OBJECTIVES: To assess the sustainability, clinical utility and acceptability to clinicians and parents of a tele-homecare programme for infants with major congenital heart disease (CHD), and to evaluate the impact on healthcare resource use. DESIGN: Randomised control trial. SETTING: UK tertiary congenital cardiac centre. PARTICIPANTS: 83 infants with major CHD. INTERVENTION: Participants were randomised to one of three groups: video-conferencing support (n=35), telephone support (n=24) and a control group (n=24). Patients in the two intervention groups received regular, standardised remote consultations. Video-conferences (VCs) were facilitated by Integrated Systems Digital Network lines and replaced by home broadband connections later in the study. MAIN OUTCOME MEASURES: Healthcare resource use, utilisation including hospitalisation, clinicians' opinions on utility and quality of interventions, parental opinions on quality of interventions. RESULTS: Clinicians were more confident making medical decisions following VCs compared with telephone consultations (p=0.01). Both VC and telephone support were very well received, but parents expressed significantly higher levels of satisfaction with VC support (p=0.001). Healthcare resource use was 37% lower in the video-conferencing group compared with both telephone support and control groups (p<0.001), as was the risk of hospitalisation (p=0.006). Direct health service costs were significantly lower in the video-conferencing group (p<0.05). CONCLUSIONS: A tele-medicine home support programme for families of infants with major CHD is feasible, sustainable and effective. Home support with video-conferencing is superior to telephone consultations. Parents are highly satisfied with tele-homecare. Tele-homecare significantly reduces health service utilisation and may reduce health service costs.
RCT Entities:
OBJECTIVES: To assess the sustainability, clinical utility and acceptability to clinicians and parents of a tele-homecare programme for infants with major congenital heart disease (CHD), and to evaluate the impact on healthcare resource use. DESIGN: Randomised control trial. SETTING: UK tertiary congenital cardiac centre. PARTICIPANTS: 83 infants with major CHD. INTERVENTION: Participants were randomised to one of three groups: video-conferencing support (n=35), telephone support (n=24) and a control group (n=24). Patients in the two intervention groups received regular, standardised remote consultations. Video-conferences (VCs) were facilitated by Integrated Systems Digital Network lines and replaced by home broadband connections later in the study. MAIN OUTCOME MEASURES: Healthcare resource use, utilisation including hospitalisation, clinicians' opinions on utility and quality of interventions, parental opinions on quality of interventions. RESULTS: Clinicians were more confident making medical decisions following VCs compared with telephone consultations (p=0.01). Both VC and telephone support were very well received, but parents expressed significantly higher levels of satisfaction with VC support (p=0.001). Healthcare resource use was 37% lower in the video-conferencing group compared with both telephone support and control groups (p<0.001), as was the risk of hospitalisation (p=0.006). Direct health service costs were significantly lower in the video-conferencing group (p<0.05). CONCLUSIONS: A tele-medicine home support programme for families of infants with major CHD is feasible, sustainable and effective. Home support with video-conferencing is superior to telephone consultations. Parents are highly satisfied with tele-homecare. Tele-homecare significantly reduces health service utilisation and may reduce health service costs.
Authors: Walter Knirsch; Sonia Bertholdt; Gaby Stoffel; Brian Stiasny; Roland Weber; Hitendu Dave; Rene Prêtre; Michael von Rhein; Oliver Kretschmar Journal: Pediatr Cardiol Date: 2014-01-18 Impact factor: 1.655
Authors: Meredith A Achey; Christopher A Beck; Denise B Beran; Cynthia M Boyd; Peter N Schmidt; Allison W Willis; Sara S Riggare; Richard B Simone; Kevin M Biglan; E Ray Dorsey Journal: Trials Date: 2014-11-27 Impact factor: 2.279
Authors: Alyson Stagg; Therese M Giglia; Monique M Gardner; Bonnie F Offit; Kate M Fuller; Shobha S Natarajan; David A Hehir; Anita L Szwast; Jonathan J Rome; Chitra Ravishankar; Benjamin L Laskin; Tamar J Preminger Journal: Pediatr Cardiol Date: 2022-09-01 Impact factor: 1.838
Authors: Meredith A Achey; Christopher A Beck; Denise B Beran; Cynthia M Boyd; Peter N Schmidt; Allison W Willis; Sara S Riggare; Richard B Simone; Kevin M Biglan; E Ray Dorsey Journal: Trials Date: 2016-01-05 Impact factor: 2.279