A Comprehensive Evaluation of the Implementation and Impact of Telecare and Telehealth across Health and Social Care - the Whole System Demonstrator (WSD) Project

Completed

Conditions: Topic: Primary Care Research Network for England
Subtopic: Not Assigned
Disease: All Diseases
Signs and Symptoms
Long-term conditions

Registration Number: ISRCTN43002091

Lead Sponsor: Department of Health (UK)

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 6000

Inclusion Criteria

The eligibility criteria for the trial have been broadly determined by the policy focus of the funder, the Department of Health, on people with long term conditions and social care needs. They have been reached through discussions with both the Department of Health and the three participating sites. They have also been derived partly from existing evidence about which populations are mostly likely to benefit from the delivery of telecare and telehealth devices but also maximise reliance on professional judgement about which groups are most likely to benefit.

Detailed inclusion criteria:
Individuals aged 18 years or over fulfilling criteria A and B:

Criteria A:
At least one of three long-term index conditions as defined using Quality and Outcomes Framework (QOF) criteria:
1. Heart failure: diagnosis confirmed by echocardiogram or by specialist assessment
2. Diabetes: those with a diagnosis of Type 1 or Type 2 diabetes and:
2.1. A recorded HbA1c in the previous 15 months
2.2. Excluding those in whom the last HbA1c is 7.4 or less
3. Chronic obstructive pulmonary disease (COPD): diagnosis confirmed by spirometry (COPD is diagnosed if the individual has a forced expiratory volume in one second [FEV1] of less than 70% of predicted normal and has an FEV1/forced vital capacity [FVC] ratio less than 70%)
4. Additional physical co-morbidities may be present; these individuals will still be eligible

Criteria B:
5. At least one unplanned admission to hospital relating to their long term
condition(s)in the previous year, or has had at least one episode of care in the past year from intermediate care services, rapid response services, ambulance services, Accident and Emergency relating to their long term condition
6. Individuals aged 18 years and over with social care needs who would benefit from telecare. They must meet one or more of the following criteria:
6.1. Currently in receipt of, or considered to have a need for night sitting
6.2. Receiving 7 or more hours per week of home care or 3.5 or more hours per week of home care plus a meals service (defined by individual not household)
6.3. Receiving 1 or more days per week of day care
6.4. Have had a fall or who are considered at high risk of falling
6.5. A live-in or nearby informal carer facing difficulties carrying their current burden of responsibilities
6.6. Cognitive impairment/confusion (people fulfilling this criterion who are unable to provide written informed consent and do not have a primary informal caregiver available or an advocate will not be approached to participate in the questionnaire study)

The following definition of an informal carer will be used:
Someone who is seeing and helping their family member, relative or friend at least once a week.

Exclusion Criteria

General exclusion criteria:
1. Lack of ability to understand English (the devices are not currently tailored to support non-English language speakers)
2. Inability to complete the questionnaire with support from a researcher (applies to questionnaire study only - Themes 2 and 3)

Telehealth exclusion criteria:
3. People with one or more of the three index conditions (above) and cognitive impairment/confusion but insufficient informal caregiver support available to enable regular readings to be taken using telehealth equipment. This group will still be eligible to receive telecare.
4. Individuals without an appropriate power supply or telephone line in their place of residence (Telehealth requires an appropriate power supply or telephone line so if this is not available it cannot be installed)
5. Telehealth already installed (this exclusion criteria is likely to only apply to the Kent site where some pilot work has already been undertaken with telehealth equipment - individuals who already have telehealth equipment will need to be excluded to reduce learning effects)

Telecare exclusion criteria:
6. Telecare already installed (excluding pendant alarms)