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BACKGROUND/RATIONALE:
VHA leads the nation in use of distance technology to monitor patients' self-care via an in-home messaging device with disease management protocols (DMPs). This strategy reduces unnecessary duplication in healthcare costs and improves quality of life for individuals with chronic disease through care coordination. No such DMPs exist for SCI/D. Thus our overall objective for this study is to develop the tools necessary for implementing a new home telehealth program to manage community-dwelling veterans with SCI/D at high risk of developing PrUs.
OBJECTIVE(S):
Study objectives will address activities necessary to implement a Home Telehealth program to manage veterans with spinal cord injury and disorders (SCI/D) at risk of developing pressure ulcers (PrUs).
METHODS:
A pre-/post-test design, outcomes include: frequency of administration of specific DMP items and skin breakdown. Veterans discharged from the Cleveland SCI Center hub-and-spoke sites agreeing to participate will be randomly assigned to receive either daily (M-F) or weekly calls, responding to the DMP questions for 2 months. Approximately 50 patients will be enrolled over a 2 month period. Study outcomes including patient knowledge, use of self-management strategies and behaviors and satisfaction with the program will be assessed at baseline, randomization and 2 months post-discharge. Clinical information, including Braden PrU risk data, nutritional assessment, etc., will be obtained from CPRS. Detailed information will be collected about wound severity, PrU treatment, size, color, dressings, etc. Providers will be questioned about barriers/facilitators and satisfaction with DMP implementation. Descriptive analyses will be use to compare pre-/post-test responses for those receiving daily vs. weekly calls using descriptive analyses. Analysis of provider interview data will involve the identification of common themes across respondents, categorization of responses, and summary of findings using a qualitative approach.
FINDINGS/RESULTS:
Five patients have been enrolled, data collection is ongoing.
IMPACT:
This study addresses issues of patient self-management, prevention, access to care, and early detection/intervention. This research will assist us in development, evaluation and validation of the skin-related DMP items as well as action steps associated for clinical follow-up. Our evaluation will be used to help SCI QUERI better understand issues associated with future implementation of this type of program in other VA SCI Hub-and-Spoke sites. It represents an important first step in development of a larger study to implement and assess the use of home telehealth data messaging units as a method for helping SCI/D patients prevent development of PrUs.
PUBLICATIONS:
None at this time.
DRA:
Chronic Diseases
DRE:
Quality of Care, Technology Development and Assessment
Keywords:
Spinal cord injury, Telemedicine
MeSH Terms:
none
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