I4F: Isla for Frailty Feasibility Study

NCT06504641 | Recruiting

• 1 other identifier: 23SM8192
• Study Type: observational
• Target: 95
• Locations: 1 country
• Sites: 1

Brief Summary

BACKGROUND: Older patients with frailty have complex support needs. How they manage with daily tasks such as eating and drinking, mobilising, communicating their preferences, and the level of support they need, can vary on a day-to-day basis. They are at risk of rapid loss of functional independence when they are acutely unwell. When older people need input from multiple different professionals, ineffective communication is sadly very common. This leads to disjointed care, and patients becoming frailer and suffering avoidable health complications. One of the problems is that it can be difficult for healthcare professionals to build up a complete picture of a patient from brief verbal handovers and written information in medical records. It is believed that video-recordings capturing the changing functional abilities and support needs of individual patients could improve care-provider communication and support for older people. Smartphones with cameras are now a part of everyday life, and people often tell their stories using photographs and videos. However, video recording patients during care delivery is not commonplace. It is not know how patients and carers feel about being video recorded or whether video recordings improve care. AIM: To explore the perspectives of frail older patients, carers, and clinical staff around video recording during routine clinical care, and to understand how patient videos could impact on communication and care delivery across care transitions. METHODS: The study team will recruit frail, older inpatients, their carers, and clinical staff from a Medicine for the Elderly ward. Over three months, doctors, nurses, and therapists will securely record and view patient videos alongside providing usual care. Videos will capture patients' functional abilities and support needs to inform ongoing assessment and care delivery. The investigators will collect information from patients/ carers/ doctors/ nurses /therapists about their experiences of the video recording intervention through interviews and questionnaires.

Conditions

Frailty

Keywords

Frailty; Communication; Patient assessment; Video-recording; Care transitions; Care continuity

Outcome Measures

Primary Outcomes (6)

• Intervention acceptability [1]

  Patient and carer perspectives on the acceptability of video-based records will be assessed within this mixed-methods feasibility study and process evaluation multiple measures: \[a\] Proportion of eligible participants declining enrolment and reasons for non-participation (% declining, descriptive statistics)

  Within three-month pilot phase

• Intervention acceptability [2]

  Patient perspectives on the acceptability of video-based records will be assessed within this mixed-methods feasibility study and process evaluation multiple measures: \[b\] Proportion of enrolled patients with ≥ 1 video linked to the electronic patient record (% with at least one video linked to electronic patient record, descriptive statistics)

  Within three-month pilot phase

• Intervention acceptability [3]

  Patient and carer perspectives on the acceptability of video-based records will be assessed within this mixed-methods feasibility study and process evaluation multiple measures: \[c\] Semi-structured interview at or within 2 weeks of discharge (Framework analysis to understand patient and carer views on acceptability)

  At or within two weeks of patient discharge

• Intervention acceptability [4]

  Ward team perspectives on the acceptability of video-based records will be assessed within this mixed-methods feasibility study and process evaluation multiple measures: \[a\] Video evaluation questionnaire (a combination of stuctured and open-ended questions asking ward team to appraise whether video quality is suitable for clinical interpretation: Yes/No/To some extent; Video length: Too long/Too short/Just right, Whether ward team want to see more patient videos in the future: Yes/No - descriptive statistics. Open-ended questions ask ward team to explain their answers)

  Within three-month pilot phase

• Intervention acceptability [5]

  Ward team perspectives on the acceptability of video-based records will be assessed within this mixed-methods feasibility study and process evaluation multiple measures: \[b\] Semi-structured interview after the three-month pilot (Framework analysis to understand ward team views on acceptability)

  Ward staff interviews to be conducted within two months after three-month pilot phase

• Intervention acceptability [6]

  Ward team perspectives on the acceptability of video-based records will be assessed within this mixed-methods feasibility study and process evaluation multiple measures: \[c\] Number of videos requested, attempted \& submitted (Quantitative, descriptive statistics)

  Within three-month pilot phase

Secondary Outcomes (10)

• Intervention feasibility - Patient enrolment [1]

  Within three-month pilot phase

• Intervention feasibility - Patient enrolment [2]

  Within three-month pilot phase

• Intervention feasibility - Intervention barriers and facilitators [1]

