One study does not demonstrate the efficacy or cost/effectiveness of an electronic monitoring system in the prevention of depression and anxiety among seniors living in specialized residences.
A randomized controlled trial by Bosmans and colleagues published in the International Journal of Geriatric Psychiatry in 2013 tested the benefits of an electronic monitoring system on 93 people without depressive, anxiety or cognitive disorders living in a specialized residential home compared to 92 people without special equipment. The intervention tested includes a video surveillance system, more if necessary and in a gradual manner, a programme to help manage depression with a "coach", a consultation with a nurse taking stock of life, and finally a consultation with a general practitioner. After 10 months, the study did not show any benefit on depression scores. The number of anxiety disorders doubled in the intervention group as opposed to the control group, which remained stable. Statistically, no difference was obtained between the groups on markers of anxiety, depression or quality of life. The study also analyzed health costs. The intervention group has an extra expenditure of 838 euros but the difference between the two groups is not statistically significant. The authors conclude by mentioning that the system tested does not provide proof of its interest for people who do not suffer from anxiety or depression and who live in specialized residences.
Rationale for the study
Anxiety and depression are common disorders among seniors living in specialized residences. They affect nearly one-third of this population. Preventing these disorders by means of an electronic video surveillance system that detects signs of depression or anxiety at an early stage, accompanied by a therapeutic education programme, can be a promising solution from both a medical and an economic point of view.
The question asked
Does a video surveillance system designed to detect signs of depression and anxiety combined with a gradual therapeutic education program reduce anxiety and depressive disorders and care costs for seniors living in specialized residences?
Does the protocol
The randomized controlled trial is testing the benefits of an electronic monitoring system on 93 people without depressive, anxiety or cognitive disorders living in specialized residences compared to 92 people not benefiting from this system. The intervention tested includes a video surveillance system for at least one month, more if necessary and in a gradual manner, a depression management assistance programme with a "coach" (including information to the general practitioner), a consultation with a nurse doing a "life review" (recommending consultation with a general practitioner), and finally a consultation with a general practitioner if the CES-D score is above 16 or after the third consultation with a nurse.
The main results
After 10 months, the study showed no benefit on depression scores. The number of anxiety disorders doubled in the intervention group as opposed to the control group, which remained stable. Statistically, there was no difference between the groups on markers of anxiety, depression or quality of life. The study also compares health costs. The intervention group has an extra expenditure of 838 euros but the difference between the two groups is not statistically significant. The authors conclude that the system tested does not provide proof of its interest for people who do not suffer from anxiety or depression and who live in specialized residences.
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