ABSTRACT
PURPOSE: Globally, assistive technology (AT) is used by over 1 billion people, but the prevalence of needs and access to AT in specific countries or regions is largely unknown. This scoping review summarises the evidence available on the prevalence of needs, access and coverage of AT in the World Health Organisation European Region and the barriers and facilitators to its use. METHODS: Relevant publications were identified using a combination of two strategies: 1) a systematic search for AT publications in five scientific literature databases; and 2) consultations with 76 of the Region's AT experts. RESULT: The search strategies yielded 103 publications, 62 of them identified by the systematic search. The included publications were predominantly from six countries, and 18 countries were unrepresented. Information on AT use for specific functional impairments was present in 57 publications: AT for hearing impairment in 14 publications; vision in 12; mobility, 12; communication, 11; self-care, 6; and cognition, 2. AT needs for vision and hearing impairment were more likely to be met (1-87% and 5-90%, respectively) compared with communication and cognition impairments (10-60% and 58%, respectively). The barriers and facilitators to AT access described were linked to accessibility, affordability and acceptability. CONCLUSION: Data on AT prevalence and coverage are limited in both quantity and quality. Agreed-upon definitions of functional impairment and assistive product categories and standards for data collection are needed to facilitate data comparisons and to build a more representative picture of AT needs and coverage.Implications for rehabilitationComprehensive and disaggregated data concerning the prevalence of needs and coverage of AT is needed to enable the development of responsive policies and actions.The literature available on the prevalence of needs and coverage of AT in the WHO European Region is primarily focussed on a small subset of countries and comparisons between studies are limited due to the use of different data collection strategies.Evidence concerning barriers and facilitators to AT access across countries is more consistent and can be organised across the key themes of accessibility, affordability and acceptability of AT.There is a need for consensus among multiple AT actors on standardised definitions for functional impairment and assistive product categories and standards for data collection to enable a more representative picture to be built of AT needs and coverage across the WHO European Region and globally.
ABSTRACT
Some emerging technologies have potential to address older people's care and support needs. However, there is still a gap in the knowledge on the potential uses of these technologies in some care domains. Therefore, a two-round Delphi survey was conducted to establish a consensus of opinion from a group of health and social technology experts (n = 21) on the potential of 10 emerging technologies to meet older people's needs in five care and support domains. Experts were also asked to provide reasons for their choices in free-text spaces. The consensus level was set at 70%. Free-text responses were analyzed using thematic analysis. Voice activated devices was the technology that reached experts consensus in all assessed care domains. Some technologies (e.g., Artificial intelligence (AI) enabled apps and wearables and Internet of things (IoT) enabled homes) also show potential to support basic self-care and access to healthcare needs of older people. However, most of the remaining technologies (e.g., robotics, exoskeletons, virtual and augmented reality (VR/AR)) face a range of technical and acceptability issues that may hinder their adoption by older people in the near future. Findings should encourage the R & D community to address some of the identified challenges to improve the adoption of emerging technologies by older people.
