Pilot Implementation of a Nighttime Telemedicine and Medication Delivery Service to Increase Access to Pre-emergency Pediatric Care in Ghana
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,239
- 试验地点
- 2
- 主要终点
- The rate of guideline adherence at the call center.
研究概览
简要总结
Globally, leading causes of death among children one month to 5 years old are pneumonia, diarrheal disease and malaria which are treatable early in the disease-course with low-cost medications. However, these diseases can progress to emergencies when access to care is delayed. In response, a telemedicine and medication delivery service (TMDS) was designed to improve nighttime access to pediatric care and treatment. The TMDS will be implemented in three distinct Ghanaian community to evaluate the clinical safety, operational feasibility of implementing,and scalability of the service.
详细描述
Globally, leading causes of death among children one month to 5 years old are pneumonia, diarrheal disease and malaria which are treatable early in the disease-course with low-cost medications. However, these diseases can progress to emergencies when access to care is delayed. In response, a telemedicine and medication delivery service (TMDS) called MotoMeds was designed to overcome barriers to seeking care. MotoMeds targets the nighttime period when barriers to accessing care are highest. The TMDS was initially deployed in Haiti and will now be evaluated for generalizability and portability in Ghana.
The study objectives are to assess clinical safety and logistical feasibility of the TMDS. The study population is children in Accra and Tamale. The workflow consists of parents/guardians calling the TMDS on their child's behalf, Emergency Medical Technicians (EMTs) referring severe cases to emergency services, EMTs performing a phone assessment for non-severe cases, and EMTs traveling to the child's household to perform an in-person exam, rapid diagnostic testing for malaria where indicated as per protocol, and to deliver protocolized medications for cases within a predefined delivery zone.
EMTs and the protocols/guidelines used are supervised by Ghanaian and US physicians.
Clinical safety and feasibility of the TMDS will be evaluated using patient and logistical metrics.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- — 至 10 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Child ≤ 10 years
- •Has an acute medical problem
- •Provides written assent (if 10 years and receives a household visit)
- •Child Participant
排除标准
- •Child > 10 years
- •Child does not have an acute medical problem
- •Medical problem involves physical trauma or mental health
- •Refusal of written assent (if 10 years and receives a household visit)
- •Parent/Guardian Participant Inclusion Criteria:
- •Calls MotoMeds during operating hours
- •Parent/guardian of a patient participant meeting inclusion criteria
- •Adult (18 years or older)
- •Provides written consent (household visit) or a waiver of documentation of consent (no household visit)
- •Parent/Guardian Participant Exclusion Criteria:
- •Age < 18 years
- •No written consent or waiver of documentation of consent
- •Corresponding child does not meet inclusion criteria
结局指标
主要结局
The rate of guideline adherence at the call center.
时间窗: 1 day
Establish the rates of provider adherence to the TMDS clinical guidelines while performing assessments and generating treatment plans at the call center. Points of non-adherence will include severity assessments, missed danger signs and non-indicated or missed antibiotic prescriptions.
次要结局
- Sensitivity, specificity and congruence of clinical variables(1 day)
- Participant clinical status at 8-12 days(Between 8-12 days)
- The rate of guideline adherence at the household.(1 day)