通过 "现实世界 "中的创新提高效率:为失语症患者共同设计远程保健解决方案的可行性

Katie E Chadd, S. Harding, J. Mortley, Pam Enderby
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引用次数: 0

摘要

背景:研究表明,通过远程医疗为失语症患者提供言语和语言治疗是可以接受的,并且有助于取得良好的治疗效果。尽管在 COVID-19 之后,远程医疗的采用率有所提高,但尚未得到广泛实施。远程医疗可以帮助服务机构达到为失语症患者推荐的治疗强度。目标: 该研究旨在调查两家当地 NHS 信托公司在为失语症患者采用远程保健服务时遇到的障碍和促进因素,并共同设计一个远程保健解决方案来应对这些挑战。此外,还对该解决方案的可行性进行了调查。次要目标是强调真实世界数据 (RWD) 收集在评估临床实践中的价值。方法:我们开展了一项基于经验的共同设计研究,在两个国家医疗服务系统(NHS)站点的服务路径中开发并试用了定制的远程医疗解决方案。通过访谈对可行性进行了定性评估,并通过远程保健软件收集的 RWD 对可行性进行了定量评估。结果:远程保健解决方案包括将服务外包给一家专业公司、提供硬件和软件,以及为失语症患者及其照顾者提供定期支持。使用该方案产生了积极的影响,RWD 显示,失语症患者接受治疗的时间大幅增加。结论:针对当地和个人需求的个性化远程医疗解决方案是可行的,也是一种可以接受的方式,可以提高一些失语症患者的言语和语言治疗强度,使服务更符合循证建议,并优化患者的治疗效果。嵌入式 RWD 收集系统对评估很有价值。
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Improving efficiency through innovation in the ‘real-world’: Feasibility of a co-designed telehealth solution for individuals with aphasia
BACKGROUND: Research indicates that speech and language therapy for individuals with aphasia delivered via telehealth is acceptable and facilitates good outcomes. Although adoption of telehealth has increased following COVID-19, it has not been implemented broadly. Telehealth could assist services to meet the recommended intensity of therapy for individuals with aphasia. OBJECTIVE: The study aimed to investigate the barriers and facilitators to adopting telehealth for individuals with aphasia at two local NHS trusts; and to co-design a telehealth solution responding to these challenges. The feasibility of this solution was also investigated. A secondary objective is to highlight the value of real-world data (RWD) collection in evaluating clinical practice. METHODS: An experience-based co-design study was conducted, which developed and piloted a bespoke telehealth solution across service pathways at two NHS sites. Feasibility was evaluated qualitatively through interviews and quantitatively from RWD collected through the telehealth software. RESULTS: The telehealth solution incorporated outsourcing of the service to a specialist company, provision of hardware and software and regular support for individuals with aphasia and their carers. Take up was associated with a positive impact and the RWD revealed a substantial increase in the hours of therapy the individuals with aphasia received. CONCLUSION: Personalised telehealth solutions which respond to local and personal needs are feasible and an acceptable way to increase the intensity of speech and language therapy for some individuals with aphasia, bringing services more in line with evidence-based recommendations and optimising patient outcomes. Embedded RWD collection systems are valuable for evaluation.
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