A Study of the Usefulness & Usability of a Healthcare IT System for Managing Multi-morbidity and Poly-pharmacy (C3-Cloud)
Diabetes Type 2, Renal Failure, Heart Failure
About this trial
This is an interventional other trial for Diabetes Type 2 focused on measuring C3-Cloud, Multimorbidity, Diabetes Type 2, Heart Failure, Cardiac Failure, Depression, Renal Failure, Kidney Failure, Ageing, Computer System, Information Technology, Patient Empowerment, Guideline Reconciliation, Polypharmacy, Integrated Care, Clinical Decision Support
Eligibility Criteria
PATIENTS - Inclusion Criteria:-
- They are aged 55 or older
- They are multimorbid patients that suffer from two or more of the following four conditions in various disease combinations (two conditions set as the minimum threshold):-
- Diabetes type 2
- Renal Failure with eGFR/GFR 30 - 59 (measured or estimated glomerular filtration rate)
- Heart Failure in compliance with NYHA I-II (New York Heart Association classification of heart failure)
- Mild or moderate depression
- They still live and generally plan on living in their home (or in the community) for the 12-month trial duration.
- They or their informal caregiver pass the ICT Handling Self-Check (see Deliverable D10.4, Annex 8.3) (i.e. they have access to and some familiarity with the use of ICT).
- They, or their informal caregiver, have stable access to the internet and at least one of the following devices readily available to use the C3-Cloud components: Computer; Notebook; Smartphone; Tablet. This includes the use of Internet Browsers to open the C3-Cloud patient dashboards online.
- They are able to provide informed consent.
PATIENTS - Exclusion Criteria:-
•The exclusion criteria include almost completely the reverse of the inclusion criteria. Patients are not eligible for recruitment if:-
- They are aged 54 or below
- They suffer from any of the following conditions:
- Severe Renal Failure with eGFR/GFR <30
- Severe Heart Failure in compliance with NYHA III-IV
- Severe depression
- They have other debilitating conditions that impair their decision making capability or their life expectancy (e.g. end-of-life patients or cancer patients)
- They or their informal caregivers do not pass the ICT Handling Self-Check (i.e. they do not have access to suitable IT devices and do not have some familiarity with the use of ICT).
- They have disabilities or other health conditions that would prevent their active involvement in the study project or which prevent them from carrying out essential functions of the trial.
- They live in a care institution, for instance in a residential home or nursing home.
- Their health care expenses are covered by a private insurance: in the C3-Cloud pilot sites, private insurances have no data exchange with EHRs.
- They do not speak the regional language: English for SWFT; Spanish for the Basque country; Swedish for RJH
- They are unable to provide informed consent for study participation.
Patients with further chronic diseases and other co-morbidities or symptoms, for example, frailty, sleeping problems, malnourishment or anxiety, will not be excluded from recruitment. Informal caregivers who pass the ICT Handling Self-Check can substitute for the patient if the patient does not pass the ICT Handling Self-Check - the patient-informal caregiver pair can then still be recruited.
PATIENT'S HELPERS/CARERS - Exclusion Criteria:-
There are no specific inclusion criteria for informal caregivers. However, the following exclusion criteria apply:-
- They are aged 17 or below
- They do not have some familiarity with the use of ICT or do not have the capability to help the patient out with ICT usage if necessary.
- They do not have stable access to the internet and at least one of the following devices readily available to use the C3-Cloud components: Computer; Notebook; Smartphone; Tablet. This includes the use of Internet Browsers to open the C3-Cloud patient dashboards online.
- They are not available most of the time in person or via telephone, email, SMS or other means as to respond to calls for help.
- They have debilitating conditions that impair their decision-making capability.
- They do not speak the local language: English for SWFT; Spanish for the Basque country; Swedish for RJH
HEALTHCARE PROFESSIONALS - Inclusion Criteria:-
- normally be involved in the selected patients care
- open to new ways of working, specifically as part of a MDT (including GPs; consultant nurses or specialist nurses; district nurses; social workers; consultants; physiotherapists or pharmacists)
- open to the use of new technology: MDT members do not have to be technologically knowledgeable but they should be willing to learn how to use technology to support their work.
HEALTHCARE PROFESSIONALS - Exclusion Criteria:-
- None specific. Reverse of the above
Sites / Locations
- Osakidetza
- Region Jamtland HarjedalenRecruiting
- South Warwickshire NHS Foundation Trust
Arms of the Study
Arm 1
Experimental
Intervention Group
Use of the C3-Cloud IT system