Table 1.

An overview of the included articles in this integrative review.

Article	Country	Methods	Main findings	Term used
Boström et al 2011 [42]
	Sweden	Focus group interviews with PERSa users	The participants’ opinions and feelings with the PERS related to five themes: safety, anxiety, satisfaction, information, and older persons as active innovators.	PERS
De San Miguel and Lewin 2008 [43]
	Australia	Mail survey to 2610 PERS users	Clients reported impacts on emergency response, living independently, sense of security and anxiety, and when and where they wear their alarm.	Personal alarms
Fallis et al 2007 [33]
	Canada	Mixed-method design, survey, and qualitative feedback	Need for improvement. The PERS gave sense of security, comfort, and reassurance, with high satisfaction with service during an emergency.	PERS
Farquhar et al 1992 [47]
	Australia	Assessment intervention with 125 persons	Respondents described high satisfaction with the alarm. Total of 38% gave up the alarm; 62% never used the alarm, but 84% felt they required it.	Personal emergency alarms
Fisk 1995 [38]
	United Kingdom and Canada	Qualitative interviews with 38 users from Oldham and Ottawa	A majority experienced a feeling of security; 40-50% had used system in emergency. The alarm was not always used in emergencies.	Personal response services
Fleming and Brayne 2008 [48]
	United Kingdom	1-year follow-up of 110 patients	Total of 54% of reported falls happened when person was alone; 80% did not use alarm to summon help. Users described different barriers.	Call alarm system
Heinbüchner et al 2010 [9]
	Germany	333 PERS users approached; response rate 19.6%	Respondents were satisfied with their device, although 24% never wore the pendant. The PERS was not activated by 83% of the persons who fell.	PERS
Hyer and Rudick 1994 [44]
	United States	Telephone survey of 117 patients monitored; maximum 1 year	One-third of PERS users requested emergency assistance (60 calls); significant cost savings; high patient satisfaction.	PERS
Johnston et al 2010 [35]
	Australia	31 semistructured interviews	Identified four subgroups: 1) used alarm effectively, 2) had alarm, but not used effectively, 3) no alarm, but were receptive, 4) no alarm and would not use it.	Personal alarms
Johnston et al 2010 [37]
	Australia	1-month retrospective audit of 1700 cases (alarms)	Difficult to separate false alarm from emergencies. Personal alarm might be helpful for people living alone, when alarm is accepted, understood, and used effectively.	Personal alarms
Lee et al 2007 [45]
	Canada	RCTb; recruited after admitted to EDc after fall	There was no difference in mean change in anxiety between the groups. Alarm user had decreased fear of falling.	PERS
Levine and Tideiksaar 1995 [49]
	United States	Structured interviews; 106 participants	Total of 45% of respondents were fully compliant; identified factors that increased compliance.	PERS
Mann et al 2005 [50]
	United States	Surveyed 606 people; users and nonusers of PERS	Total of 92.7% were satisfied with their PERS; 84.3% rated their PERS as very important. The major reason for potential use was falling and feeling ill.	PERS
McWhirter 1987 [51]
	United Kingdom	Quantitative client register questionnaire; 667 females, 194 males	Main reason for referral: problems with mobility (45.6%) and falls (43.4%); 40% of all calls were false alarms.	A dispersed alarm system
Melkas 2003 [55]
	Finland and Sweden	40 interviews with service personnel	The study is mainly about information systems around use of the PERS; bottlenecks are identified.	Safety telephone services
Melkas 2010 [56]
	Finland	Human impact assessment methodologies	Total of 8 care workers at 8 workplaces. Changes, problems, and strengths related to information environment; improving information environment.	Safety telephone services
Nyman and Victor 2014 [41]
	United Kingdom	A secondary analysis from an English study of ageing	Investigated self-reported users of personal call alarms among 3091 adults aged 65+. From a large sample of those aged 65+, use of call alarm was rare.	Personal call alarms
Olsson et al 2012 [39]
	Sweden	Interview with 14 spouses of persons with dementia	Total of 4 spouses had safety alarm; used for different purposes (eg, if person with dementia had fallen or suddenly fell ill and they needed help).	Safety alarm
Pekkarinen and Melkas 2010 [16]
	Finland	Mixed methods; qualitative interviews; survey with users and personnel	Describing different “potholes” in the technology, service, process, organization, marketing, and ethics and how these can be dealt with.	Safety alarm systems
Porter 2003 [27]
	United States	56 qualitative interviews with 8 widows	Experiences of having the PERS. The findings were a basis for considering the potential influences of having a PERS on older people’s well-being.	PERS
Porter 2008 [28]
	United States	Phenomenology; semistructured interviews with 14 women	How the PERS influenced what older people would do if an intruder got in their house.	PERS
Porter and Lasiter 2012 [29]
	United States	Phenomenology; part of a larger RHQdproject; 95 interviews with 25 women	Life-world being influenced by a peer’s situation regarding adopting or using a PERS for reaching help quickly.	PERS
Porter 2005 [30]
	United States	Phenomenology; interviews with 7 frail women during 3 years	The women’s experiences of PERS; a description of temporizing about the PERS button—deciding when to wear it and whether to use it.	PERS
Porter 2002 [31]
	United States	Phenomenology; part of a longitudinal study; 71 interviews of 11 widows	Experiences of not having the PERS; exploring reasons and barriers for PERS use.	PERS
Porter et al 2013 [32]
	United States	Phenomenology; 99 interviews with 23 women	PERS subscribers’ and nonsubscribers’ intentions and context differ relative to reaching help quickly (RHQ).	PERS
Premik et al 1997 [53]
	Slovenia	Quantitative data from the PERS	Total of 18,500 alarm calls in 4 years; 2.1% health related. The alarm could be a basic communication device for older people.	Community social alarm system
Raappana et al 2007 [57]
	Finland	Human impact assessment methodology; 8 workplaces, 78 care workers	Safety alarms might be useful both for administration and actual care work.	Safety alarm system
Roush and Teasdale 2011 [34]
	United States and Canada	Survey; 267 older persons	PERS users utilized emergency departments twice as often as those without. Strong relation between access to a PERS, sense of security, and higher levels of well-being.	PERS
Roush et al 1995 [40]
	United States and Canada	Hospital utilization rates; 106 patients; 1-year follow-ups	PERS users had a significant decrease in per-person hospital admissions and inpatient days. No significant differences in ED visits.	PERS
Sjölinder et al 2014 [52]
	Sweden	Mixed-methods survey, interviews, and focus groups	The municipalities’ knowledge about the new technology was deficient. Focuses on possibilities for using alarms outside.	Social alarm system
Tinker 1993 [36]
	United Kingdom	Literature summary from two major reports	Summary findings from two reports.	Dispersed alarms
Vincent et al 2006 [49]
	Canada	Quantitative quasi-experimental design; 975 calls for 38 clients over 6-month period	Positive effect on caregiver burden. Number of home visits by care workers decreased. No improvement in quality of life.	Tele-surveillance
Youssef et al 2000 [41]
	United Kingdom	Quantitative study; recorded calls to a control center for 6 months	Total of 542 alarms excluding false alarms. Caregiver solved most problems. GPe was called on 38 occasions, ambulance called on 91 occasions, 44 transported to ED, and 29 admitted.	Community alarm

^aPERS: personal emergency response system.

^bRCT: randomized controlled trial.

^cED: emergency department.

^dRHQ: reach help quickly.

^eGP: general practitioner.