Abstract
INTRODUCTION: Remote home monitoring models were implemented during the COVID-19 pandemic to shorten hospital length of stay, reduce unnecessary hospital admission, readmission and infection and appropriately escalate care. Within these models, patients are asked to take and record readings and escalate care if advised. There is limited evidence on how patients and carers experience these services. This study aimed to evaluate patient experiences of, and engagement with, remote home monitoring models for COVID-19.
METHODS: A rapid mixed-methods study was carried out in England (conducted from March to June 2021). We remotely conducted a cross-sectional survey and semi-structured interviews with patients and carers. Interview findings were summarized using rapid assessment procedures sheets and data were grouped into themes (using thematic analysis). Survey data were analysed using descriptive statistics.
RESULTS: We received 1069 surveys (18% response rate) and conducted interviews with patients (n = 59) or their carers (n = 3). 'Care' relied on support from staff members and family/friends. Patients and carers reported positive experiences and felt that the service and human contact reassured them and was easy to engage with. Yet, some patients and carers identified problems with engagement (e.g., hesitancy to self-escalate care). Engagement was influenced by patient factors such as health and knowledge, support from family/friends and staff, availability and ease of use of informational and material resources (e.g., equipment) and service factors.
CONCLUSION: Remote home monitoring models place responsibility on patients to self-manage symptoms in partnership with staff; yet, many patients required support and preferred human contact (especially for identifying problems). Caring burden and experiences of those living alone and barriers to engagement should be considered when designing and implementing remote home monitoring services.
PATIENT OR PUBLIC CONTRIBUTION: The study team met with service users and public members of the evaluation teams throughout the project in a series of workshops. Workshops informed study design, data collection tools and data interpretation and were conducted to also discuss study dissemination. Public patient involvement (PPI) members helped to pilot patient surveys and interview guides with the research team. Some members of the public also piloted the patient survey. Members of the PPI group were given the opportunity to comment on the manuscript, and the manuscript was amended accordingly.
| Original language | English |
|---|---|
| Number of pages | 19 |
| Journal | Health Expectations |
| Early online date | 7 Jul 2022 |
| DOIs | |
| Publication status | E-pub ahead of print - 7 Jul 2022 |
Bibliographical note
Funding Information:The authors are indebted to all of the services who participated in this study and to all of the patients and carers who participated in our surveys and interviews. Thanks are due to Dr Jennifer Bousfield for supporting with study design and data collection, Simon Barnes for supporting with data entry; Steve Morris, Chris Sherlaw‐Johnson, Theo Georghiou and Jon Sussex for advice given throughout the project; our NIHR BRACE and NIHR RSET public patient involvement members for feedback throughout the study and to Raj Mehta for commenting on a draft of the manuscript; the NIHR 70@70 Senior Nurse research Leaders for providing feedback on the development of our study; Russell Mannion for peer‐reviewing our study protocol; and the NIHR Clinical Research Networks for supporting study set‐up and data collection. The authors thank the NHS Digital CO@h Evaluation Workstream Group chaired by Professor Jonathan Benger for facilitating and supporting the evaluation, and the other two evaluation teams for their collaboration throughout this evaluation: (i) Institute of Global Health Innovation, NIHR Patient Safety Translational Research centre, Imperial College London, and (ii) the Improvement Analytics Unit (Partnership between the Health Foundation and NHS England and NHS Improvement). Many thanks to our Clinical Advisory Group for providing insights and feedback throughout the project (Dr Karen Kirkham (whose previous role was the Integrated Care System Clinical Lead, NHSE/I Senior Medical Advisor Primary Care Transformation, Senior Medical Advisor to the Primary Care Provider Transformation team), Dr Matt Inada‐Kim (Clinical Lead Deterioration & National Specialist Advisor Sepsis, National Clinical Lead ‐ Deterioration & Specialist Advisor Deterioration, NHS England & Improvement) and Dr Allison Streetly (Senior Public Health Advisor, Deputy National Lead, Healthcare Public Health, Medical Directorate NHS England). This is independent research funded by the National Institute for Health Research, Health Services & Delivery Research programme (RSET Project no. 16/138/17; BRACE Project no. 16/138/31) and NHSEI. NJF is an NIHR Senior Investigator. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.
Publisher Copyright:
© 2022 The Authors. Health Expectations published by John Wiley & Sons Ltd.
Keywords
- care
- COVID-19
- patient engagement
- patient experience
- remote home monitoring
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
