Telehealth in Motor Neurone Disease

Study Overview
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Brief Summary
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Motor neurone disease (MND) is a rare but debilitating neurological condition that causes paralysis of the body's muscles leading to severe disability and eventually death. Patients often struggle to travel the long distances to specialist clinics to receive the care they require whilst this expert care is often unavailable in the community. Telehealth has the potential to enable a specialist team to monitor the health and wellbeing of patients and their carers whilst they are at home. This could improve the patient's health, improve the quality of life of both patients and their carers, and lead to more effective use of health resources. This is a randomised controlled pilot study that will involve 40 patients who are cared for by the Sheffield Motor Neurone Disease care centre and their main informal carer (a total of 80 participants). Half of the participants will use the telehealth system for a minimum of six months and maximum of eighteen months and information will be collected from patients, carers and their care team. This will include collecting clinical outcome measures, health resource use and the opinions and experience of using the system. All participants will continue to receive their usual care. This is a pilot study. It aims to determine the feasibility and acceptability of the telehealth system to patients, carers and their health care providers. It also aims to determine how a larger trial could successfully evaluate the clinical and cost-effectiveness of the system.

Detailed Description
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MND is often referred to as amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease.

Official Title
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Telehealth in Motor Neurone Disease: A Single Centre, Randomised Controlled Feasibility and Pilot Study of the Use of the TiM Telehealth System to Deliver Highly Specialised Care in Motor Neurone Disease at a Distance

Conditions
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Motor Neuron Disease

Intervention / Treatment
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* Other: TiM telehealth arm


Participation Criteria
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Eligibility Criteria
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Patient Inclusion Criteria: Patients aged 18 years or over who have attended the MND clinic at the Royal Hallamshire Hospital, Sheffield. Patients with amyotrophic lateral sclerosis diagnosed by a consultant neurologist with symptom onset within the last three years. o Or Patients with amyotrophic lateral sclerosis, primary muscular atrophy or progressive lateral sclerosis diagnosed by a consultant neurologist with a deterioration in their condition as evidenced by a deterioration in the ALS functional rating score (ALSFRS-R) by at least two points during the previous 18 months. Live within 120 minute drive from Sheffield Patient Exclusion Criteria: Patients attend another MND care centre in the UK. Significant impairment in decision making capacity preventing informed consent by the subject due to a major mental disorder including fronto-temporal dementia. Patient unable to use the TiM system due to physical, intellectual or language difficulties and unwilling to permit carer to operate it on their behalf. Patients will be asked to complete two questions used within the TiM system, with, or without the help to their carer to verify their ability to use the system. The patient has no eligible informal carer willing to participate in the trial Insufficient mobile telephone reception in the patients' home to use the TiM system. Any other major impairment that may affect their ability to participate in the study Carer inclusion criteria Age 18 years or older Person identified by the patient as the major provider of informal care (emotional and/or practical support) to the patient and provides more than one hour per week of unpaid care Carer willing to allow data they provide during the trial to be shared by the research team with their own doctor in the event of serious clinical need. Carer exclusion criteria Significant decision making capacity preventing informed consent due to a major mental disorder. Carer unable to use the TiM system due to physical, intellectual or language difficulties. Carers will be asked to complete two questions used within the TiM system to verify their ability to use the system. Inability to participate in the study due to other major physical or mental illness or language difficulties. Professional carers receiving direct payment for their services.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Patients and their primary carer will use a weekly telehealth system. This involves a series of questions on a tablet computer that is transmitted to their regional MND care centre for review and action. | Other: TiM telehealth arm<br> <br> |
| No Intervention: Control<br>Usual care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility and acceptability of using the telehealth system from interviews | Recruitment rate, retention rate. | Up to 18 months |