheumatoid arthritis: A systematic review. Seminars in Arthritis and Rheumatism, 44(4), 389-398. Web.

Hamm, J., Money, A., Atwal, A., & Paraskevopoulos, I. (2016). Fall prevention intervention technologies: A conceptual framework and survey of the state of the art. Journal of Biomedical Informatics, 59, 319-345. Web.

Khanuja, K., Joki, J., Bachmann, G., & Cuccurullo, S. (2018). Gait and balance in the aging population: Fall prevention using innovation and technology. Maturitas, 110, 51-56. Web.

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Manlapaz, D., Sole, G., Jayakaran, P., & Chapple, C. (2019). Risk factors for falls in adults with knee osteoarthritis: A systematic review. PM&R, 11(7), 745-757. Web.

Quach, L., & Burr, J. (2018). Arthritis, depression, and falls among community-dwelling older adults: Evidence from the health and retirement study. Journal of Applied Gerontology, 37(9), 1133-1149. Web.

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