Telemedicine Makes the Patient Stay in Hospital at Home (TeleSCIpi)

Telemedicine Makes the Patient Stay in Hospital at Home. Service Innovation With Focus on Multidisciplinary Collaboration

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.

Study Overview

• Status: Completed
• Conditions: Spinal Cord Injury; Pressure Injury
• Intervention / Treatment: Other: Service innovation with focus on multidisciplinary collaboration

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.

• Study Type: Interventional
• Enrollment (Actual): 56
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Norway
  • Akershus
    • Nesoddtangen, Akershus, Norway, 1450
      • Sunnaas rehabilitation hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention, telemedicine and multidisciplinary cooperation; The intervention group will be offered regular multidisciplinary outpatient follow-up via telemedicine.	Other: Service innovation with focus on multidisciplinary collaboration; The follow-up is performed via telemedicine (videoconference) to the patient in his or her own home, and in cooperation with the district nurses.; Other Names: Telemedicine in outpatient follow-up
Active Comparator: Control, multidisciplinary guidance on request.; The control group will receive guidance based on existing routines (on-site consultations at the wound clinic and telephone consultations), and based on initiative taken by the local healthcare service/ patient/ next of kin.	Other: Service innovation with focus on multidisciplinary collaboration; The follow-up is performed via telemedicine (videoconference) to the patient in his or her own home, and in cooperation with the district nurses.; Other Names: Telemedicine in outpatient follow-up

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Health related quality of life	Measured by the use of SF-36, EQ-5D and SCI QoL BDS	1 year
Wound healing	The reduction of pressure injury size will be measured in percentage and time to healing as days from baseline to healing	1 year
Cost-utility	Measured in Euro, by use of QUALYs and ICER in a CE plane	1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Experienced interaction, satisfaction and safety in the follow-up	Measured by use of a custom made Likert scale with 1 being completely dissatisfied and 5 being totally satisfied	1 year
Environmental evaluation	Measured in terms of travel distance, travel time used and travel costs by use of The Michelin Travel's Route Planner. Environmental emission due to the travel will be measured in terms of Carbon Oxide values, called CO2 equivalents	1 year

Collaborators and Investigators

• Sponsor: Sunnaas Rehabilitation Hospital
• Collaborators: University of Oslo; Karolinska Institutet; Oslo University Hospital; Sahlgrenska University Hospital, Sweden; Haukeland University Hospital; Central Jutland Regional Hospital; University Hospital of Trondheim, Norway; Oslo Centre for Biostatistics and Epidemiology, Norway; Norwegian Centre for Integrated Care and Telemedicine (NST), Norway; Institute of Clinical Medicine, Rigshospitalet, Denmark; Birmingham VA Medical Center/University of Alabama School of Medicine, USA
• Investigators: Study Director: Johan K Stanghelle, Prof. MD/PhD, University of Oslo

Publications and helpful links

General Publications

• 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.
• 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.

Helpful Links

• Protocol of the study
• Pressure injury occurence in people with a newly aqcuired spinal cord injury in acute care rehabilitation

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2016
• Primary Completion (Actual): August 31, 2019
• Study Completion (Actual): August 31, 2019

Study Registration Dates

• First Submitted: May 5, 2016
• First Submitted That Met QC Criteria: June 12, 2016
• First Posted (Estimate): June 15, 2016

Study Record Updates

• Last Update Posted (Actual): January 21, 2022
• Last Update Submitted That Met QC Criteria: January 5, 2022
• Last Verified: January 1, 2022

More Information

Terms related to this study

• Keywords: Rehabilitation; Telemedicine; Spinal Cord Injury; Interdisciplinary collaboration; Health economics; Health Related Quality of Life; Pressure Injury; Service Innovation; User-participation; Activity and participation
• Additional Relevant MeSH Terms: Central Nervous System Diseases; Nervous System Diseases; Trauma, Nervous System; Spinal Cord Diseases; Wounds and Injuries; Spinal Cord Injuries; Crush Injuries
• Other Study ID Numbers: 2014/684