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	Institution: CLOCKSS  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 8 No. 3, May 1999   Archives  •  Online Features Original Contribution  This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (81)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Randomized Controlled Trial  • Alert me on articles by topic Effectiveness of Assistive Technology and Environmental Interventions in Maintaining Independence and Reducing Home Care Costs for the Frail Elderly A Randomized Controlled Trial William C. Mann, OTR, PhD; Kenneth J. Ottenbacher, OTR, PhD; Linda Fraas, OTR, MA; Machiko Tomita, PhD; Carl V. Granger, MD Arch Fam Med. 1999;8:210-217. Context  Home environmental interventions (EIs) and assistive technology (AT) devices have the potential to increase independence for community-based frail elderly persons, but their effectiveness has not been demonstrated. Objective  To evaluate a system of AT-EI service provision designed to promote independence and reduce health care costs for physically frail elderly persons. Design  Randomized controlled trial. Setting and Participants  A total of 104 home-based frail elderly persons living in western New York were assigned to 1 of 2 groups (52 treatment, 52 control). Intervention  All participants underwent a comprehensive functional assessment and evaluation of their home environment. Participants in the treatment group received AT and EIs based on the results of the evaluation. The control group received "usual care services." Main Outcome Measures  Functional status as measured by the Functional Independence Measure (FIM) and the Craig Handicap Assessment and Reporting Technique; pain as measured by the Functional Status Instrument; and health care costs including the costs. Results  After the 18-month intervention period, the treatment groups showed significant decline for FIM total score and FIM motor score, but there was significantly more decline for the control group. Functional Status Instrument pain scores increased significantly more for the control group. In a comparison of health care costs, the treatment group expended more than the control group for AT and EIs. The control group required significantly more expenditures for institutional care. There was no significant difference in total in-home personnel costs, although there was a large effect size. The control group had significantly greater expenditures for nurse visits and case manager visits. Conclusion  The frail elderly persons in this trial experienced functional decline over time. Results indicate rate of decline can be slowed, and institutional and certain in-home personnel costs reduced through a systematic approach to providing AT and EIs. From the Rehabilitation Engineering Research Center on Aging (Drs Mann and Tomita and Ms Fraas) and the Center for Functional Assessment Research, Uniform Data Systems for Medical Rehabilitation (Dr Granger), University at Buffalo, Buffalo, NY; and the Office of the Dean, School of Allied Health Sciences, University of Texas Medical Branch, Galveston (Dr Ottenbacher). RELATED ARTICLE The Archives of Family Medicine Continuing Medical Education Program Arch Fam Med. 1999;8(3):207-209. FULL TEXT   THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES Pilot randomised controlled trial of occupational therapy to optimise independence in Parkinson's disease: the PD OT trial Clarke et al. J. Neurol. Neurosurg. Psychiatry 2009;80:976-978. 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