Introducing Technology in the Home of Elderly Patients With Multimorbidity, a Hybrid Effectiveness Implementation Study

Brief Summary

Detailed Description

PURPOSE AND AIMS In this study, the objective is to evaluate available digital technology with remote symptom monitoring designed to support self-care at home of elderly patients with multimorbidity. There are a lot of technology with the possibility to remotely monitor signs and symptoms placed in patients' home available. This technology have been shown to increase quality of life, experiences of security and reduce the need for in-hospital care, but few tools are implemented in routine care of elderly with multimorbidity and extensive needs of coordinated health and community care. Limited collaboration and lack of joint care goals between the different care providers are known barriers of implementation of digital technology with remote symptom monitoring. The overall aims of the project are: 1. To describe the implementation process of digital technology in two different care settings from both patients, family members, and healthcare professional's perspective. 2. To evaluate the feasibility of digital technology for remote symptom monitoring and digital consultations with the caregiver in the home of elderly patients with multimorbidity. 3. To examine the effectiveness of the technology. Specific research questions the study is set to answer: 1. What effects does the use of digital technology for remote symptom monitoring have on elderly patients with multimorbidity's healthcare consumption, self-care management, depression, experience of control over the disease, well-being and activity level? 2. How do patients and informal caregivers perceive that the use of digital technology at home affects the ability to manage the patient's health situation? 3. How do physicians, nurses and assistant nurses experience the use of remote monitoring in their daily work? 4. Which are the barriers to and facilitators for implementation of digital technology? 5. Does digital technology reduce the risk of hospitalisation and healthcare costs in elderly patients with multimorbidity? The study has a hybrid design, which means a double focus: both the implementation process and the clinical outcomes are studied simultaneously through a mixed data collection with both quantitative and qualitative parts. The implementation process will be based on The Quality Implementation Framework. Phase 1; During winter 2021-22 the implementation process of digital technology with remote symptom monitoring with adaptation and preparation in the care team will begin. The team needs to develop a structure for handling the incoming patient data and develop action plans on how to act in case of symptoms and signs of deterioration. The technology, OPTILOGG PLUS, will be place in patients' home.It consists of a tablet with personalized sensors, such as weighing scale, blood pressure, oxygenation and activity meters based on the patient's individual needs. The technology also includes a platform for digital consultation. The patient performs measurements at home every morning and sends data to the receiving station installed in the care teams' premises where the staff access the patient's data via secure login.The main purpose of the technology is to enhance the patients' self-care behaviour, and coach them to contact the healthcare provider if and when self-care is not enough to prevent deterioration. Also the caregiver can initiate a virtual home visit or a physical home visit if they observe signs of deterioration not recognised by the patient.

Primary Outcomes

Secondary Outcomes

• Anxiety and depression(December 2021-December 2022)
• Perceived control(December 2021-December 2022)
• Physical activity(December 2021-December 2022)
• Well-being(December 2021-December 2022)
• Experience of digital technology(December 2021-December 2022)