TEC4Home: Telehealth for Emergency-Community Continuity of Care Connectivity Via Home-Telemonitoring
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 70
- 主要终点
- Change in number of emergency department revisits 90 day pre and 90 days post enrollment.
研究概览
简要总结
Modern technology like computers, smartphones and the Internet enable patients to measure certain health indicators, like blood pressure and body weight, from the comfort of their own homes. This information can also be shared electronically with doctors and other healthcare providers to monitor remotely. This is called home health monitoring. In TEC4Home, we are developing a home monitoring solution for patients with heart failure to support their care and recovery at home after a visit to the emergency department. We hope to show that this solution decreases revisits to the emergency department and increases quality of life for patients.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •PATIENT PARTICIPANTS:
- •Have one or more typical symptoms of Heart Failure (i.e. dyspnoea at rest or minimal exertion (includes orthopnoea, reduced exercise tolerance)) AND
- •Have one or more typical signs of Heart Failure (i.e. elevated jugular venous pressure, pulmonary crepitations, pleural effusions, peripheral oedema) AND
- •Have one or more objective measures of heart failure:
- •Radiological congestion.
- •Elevated BNP ≥ 400 pg/mL or NT-proBNP ≥ 1000 pg/mL.
- •Reduced left ventricular ejection fraction <40% (or <45%) in previous 12 months.
- •Diastolic dysfunction including tissue Doppler E/e' ratio > 15 in previous 12 months.
- •Pulmonary capillary wedge pressure >20 mmHg.
- •Diuretic therapy. The additional value of diuretic therapy (IV or oral) is debatable, as presumably unlikely (or unsafe) that patient with genuine HF will be discharged without diuretic.
- •CLINICIAN PARTICIPANTS:
- •To be eligible to participate, clinician participants (i.e. ED physicians, family physicians and monitoring nurse(s)) must have referred or have a patient enrolled in the TEC4Home monitoring service.
排除标准
- •PATIENT PARTICIPANTS:
- •Physical barriers e.g. unable to stand on scales.
- •Cognitive impairment (e.g. MMSE <20), unless suitable caregiver support.
- •Language (must be able to read and understand English), unless suitable caregiver support.
- •Documented history of current and active substance misuse (within 3 months).
- •Lack digital connectivity or landline phone connection.
- •No regular care provider e.g. GP, or at least regular walk-in clinic.
- •Existing intensive system of care: LVAD, transplant, dialysis.
- •Anticipated improvement due to revascularization (PCI/CABG) or valve intervention during index hospitalization.
- •Anticipated survival <90 days. Active palliative care, less-than level III care, disseminated malignancy.
- •CLINICIAN PARTICIPANTS:
- •Clinicians who do not have patients enrolled in the TEC4Home service or who themselves are not involved in the implementation or operation of the TEC4Home monitoring service will not be eligible to participate.
结局指标
主要结局
Change in number of emergency department revisits 90 day pre and 90 days post enrollment.
时间窗: 90 days
Hospital administrative data and self-reported data will be reviewed to assess the number of emergency department visits 90 day pre and 90 days post enrollment.
Change in the length of stay (in days)
时间窗: 90 days
Hospital administrative data and self-report data will be reviewed to assess the length of stay (measured in days) 90 day pre and 90 days post enrollment.
Change in the number of hospitalizations
时间窗: 90 days
Hospital administrative data and self-report data will be reviewed to assess the number of hospitalizations 90 day pre and 90 days post enrollment.
Mortality rate
时间窗: 90 days
The number of patients who pass away during the 90 day follow-up period will be recorded.
次要结局
- Difference in self-care efficacy scale scores as assessed by the European Heart Failure Self-care Behaviour Scale(90 Days)
- Difference in quality of life (general) scores as assessed by the VR-12(90 Days)
- Difference in quality of life (HF-specific) scores as assessed by the Kansas City Cardiomyopathy Questionnaire 12 (KCCQ-12) scale(90 days)
- Impact of patient experience of care via interviews(90 days)
- Difference in costs and savings via administrative data and a self-report healthcare utilization survey.(90 days)
- Impact of patient experience of care via surveys(90 days)
- Impact on communication between healthcare providers and patients via surveys(90 days)
- Impact on communication between healthcare providers and patients via interviews(90 days)
研究者
Kendall Ho
Lead, Digital Emergency Medicine; Professor, Department of Emergency Medicine, Faculty of Medicine, UBC
University of British Columbia