Dinsmore, John, Hannigan, Caoimhe, Smith, Suzanne, Murphy, Emma, Kuiper, Janneke M L, O'Byrne, Emma, Galvin, Mary, Jacobs, An, Sillevis Smitt, Myriam, van Leeuwen, Cora, McAleer, Patricia, Tompkins, Lorraine, Brady, Anne-Marie, McCarron, Mary and Doyle, Julie (2021) A Digital Health Platform for Integrated and Proactive Patient-Centered Multimorbidity Self-management and Care (ProACT): Protocol for an Action Research Proof-of-Concept Trial. JMIR Research Protocols, 10 (12). e22125. ISSN 1929-0748
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Abstract
Background: Multimorbidity is defined as the presence of two or more chronic diseases and associated comorbidities. There
is a need to improve best practices around the provision of well-coordinated, person-centered care for persons with multimorbidities.
Present health systems across the European Union (EU) focus on supporting a single-disease framework of care; the primary
challenge is to create a patient-centric, integrated care ecosystem to understand and manage multimorbidity. ProACT is a large-scale
project funded by the European Commission under the Horizon 2020 programme, that involved the design, development, and
evaluation of a digital health platform to improve and advance home-based integrated care, and supported self-management, for
older adults (aged ≥65 years) living with multimorbidity.
Objective: This paper describes the trial implementation protocol of a proof-of-concept digital health platform (ProACT) in 2
EU member states (Ireland and Belgium) to support older persons with multimorbidities self-managing at home, supported by
their care network (CN).
Methods: Research was conducted across 2 EU member states, Ireland and Belgium. A 12-month action research trial design,
divided into 3 evaluation cycles and lasting 3 months each, with a reflective redesign and development phase of 1 month after
cycles 1 and 2 was conducted. Participants were 120 (60/120, 50% in Ireland and 60/120, 50% in Belgium) older persons with
multimorbidities diagnosed with two or more of the following chronic conditions: diabetes, chronic obstructive pulmonary disease,
chronic heart failure, and cardiovascular diseases. With permission from persons with multimorbidities, members of their CN
were invited to participate in the study. Persons with multimorbidities were provided with ProACT technologies (tablet, devices,
or sensors) to support them in self-managing their conditions. CN members also received access to an app to remotely support
their persons with multimorbidity. Qualitative and quantitative feedback and evaluation data from persons with multimorbidity
and CN participants were collected across four time points: baseline (T1), at the end of each 3-month action research cycle (T2
and T3), and in a final posttrial interview (T4). Thematic analysis was used to analyze the qualitative interview data. Quantitative.
data were analyzed via platform use statistics (to assess engagement) and standardized questionnaires (using descriptive and
inferential statistics). This study is approved by the ethics committees of Ireland and Belgium.
Results: The trial implementation phase for this 44-month (2016-2019) funded study was April 2018 to June 2019. The trial
outcomes are at various stages of publication since 2021.
Conclusions: ProACT aims to co-design and develop a digital intervention with persons with multimorbidities and their CN,
incorporating clinical guidelines with the state of the art in human-computer interaction, behavioral science, health psychology,
and data analytic methods to deliver a digital health platform to advance self-management of multimorbidity at home, as part of
a proactive, integrated model of supported person-centered care.
Item Type: | Article |
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Keywords: | multimorbidity; digital health; chronic disease; self-management; older adults; integrated care; behaviour change; mobile phone; smart phone; smart device; |
Academic Unit: | Faculty of Social Sciences > Design Innovation |
Item ID: | 18595 |
Identification Number: | 10.2196/22125 |
Depositing User: | Mary Galvin |
Date Deposited: | 30 May 2024 08:40 |
Journal or Publication Title: | JMIR Research Protocols |
Publisher: | JMIR Publications |
Refereed: | Yes |
Related URLs: | |
URI: | https://mural.maynoothuniversity.ie/id/eprint/18595 |
Use Licence: | This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here |
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