Clinical trial NCT02800915: Telemedicine Makes the Patient Stay in Hospital at Home
Official title: Telemedicine Makes the Patient Stay in Hospital at Home. Service Innovation With Focus on Multidisciplinary Collaboration
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Spinal Cord Injury
Pressure Injury
Keywords: Spinal Cord Injury
Pressure Injury
Health Related Quality of Life
Telemedicine
Service Innovation
Rehabilitation
Interdisciplinary collaboration
User-participation
Activity and participation
Health economics
Lead sponsor: Sunnaas Rehabilitation Hospital
Sponsor class: OTHER
Collaborators: name: Haukeland University Hospital
name: University of Oslo
name: Central Jutland Regional Hospital
name: Sahlgrenska University Hospital
name: Oslo University Hospital
name: University Hospital of Trondheim, Norway
name: Oslo Centre for Biostatistics and Epidemiology, Norway
name: Norwegian Centre for Integrated Care and Telemedicine (NST), Norway
name: Institute of Clinical Medicine, Rigshospitalet, Denmark
name: Birmingham VA Medical Center/University of Alabama School of Medicine, USA
name: Karolinska Institutet
First posted: 2016-06-15
Enrollment: 56
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

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.

Eligibility criteria: 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.

Primary outcomes:
measure: Health related quality of life
timeFrame: 1 year
measure: Wound healing
timeFrame: 1 year
measure: Cost-utility
timeFrame: 1 year
Secondary outcomes:
measure: Experienced interaction, satisfaction and safety in the follow-up
timeFrame: 1 year
measure: Environmental evaluation
timeFrame: 1 year
Other outcomes:
Locations:
city: Nesoddtangen
country: Norway
facility: Sunnaas Rehabilitation Hospital
state: Akershus
Study officials:
affiliation: University of Oslo
name: Johan K Stanghelle, Prof. MD/PhD
role: STUDY_DIRECTOR
References:
citation: Irgens I, Midelfart-Hoff J, Jelnes R, Alexander M, Stanghelle JK, Thoresen M, Rekand T. Videoconferencing in Pressure Injury: Randomized Controlled Telemedicine Trial in Patients With Spinal Cord Injury. JMIR Form Res. 2022 Apr 19;6(4):e27692. doi: 10.2196/27692.
citation: Irgens I, Hoff JM, Sorli H, Haugland H, Stanghelle JK, Rekand T. Hospital based care at home; study protocol for a mixed epidemiological and randomized controlled trial. Trials. 2019 Jan 24;20(1):77. doi: 10.1186/s13063-019-3185-y.