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TElehealth in CHronic disease: mixed-methods study to develop the TECH conceptual model for intervention design and evaluation

TElehealth in CHronic disease: mixed-methods study to develop the TECH conceptual model for intervention design and evaluation
TElehealth in CHronic disease: mixed-methods study to develop the TECH conceptual model for intervention design and evaluation
Objective

To develop a conceptual model for effective use of telehealth in the management of chronic health conditions, and to use this to develop and evaluate an intervention for people with two exemplar conditions: raised cardiovascular disease risk and depression.

Design

The model was based on several strands of evidence: a metareview and realist synthesis of quantitative and qualitative evidence on telehealth for chronic conditions; a qualitative study of patients’ and health professionals’ experience of telehealth; a quantitative survey of patients’ interest in using telehealth; and review of existing models of chronic condition management and evidence-based treatment guidelines. Based on these evidence strands, a model was developed and then refined at a stakeholder workshop. Then a telehealth intervention (‘Healthlines’) was designed by incorporating strategies to address each of the model components. The model also provided a framework for evaluation of this intervention within parallel randomised controlled trials in the two exemplar conditions, and the accompanying process evaluations and economic evaluations.

Setting

Primary care.

Results

The TElehealth in CHronic Disease (TECH) model proposes that attention to four components will offer interventions the best chance of success: (1) engagement of patients and health professionals, (2) effective chronic disease management (including subcomponents of self-management, optimisation of treatment, care coordination), (3) partnership between providers and (4) patient, social and health system context. Key intended outcomes are improved health, access to care, patient experience and cost-effective care.

Conclusions

A conceptual model has been developed based on multiple sources of evidence which articulates how telehealth may best provide benefits for patients with chronic health conditions. It can be used to structure the design and evaluation of telehealth programmes which aim to be acceptable to patients and providers, and cost-effective.
Salisbury, Chris
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Thomas, Clare
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O'Cathain, Alicia
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Rogers, Anne
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Pope, Catherine
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Yardley, Lucy
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Hollinghurst, Sandra
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Fahey, Tom
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Lewis, Glyn
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Large, Shirley
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Edwards, Louisa
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Rowsell, Alison
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Segar, Julia
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Brownsell, Simon
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Montgomery, Alan A.
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Salisbury, Chris
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Thomas, Clare
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O'Cathain, Alicia
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Rogers, Anne
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Pope, Catherine
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Yardley, Lucy
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Hollinghurst, Sandra
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Fahey, Tom
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Lewis, Glyn
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Large, Shirley
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Edwards, Louisa
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Rowsell, Alison
058f3917-b556-4eef-a393-4c025a3c4ccb
Segar, Julia
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Brownsell, Simon
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Montgomery, Alan A.
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Salisbury, Chris, Thomas, Clare, O'Cathain, Alicia, Rogers, Anne, Pope, Catherine, Yardley, Lucy, Hollinghurst, Sandra, Fahey, Tom, Lewis, Glyn, Large, Shirley, Edwards, Louisa, Rowsell, Alison, Segar, Julia, Brownsell, Simon and Montgomery, Alan A. (2015) TElehealth in CHronic disease: mixed-methods study to develop the TECH conceptual model for intervention design and evaluation. BMJ Open, 5 (2), [e006448]. (doi:10.1136/bmjopen-2014-006448). (PMID:25659890)

Record type: Article

Abstract

Objective

To develop a conceptual model for effective use of telehealth in the management of chronic health conditions, and to use this to develop and evaluate an intervention for people with two exemplar conditions: raised cardiovascular disease risk and depression.

Design

The model was based on several strands of evidence: a metareview and realist synthesis of quantitative and qualitative evidence on telehealth for chronic conditions; a qualitative study of patients’ and health professionals’ experience of telehealth; a quantitative survey of patients’ interest in using telehealth; and review of existing models of chronic condition management and evidence-based treatment guidelines. Based on these evidence strands, a model was developed and then refined at a stakeholder workshop. Then a telehealth intervention (‘Healthlines’) was designed by incorporating strategies to address each of the model components. The model also provided a framework for evaluation of this intervention within parallel randomised controlled trials in the two exemplar conditions, and the accompanying process evaluations and economic evaluations.

Setting

Primary care.

Results

The TElehealth in CHronic Disease (TECH) model proposes that attention to four components will offer interventions the best chance of success: (1) engagement of patients and health professionals, (2) effective chronic disease management (including subcomponents of self-management, optimisation of treatment, care coordination), (3) partnership between providers and (4) patient, social and health system context. Key intended outcomes are improved health, access to care, patient experience and cost-effective care.

Conclusions

A conceptual model has been developed based on multiple sources of evidence which articulates how telehealth may best provide benefits for patients with chronic health conditions. It can be used to structure the design and evaluation of telehealth programmes which aim to be acceptable to patients and providers, and cost-effective.

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More information

Accepted/In Press date: 9 January 2015
e-pub ahead of print date: 6 February 2015
Published date: 6 February 2015
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 375101
URI: http://eprints.soton.ac.uk/id/eprint/375101
PURE UUID: b06c4213-5908-42ca-b090-37ef68b63a05
ORCID for Catherine Pope: ORCID iD orcid.org/0000-0002-8935-6702
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

Catalogue record

Date deposited: 08 Jul 2015 13:50
Last modified: 28 Apr 2022 01:52

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Contributors

Author: Chris Salisbury
Author: Clare Thomas
Author: Alicia O'Cathain
Author: Anne Rogers
Author: Catherine Pope ORCID iD
Author: Lucy Yardley ORCID iD
Author: Sandra Hollinghurst
Author: Tom Fahey
Author: Glyn Lewis
Author: Shirley Large
Author: Louisa Edwards
Author: Alison Rowsell
Author: Julia Segar
Author: Simon Brownsell
Author: Alan A. Montgomery

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