Care coordinator application to manage chronic disease in primary care

Abstract

Purpose In prior studies, we showed clinical efficacy of person-centered community based multicomponent program in preventing progression of frailty and disability in vulnerable older adults. Even with its potential efficacy, person specific provision of multicomponent exercise has been rarely provided for frailty prevention in resource-constrained communities. To facilitate the scaling up of multicomponent frailty prevention program, we aimed to develop an electronic cognitive behavioral therapy (eCBT) based smartphone application comprising multicomponent mobility exercises with incentive features that was personalized to physical performance parameters acquired by a multisensor device. Methods Pilot programs using eCBT application were conducted in welfare centers and daycare centers. Adherence rate was compared between participants with or without the presence of eCBT feature in the application. Results and Discussion By before-after analysis, physical performance was meaningfully improved in participants with mean change of short physical performance battery (SPPB) score of 1.3. eCBT feature was associated with higher adherence in study populations. In resource-scarce community settings of Korea, eCBT based approach might be a potential solution to provide person-specific multicomponent exercise program for frailty prevention.