Remote-by-Default Care in the COVID-19 Pandemic

NCT04435041 | Completed

• 1 other identifier: 283196
• Study Type: observational
• Target: 103
• Locations: 1 country
• Sites: 1

Brief Summary

18 month study, funded by ESRC COVID-19 research fund. The aim is to explore and support the rapid shift from face-to-face to remote (telephone and video) conversations in primary care. There are three components: a study of clinical interactions and decision making (micro); four locality-based organisational case studies of new models of care (meso); abd a a study of how digital innovation can support NHS infrastructure and vice versa (macro).

Conditions

COVID-19

Outcome Measures

Primary Outcomes (1)

• Remote COVID-19 Assessment in Primary Care (RECAP) Early warning score

  A set of questions and a predictive tool built into electronic records, designed to distinguish people with suspected covid-19 who need to go to hospital from those who can safely be monitored at home. The final Remote COVID-19 Assessment in Primary Care (RECAP) Early warning score score divides people into 'green' (stay at home, self-monitor), amber (professional monitoring e.g., via virtual wards with home oximetry), or red (assess in person promptly).

  18 months

Study Arms (4)

Remote assessment tools

Qualitative methods: semi-structured interviews for approx 40 front line clinical practitioners

RECAP early warning score

Development of disease specific early warning score, building on earlier work through literature review and NEWS2 score

Implementation/Scale up case studies

Study of implementation and scale up of remote-by-default at four different UK sites

Infrastructure strengthening

Theory and data driven change effort involving policymakers, regulators, professional bodies, industry, patients and citizens with a view to overcoming interacting issues impacting success of digital projects.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Mixed methods study

You may qualify if:

• Willing and able to give informed consent for participation
• Aged 18 years or above
• Staff involved in delivering remote-by-default services in the frontline or 'back offices'
• Patients/carers who have crossed paths with primary care services during the Covid pandemic.
• Pharmacy case studies:
• Staff involved in delivering remote pharmacist consultation services in the frontline or 'back offices'
• Patients/carers who have crossed paths with community pharmacy primary care services during the COVID-19 pandemic.
• Patients who have remote primary care consultation regarding symptoms associated with COVID-19 and their clinicians (based in Oxford/Thames Valley) who have agreed to participate in the study
• Patients that have experienced self-reported 'long Covid' symptoms (for patient only focus groups)
• Clinicians that have experienced self-reported 'long Covid' symptoms (for clinician only focus groups)

You may not qualify if:

• Patients or clinicians who are too ill to be interviewed

Sponsors & Collaborators

• University of Oxford: lead
• University of Plymouth: collaborator
• Nuffield Trust: collaborator

Study Sites (1)

University of Oxford

Oxford, United Kingdom

Location

Related Publications (3)

• Fiorentino F, Prociuk D, Espinosa Gonzalez AB, Neves AL, Husain L, Ramtale SC, Mi E, Mi E, Macartney J, Anand SN, Sherlock J, Saravanakumar K, Mayer E, de Lusignan S, Greenhalgh T, Delaney BC. An Early Warning Risk Prediction Tool (RECAP-V1) for Patients Diagnosed With COVID-19: Protocol for a Statistical Analysis Plan. JMIR Res Protoc. 2021 Oct 5;10(10):e30083. doi: 10.2196/30083.

  PMID: 34468322 DERIVED

• Ladds E, Rushforth A, Wieringa S, Taylor S, Rayner C, Husain L, Greenhalgh T. Persistent symptoms after Covid-19: qualitative study of 114 "long Covid" patients and draft quality principles for services. BMC Health Serv Res. 2020 Dec 20;20(1):1144. doi: 10.1186/s12913-020-06001-y.

  PMID: 33342437 DERIVED

• Greenhalgh T, Thompson P, Weiringa S, Neves AL, Husain L, Dunlop M, Rushforth A, Nunan D, de Lusignan S, Delaney B. What items should be included in an early warning score for remote assessment of suspected COVID-19? qualitative and Delphi study. BMJ Open. 2020 Nov 12;10(11):e042626. doi: 10.1136/bmjopen-2020-042626.

  PMID: 33184088 DERIVED

MeSH Terms

Conditions

COVID-19

Condition Hierarchy (Ancestors)

Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: OTHER
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 16, 2020
• First Posted: June 17, 2020
• Study Start: May 13, 2020
• Primary Completion: July 27, 2021
• Study Completion: February 28, 2022
• Last Updated: April 11, 2022

Record last verified: 2020-05

Locations

GB (1)