Telemedicine Makes the Patient Stay in Hospital at Home

Not Applicable

Completed

• Conditions: Pressure Injury; Spinal Cord Injury
• Interventions: Other: Service innovation with focus on multidisciplinary collaboration

• Registration Number: NCT02800915
• Lead Sponsor: Sunnaas Rehabilitation Hospital

Brief Summary

The goal of the project is to study whether multidisciplinary follow- up performed via telemedicine to the patient in his or her own home, will improve the healthcare services offered to a particular group of patients. The hypotheses are that this could increase the treatment options, increase knowledge translation, give significant socioeconomic benefits, and allow greater accessibility to specialized healthcare services, as well as increase the involvement of patients and those working in primary healthcare.

Detailed Description

The goals of rehabilitation are to improve functional level, decrease secondary morbidity and enhance health-related quality of life. The costs associated with pressure injury are considerable. In addition to direct treatment- related costs, pressure injury also impact the hospital performance metrics. On top of the financial implications, pressure injury have a significant impact on patient morbidity and -mortality, as well as on health related quality of life. The researchers believe there is a large potential for improvement in treatment of pressure injuries. An multidisciplinary approach, including home-based rehabilitation programs, might help prevent pressure injuries and their complications, and thus reduce associated costs. The investigators conducted a pilot in 2012, in which patients with spinal cord injury and pressure injury were monitored through multidisciplinary outpatient home care, using telemedicine. The project was beneficial for the consumers/ patients, especially in terms of consumer- participation and -contribution, improved quality of life, and a better cooperation between primary and specialized healthcare services. Retrospective economic analysis indicated that telemedicine provides great savings for public healthcare services, and that using telemedicine with other patient groups with similar problems, could be beneficial. A positive outcome of the current study can be made available to most people with pressure injury. Knowledge about pressure injury will contribute in both planning and establishment of good treatment lines for the patients, as well as contribute to environmental savings, and more proper use of the health resources. This may reduce the consumption of hospital services, because a larger proportion of services are provided by the municipality. An important scientific significance of this research will thus be to improve, simplify and streamline health care and health- related services.

Study Timeline

• Study Start: 2016-01-01
• Study First Submitted: 2016-05-05
• Study First Submitted QC: 2016-06-12
• Study First Posted: 2016-06-15
• Primary Completion: 2019-08-31
• Study Completion: 2019-08-31
• Status Verified: 2022-01
• Last Update Submitted: 2022-01-05
• Last Update Posted: 2022-01-21

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 56

Inclusion Criteria

• Traumatic or non- traumatic SCI and ongoing pressure injury.
• Consent to participate.

Exclusion Criteria

• Patients who are unable to give their consent due to cognitive problems.
• Patients who do not have a permanent/ known address.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intervention, telemedicine and multidisciplinary cooperation	Service innovation with focus on multidisciplinary collaboration	The intervention group will be offered regular multidisciplinary outpatient follow-up via telemedicine.
Control, multidisciplinary guidance on request.	Service innovation with focus on multidisciplinary collaboration	The control group will receive guidance based on existing routines (on-site consultations at the wound clinic and telephone consultations), and based on initiative taken by the local healthcare service/ patient/ next of kin.

Primary Outcome Measures

Name	Time	Method
Health related quality of life	1 year	Measured by the use of SF-36, EQ-5D and SCI QoL BDS
Wound healing	1 year	The reduction of pressure injury size will be measured in percentage and time to healing as days from baseline to healing
Cost-utility	1 year	Measured in Euro, by use of QUALYs and ICER in a CE plane

Secondary Outcome Measures

Name	Time	Method
Environmental evaluation	1 year	Measured in terms of travel distance, travel time used and travel costs by use of The Michelin Travel's Route Planner. Environmental emission due to the travel will be measured in terms of Carbon Oxide values, called CO2 equivalents
Experienced interaction, satisfaction and safety in the follow-up	1 year	Measured by use of a custom made Likert scale with 1 being completely dissatisfied and 5 being totally satisfied

Trial Locations

Locations (1)

Sunnaas Rehabilitation Hospital; 🇳🇴 Nesoddtangen, Akershus, Norway