Process evaluation and exploration of telehealth in motor neuron disease in a UK specialist centre
Objectives To evaluate the processes involved in using a novel digitally enabled healthcare system (telehealth in motor neuron disease (TiM)) in people living with motor neuron disease (MND) and their informal carers. We examined TiM implementation, potential mechanisms of impact and contextual fact...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/10/e028526.full |
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| author | Susan Mawson Cindy Cooper Mike Bradburn Pamela J Shaw Ann Quinn Theresa Walsh Esther Hobson Wendy Baird |
| author_facet | Susan Mawson Cindy Cooper Mike Bradburn Pamela J Shaw Ann Quinn Theresa Walsh Esther Hobson Wendy Baird |
| author_sort | Susan Mawson |
| collection | DOAJ |
| description | Objectives To evaluate the processes involved in using a novel digitally enabled healthcare system (telehealth in motor neuron disease (TiM)) in people living with motor neuron disease (MND) and their informal carers. We examined TiM implementation, potential mechanisms of impact and contextual factors that might influence TiM implementation or impact.Design An 18-month, single-centre process evaluation within a randomised, pilot and feasibility study.Intervention TiM plus usual care versus usual care alone.Setting A specialist UK MND care centre.Participants 40 patients with MND and 37 primary informal carers.Primary and secondary outcome measures Patient, carer and staff outcomes and experiences using semistructured interviews. Descriptive data on implementation and use of TiM.Results The TiM was acceptable and accessible to patients, carers and staff. Intervention uptake and adherence were good: 14 (70%) patients completed a TiM session at least fortnightly. Barriers to TiM use (such as technology experience and disability) were overcome with well-designed technology and face-to-face training. Reported potential benefits of TiM included improved communication and care coordination, reassurance, identification of complications and the potential for TiM to be an alternative or addition to clinic. Benefits depended on patients’ current level of needs or disability. The main challenges were the large number of alerts that were generated by TiM, how the clinicians responded to these alerts and the mismatch between patient/carer expectations and nurses actions. This could be improved by better communication systems and adjusting the alerts algorithm.Conclusion TiM has the potential to facilitate access to specialist care, but further iterative developments to the intervention and process evaluations of the TiM in different services are required.Trial identifier number ISRCTN26675465. |
| format | Article |
| id | doaj-art-2f53e70fa5e94851927cc6f647e2dacc |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-2f53e70fa5e94851927cc6f647e2dacc2024-12-13T04:00:09ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2018-028526Process evaluation and exploration of telehealth in motor neuron disease in a UK specialist centreSusan Mawson0Cindy Cooper1Mike Bradburn2Pamela J Shaw3Ann Quinn4Theresa Walsh5Esther Hobson6Wendy Baird71 School of Health and Related Research, The University of Sheffield, Sheffield, UKprofessor of health services research and clinical trials4 Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK1 Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK5 Sheffield Motor Neurone Disease Association Research Advisory Group, Sheffield, UK1 Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK1 Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UKSchool of Health and Related Research, The University of Sheffield, Sheffield, UKObjectives To evaluate the processes involved in using a novel digitally enabled healthcare system (telehealth in motor neuron disease (TiM)) in people living with motor neuron disease (MND) and their informal carers. We examined TiM implementation, potential mechanisms of impact and contextual factors that might influence TiM implementation or impact.Design An 18-month, single-centre process evaluation within a randomised, pilot and feasibility study.Intervention TiM plus usual care versus usual care alone.Setting A specialist UK MND care centre.Participants 40 patients with MND and 37 primary informal carers.Primary and secondary outcome measures Patient, carer and staff outcomes and experiences using semistructured interviews. Descriptive data on implementation and use of TiM.Results The TiM was acceptable and accessible to patients, carers and staff. Intervention uptake and adherence were good: 14 (70%) patients completed a TiM session at least fortnightly. Barriers to TiM use (such as technology experience and disability) were overcome with well-designed technology and face-to-face training. Reported potential benefits of TiM included improved communication and care coordination, reassurance, identification of complications and the potential for TiM to be an alternative or addition to clinic. Benefits depended on patients’ current level of needs or disability. The main challenges were the large number of alerts that were generated by TiM, how the clinicians responded to these alerts and the mismatch between patient/carer expectations and nurses actions. This could be improved by better communication systems and adjusting the alerts algorithm.Conclusion TiM has the potential to facilitate access to specialist care, but further iterative developments to the intervention and process evaluations of the TiM in different services are required.Trial identifier number ISRCTN26675465.https://bmjopen.bmj.com/content/9/10/e028526.full |
| spellingShingle | Susan Mawson Cindy Cooper Mike Bradburn Pamela J Shaw Ann Quinn Theresa Walsh Esther Hobson Wendy Baird Process evaluation and exploration of telehealth in motor neuron disease in a UK specialist centre BMJ Open |
| title | Process evaluation and exploration of telehealth in motor neuron disease in a UK specialist centre |
| title_full | Process evaluation and exploration of telehealth in motor neuron disease in a UK specialist centre |
| title_fullStr | Process evaluation and exploration of telehealth in motor neuron disease in a UK specialist centre |
| title_full_unstemmed | Process evaluation and exploration of telehealth in motor neuron disease in a UK specialist centre |
| title_short | Process evaluation and exploration of telehealth in motor neuron disease in a UK specialist centre |
| title_sort | process evaluation and exploration of telehealth in motor neuron disease in a uk specialist centre |
| url | https://bmjopen.bmj.com/content/9/10/e028526.full |
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