Transition to LIVE (Long-term In Home Ventilation Engagement) Study

  • STATUS
    Recruiting
  • days left to enroll
    53
  • participants needed
    440
  • sponsor
    The Hospital for Sick Children
Updated on 4 October 2022
Investigator
Munazzah Ambreen
Primary Contact
The Ottawa Hospital (4.0 mi away) Contact
+7 other location

Summary

The rising prevalence of ventilator assisted individuals (VAIs) who depend on Home Mechanical Ventilation (HMV) is an escalating public health challenge with important social and economic implications. VAIs are high cost users of the healthcare system, requiring competent healthcare and family caregivers for successful transition to HMV. The TTLive Study will evaluate the effect of a virtual transition intervention delivered through a virtual care platform, compared to usual care on emergent healthcare utilization, caregiver burden, health cost-effectiveness including cost of family caregiver time, and efficiency of clinical encounters for individuals newly transitioning to HMV.

Description

Ventilator Assisted Individuals (VAIs) on HMVs are an ideal population for a virtual care platform that offers a comprehensive bundle of virtual care solutions, sophisticated enough for the complex care demands of this population. A first complex care demand is the challenging clinical follow ups that impose significant financial and medical costs associated with travel to healthcare appointments, and which can predispose these patients to adverse events during travel periods due to an inability to maintain access to some vital technology such as suctioning.

A second complex care demand is the multiple transitions in care as some VAIs on HMVs move between and within healthcare sectors due to changing health status or care needs, and multi-morbidity. Formalized handovers between providers are lacking. This results in information gaps and additional and sometimes unnecessary time spent by healthcare providers searching for care plan documentation.

A third demand is the lack of timely access to respiratory health professionals experienced in HMV and availability of home follow-up, particularly in the early stages of transition which impedes the transition process.

Virtual Care can be defined as any interaction between patients and/or members of their circle of care, occurring remotely, using any form of communication or information technology, with the aim of facilitating or maximizing the effectiveness and quality of patient care. It includes electronic messaging, tele-consultations and tele-monitoring. The advantages of virtual care include the following: 1) enabling the preconditions for truly empowered patients and patient/family-centered care; 2) overcoming the silos of care, and 3) reducing redundancy within the healthcare system by greater knowledge sharing across healthcare sectors. Virtual care provides an opportunity to make healthcare better by overcoming constraints of distance, cost, and time.

In TTLive Study, a multi-component platform delivered on an electronic tablet developed for complex care management at home is used in partnership with the patient, family and healthcare team to enable the following: 1) virtual home visits; 2) customizable care plans; 3) basic clinical workflows that incorporate reminders, completion of symptom profiles and tele-monitoring, and 4) secure communication via messaging, audio, and video calls. Investigators hypothesize that this virtual transition intervention will reduce emergent healthcare utilization, improve the experience of care, reduce caregiver burden, become more cost-effective than usual care, and enable more efficient use of healthcare provider time.

Details
Condition Long-term Ventilation at Home
Treatment aTouchAway™ platform
Clinical Study IdentifierNCT04180722
SponsorThe Hospital for Sick Children
Last Modified on4 October 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

i. Primary caregiver of an individual newly initiated (in-hospital or
outpatient) on a ventilator for HMV prescribed by a participating clinic in
the previous two months; ii. Reads, writes and understands English; and iii
Provides informed consent
Eligibility Criteria for the Qualitative Interviews
Investigators will exclude those participants
i. Unable to communicate verbally for the duration of an interview
Inclusion Criteria for Healthcare Providers in the Circle of Care for the
Intervention Group
Healthcare provider of an individual from a participating centre i. Use of the
aTouchAway for at least five participant encounters ii. Provides informed
consent

Exclusion Criteria

i. Projected life expectancy of 2 months. ii. Significant cognitive impairment
and absence/inability of a family caregiver to use aTouchAway or complete
questionnaires
iii. Uncontrolled psychiatric illness. iv. No internet access (SIM cards and
data costs will be covered by the project budget)
v. Currently enrolled in a research study to evaluate another eHealth platform
or care coordination
vi. Plans to move outside of Ontario within the next 12 months
Caregivers Eligibility Criteria
Clear my responses

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Additional screening procedures may be conducted by the study team before you can be confirmed eligible to participate.

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If you are confirmed eligible after full screening, you will be required to understand and sign the informed consent if you decide to enroll in the study. Once enrolled you may be asked to make scheduled visits over a period of time.

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Complete your scheduled study participation activities and then you are done. You may receive summary of study results if provided by the sponsor.

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