Homebound Elderly People Psychotherapeutic Intervention Program: Results from a pilot randomized controlled trial.

Homebound older adults who rarely or never leave home due to multiple physical, psychological, and social vulnerabilities benefit from home healthcare services to support home-based living. This study explored the feasibility, acceptability, and preliminary efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a 10-week cognitive-emotional intervention program for homebound older adults with mild cognitive impairment and depressive or anxiety symptoms. A pilot randomized two-arm controlled trial was conducted. Participants were randomly assigned to one of the two conditions: HEPPI (n = 27) and wait-list control (n = 24). Outcome measurements were conducted at baseline and post-intervention. Primary outcomes included the feasibility and acceptability of the HEPPI. Secondary outcomes were changes in cognitive function, depressive and anxiety symptoms, subjective memory complaints, functional status, and quality of life. Intervention effects were assessed both at a group level (two-way mixed ANOVA) and an individual level (Reliable Change Index). HEPPI was feasible as demonstrated by recruitment and retention rates of 82% and 100%, respectively. Acceptability of the HEPPI was high, with all participants expressing willingness to use it again. No differences were found between groups at baseline. The intervention group reported significant increases in cognitive, emotional, and functional domains from baseline to post-intervention, compared to the control group. Clinical change data showed differences between groups in the distributions by clinical change categories. These results point out the feasibility, acceptability, and preliminary efficacy of the HEPPI in improving the cognitive and functional performance of homebound older adults and reducing their psychological symptomatology. Our findings call attention to the mental health needs of the homebound population and highlight the importance of providing these older adults with a home-delivered evidence-based multi-component non-pharmacological intervention. [ABSTRACT FROM AUTHOR]