The effect of digital communication technology on older adults’ formal care use in Norway: a randomized controlled trial

Norway’s population is ageing, increasing the pressure on already strained health and care services. In response, Norwegian policymakers have promoted a strategy of aging in place, i.e., that older adults are encouraged to live longer in their own homes. Low social contact is one of many risk factors for transitions to long-term care facilities. Digital technologies that facilitate social contact have been promoted as promising tools for increasing social contact among older adults and may also contribute to reduce strain on health and care services. In this RCT, we evaluate whether a digital communication technology, Komp, may prolong home-dwelling and reduce the need for formal care services among frail older adults. Given Komp’s documented potential to promote social connectedness and facilitate informal care, we hypothesize that Komp prolongs home-dwelling and reduces reliance on formal care services. We compared an intervention group offered to try Komp (n = 516) with a control group receiving services as usual (n = 595). 150 Komp units were delivered. Outcomes were assessed 28 months after randomization. We obtained administrative data from Statistics Norway and service use data from the boroughs’ journal records. We analyzed 1,099 participants (mean age: 84.6 years, range: 67–98; 64.7% [n = 711] female) using Cox proportional hazards regression (primary outcomes) and ZINB and ZIP regression models (secondary outcomes). The intervention group had a higher, though non-significant, risk of moving to long-term care facilities compared to the control group (HR = 1.162 [0.944, 1.431]). ZINB regression models indicated that the intervention group experienced a reduction of five days of short-term institutional stays (IRR=0.833 [0.728, 0.952]). There were no differences between groups in the amount of other formal care services received. The implementation of Komp did not prolong home-dwelling among frail older adults. However, the results showed a reduction in formal care services, indicating that Komp may reduce some strain on health and care services. Future studies should evaluate the effect of other types of digital communication technologies on objective outcomes. ClinicalTrials.gov: NCT05919355. Date of registration: 16 June 2023.