A comprehensive evaluation of the impact of telemonitoring in patients with long-term conditions and social care needs: protocol for the whole systems demonstrator cluster randomised trial

TLDR

Growing numbers of older adults with long‑term conditions and social care needs are expected to increase service demand, and while telehealth and telecare are seen as promising ways to reduce utilisation, rigorous evidence of their impact remains limited. The study aims to evaluate the implementation, impact, and acceptability of telehealth and telecare technologies in this population. A cluster‑randomised controlled trial across multiple sites compares telehealth and telecare with usual care, measuring outcomes such as health‑care utilisation and quality of life. The trial’s design and evaluation framework are outlined, with the expectation that effective use of telehealth and telecare could expand care options for high‑need populations worldwide. Trial registration: ISRCTN43002091.

Abstract

Abstract Background It is expected that increased demands on services will result from expanding numbers of older people with long-term conditions and social care needs. There is significant interest in the potential for technology to reduce utilisation of health services in these patient populations, including telecare (the remote, automatic and passive monitoring of changes in an individual's condition or lifestyle) and telehealth (the remote exchange of data between a patient and health care professional). The potential of telehealth and telecare technology to improve care and reduce costs is limited by a lack of rigorous evidence of actual impact. Methods/Design We are conducting a large scale, multi-site study of the implementation, impact and acceptability of these new technologies. A major part of the evaluation is a cluster-randomised controlled trial of telehealth and telecare versus usual care in patients with long-term conditions or social care needs. The trial involves a number of outcomes, including health care utilisation and quality of life. We describe the broad evaluation and the methods of the cluster randomised trial Discussion If telehealth and telecare technology proves effective, it will provide additional options for health services worldwide to deliver care for populations with high levels of need. Trial Registration Current Controlled Trials ISRCTN43002091