1. “I wasn't phoning because the sats were low I was phoning because I couldn't breathe”
The Effect of Telehealth on Patients Beliefs and Behaviours After 12 Months of Continual Use.
Prof Marion Bennie¹, Mrs Pamela MacIntyre2,3, Mr Stewart Cusick2
¹ Strathclyde Institute of Pharmacy & Biomedical Sciences (SIPBS), University of Strathclyde ² NHS Greater Glasgow & Clyde 3 West Dunbartonshire Health and Social Care Partnership
Background
Results
Five patients opted-in
Five themes were identified in the analysis of the transcribed interviews; Support Before Telehealth, Ease of Use, Disease Understanding, Self-Management and Confidence.
Participants described themselves as happy with the service they received and felt they were looked after and supported (Quote 1)
Participants acknowledged that there were limitations of the current service and made suggestions on how it could be improved. (Quote 2)
Participants demonstrated a good understanding of their oxygen saturations and how they could be affected by what they did. (Quote 3)
Participants acknowledged that they would rely on how they felt their symptoms were as a prompt to contact a healthcare professional rather than the oxygen saturations. (Quote 4)
There was an increase in the use of inhalers and the number of courses of antibiotics and a reduction in the number of courses of steroids, none of these were statistically significant. (Table 1)
COPD is a progressive condition that can have a negative impact on quality of life[1]. Improving the care of those with COPD is a priority for West Dunbartonshire Health and Social Care Partnership (WDHSCP) General Practitioner Locality Group.
Improvements in quality of life have been noted in some studies but a meta-analysis did not validate this[2].
Florence™ Telehealth was implemented through the Community COPD team in April Florence™ allows a message to be sent via mobile phone containing oxygen saturations (sats) and whether there are worsening symptoms
Aim
To explore the impact of Florence™ after 12 months continued use.
To determine whether the change in support provided causes a change in patients behaviour in regards their medication use.
Conclusions
Methods
Although they do not give examples of using it as intended the participants gained reassurance and confidence through the continued use of telehealth.
Further research, of sufficient size, should investigate:
if there is an impact on patients stopping telehealth after prolonged use.
whether there are any unintended consequences of telehealth on the adherence to prescribed medication.
Semi-structured interview conducted with patients that have used Florence™ for a minimum of 12 months as of 1st May 2018
Analyze transcripts for common themes in the answers given by the participants
Analyze prescription dispensed data to determine whether there is a significant change (p<0.05) in the quantity of courses or doses used.
Quote 1. “They've all been fantastic so I'd feel confident that they'd be there”
Quote 2: “when you've got two days (not covered at the weekend), if it's a holiday weekend you can have four days so where's the value if you're not doing it every day”
Table 1. Dispensed prescription data
Mean Value (April March 2017)
Mean Value (April March 2018)
Difference of Mean Values
Significance (p)
Antibacterials (Items)
1.83
1.92
0.09
0.928
Corticosteroids - Endocrine (items)
1.75
1.67
-0.08
0.964
Corticosteroids - Respiratory (DDDs)
100
105 5
0.959
Antimuscarinic Bronchodilators (DDDs) 90
117.5
27.5
0.304
DDD: Defined Daily Dose
Quote 3: “At 88, anything after 88 is OK but anything under 88 is not alright”
Quote 4: “I wasn't phoning because the sats were low I was phoning because I couldn't breathe”
Acknowledgment: WDHSCP Community COPD Team, WDHSCP GP Locality COPD Sub-Group
References. 1. GOLD 2017 Global Strategy for the Diagnosis, Management and Prevention of COPD - Global Initiative for Chronic Obstructive Lung Disease - GOLD 2. McLean S, Nurmatov U, Liu JL, Pagliari C, Car J, Sheikh A: Telehealthcare for chronic obstructive pulmonary disease: Cochrane Review and meta-analysis. Br J Gen Pract 2012, 62:e