Caregiver control of multi-morbid disease management www.chessitn.eu

1. STUDY DESIGN
• This is an observational and longitudinal study.
• There will be two groups: the CH group and a control group. Both groups will follow their traditional
care plan but the CH group will be provided with monitoring devices and a tablet computer
containing a technology platform for home use, which will connect the key stakeholders in the
patients care (caregiver, General Practitioner, Public Health Nurse and hospital geriatric services)
through a secure internet portal. Monitoring will include clinical measures of heart rate,
bloodpressure, weight, standing balance, gait speed, sleep and physical activity levels, which will
be daily/weekly measured by Bluetooth enabled devices (where applicable). Furthermore
comprehensive assessments about mental, emotional and physical distress will be performed at
baseline, 3-6-9 and 12 months, using international and standardized questionnaires which will be
completed electronically on the tablet by the caregiver or patient. The generated data will be
presented on the portal. The patient and carer supports, which will be offered in the home through
the connected healthinterface, will adhere to best evidence for education and advice about
exercise and cognitive support as deemed appropriate by the healthcare team.The control group
will have exactly the same schedule of assessments but will not have the daily monitoring of BP,
HR, physical activity and sleep, and will not have the communication platform and tablet. This
group will similarly receive care as usual from their health care providers.
• Risks to the vulnerable
• As this is an observational study with no interference in the clinical management of the patient, no
risks are anticipated related to the research. Any adverse events will be notified to the ethics
committees from which approval has been sought.
INTRODUCTION
• Increasing life expectancies and a rapidly ageing population is contributing to an increase in the
number of persons with multi-morbid disease, leading to increases in health care utilisation. At the
same time, their care plan is not well coordinated with minimal timely transfer of patient status and
information between stakeholders, placing further unnecessary strain on all those involved. In that
coordination, the majority of the responsibility lies with the caregiver, usually a family member, a
friend or close relative, who takes care of them in all of their aspects in life, including activities of
daily life (ADL), financial and economic issues and health. Caregivers often use their own time and
effort taking care of their loved ones, which often impacts on their social life, rest time and work. In
addition, a lack of resource availability and support can have a negative impact on the caring
process. These negative impacts can result in feelings of anxiety, depression, stress and burden,
and can also have a negative impact on the recipient, and other members of the family, and can be
the determining factor in the decision of care home placement.
• Smart technologies are being developed to support family caregivers of multi-morbid patients in a
variety of ways, including provision of information and support resources online. Technology can be
used to support independent mobility of the patient, monitoring systems to alert caregivers to
changes in the patient and their environment and telemedicine and e-health services linking
caregivers and patients with health care providers. With this new technology potential opportunities
to reduce both the burden of caregiving and the need for premature nursing home placement may
be possible.
• One of the most care-demanding chronic condition is Dementia Disease. Dementia is
characterized by progressive cognitive impairment and deterioration in memory, thinking, behavior
and the ability to perform ADL (WHO, 2012). The signs and symptoms may vary between each
person and the stage of the illness. Studies of prevalence of Dementia in Western Europe show a
doubling with every 6.3 year increment in age (Alzheimer’s Disease International, 2012), and the
WHO declared it a global public health priority in 2012. For these reasons, our first research
approach will be focused on a person with dementia (PwD) and their caregiver.
OBJECTIVES
The overall aim is to evaluate the utility of a Connected Health (CH) platform in supporting people
with dementia and their caregivers in sustaining the patient at home. We propose that the CH model
allows enhanced information sharing between patient, caregiver and healthcare team (GP, Hospital
Consultant and Public Health Nurse) and that this model offers benefits over usual care.
1. LONGITUDINAL MONITORING OF PATIENT-CARER COUPLE.
2. MEASURE THE VALUE OF THE CH PLATFORM IN SUPPORTING CAREGIVERS.
3. THE USABILITY AND USER EXPERIENCE.
CAREGIVER CONTROL OF MULTI-MORBID
DISEASE MANAGEMENT
Estefanía Guisado Fernández
ESR 1- University College of Dublin (UCD)
This project has received funding from the European Union's Horizon 2020 research and
innovation programme under the Marie Sklodowska-Curie grant agreement No 676201
Supervision by Prof. Brian Caulfield and Dr. Catherine Blake.
Post Doctoral Researcher: Dr. Laura MacKey
WHERE WE ARE NOW
The project is still in the development phase, involving the participation from both, healthcare and
technology experts. In addition, we are waiting for the ethics committee approval to start with the
recruitment of the participants.