  At or within two weeks of patient discharge

• Intervention feasibility - Intervention barriers and facilitators [2]

  Ward staff interviews to be conducted within two months after three-month pilot phase

• Intervention feasibility - Use of the Isla platform [1]

  Within three-month pilot phase

Study Arms (3)

Patients

Up to 30 adults, aged 65 years or older, who are frail or pre-frail, and who are admitted as an inpatient to an acute Medicine for the Elderly ward during a three-month pilot phase Intervention: Isla for Frailty - video-based patient records. Isla is a technology company providing a visual patient record platform. The platform allows anyone involved in a patient's care to capture and review visual data (photographs, videos) relating to a patient's health. The platform is web-based (a "progressive web application") and supports secure capture of visual data with encrypted storage in the cloud. Isla interfaces with Electronic Health Record (EHR) systems including Cerner, enabling health professionals to view data held on Isla's servers from within the electronic patient record, via the 'Cerner Red Button'. Health professionals can also view a patient's visual record through a secure weblink requiring an NHS email address and password.

Other: Isla for Frailty

Carers

Carers of enrolled patients, who are in receipt of the Isla for Frailty intervention (described above) Carers are those who provide the enrolled patient with assistance in their daily activities and are unpaid for these caring activities. A carer may be a member of the patient's family, a friend, or other person who provides the patient with unpaid care.

Other: Isla for Frailty

Ward team

Clinical staff working on one of three Medicine for the Elderly wards at St Mary's Hospital, where the Isla for Frailty intervention (described above) will be subject to a feasibility trial. Clinical staff must work regular shifts on the ward during study initiation and pilot phases.

Other: Isla for Frailty

Interventions

Isla for Frailty OTHER

Isla for Frailty - video-based patient records. Isla is a technology company providing a visual patient record platform. The platform allows anyone involved in a patient's care to capture and review visual data (photographs, videos) relating to a patient's health. The platform is web-based (a "progressive web application") and supports secure capture of visual data with encrypted storage in the cloud. Isla interfaces with Electronic Health Record (EHR) systems including Cerner, enabling health professionals to view data held on Isla's servers from within the electronic patient record, via the 'Cerner Red Button'. Health professionals can also view a patient's visual record through a secure weblink requiring an NHS email address and password.

Carers; Patients; Ward team

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients: Adults, aged 65 years or older, who are frail or pre-frail, and who are admitted as an inpatient to an acute Medicine for the Elderly ward during a three-month pilot phase Carers: Carers of enrolled patients, who provide the enrolled patient with assistance in their daily activities and are unpaid for these caring activities. A carer may be a member of the patient's family, a friend, or other person who provides the patient with unpaid care Ward team: Clinical staff working on one of three Medicine for the Elderly wards at St Mary's Hospital, where the Isla for Frailty intervention (described above) will be subject to a feasibility trial

You may qualify if:

• Admitted as an inpatient to an acute Medicine for the Elderly ward at St Mary's Hospital during a 3-month pilot phase of Isla's visual record platform
• Aged ≥65 years old
• Are considered to be frail or pre-frail by the direct care team
• Have capacity to consent to study participation OR lack capacity to consent on the condition that a 'personal consultee' is available to advise on the patient's likely wishes and feelings about taking part.

You may not qualify if:

• Patients who lack capacity to consent will be excluded if a personal consultee is not available to advise on the patients' likely wishes or feelings about taking part.
• Carers.
• Aged ≥18 years
• Provide the patient/care-recipient with assistance in their daily activities and are unpaid for these caring activities
• Are willing to participate in an interview as part of the study
• A carer may be a member of the patient's family, a friend, or other person who provides the patient with unpaid care
• \- Carers will be excluded if the patient/care-recipient declined to participate in the study
• Ward team.
• Clinical staff working on an acute Medicine for the Elderly ward at St Mary's Hospital.
• Staff must be working regular shifts on the ward during study initiation and pilot phases
• Staff must have an active nhs.net account.
• Ad-hoc bank/agency staff
• Permanent staff on long-term leave (e.g. sick/maternity) during the pilot

Sponsors & Collaborators

• Imperial College London: lead
• Imperial College Healthcare NHS Trust: collaborator
• National Institute for Health Research, United Kingdom: collaborator
• Health Education England, Wessex: collaborator

Study Sites (1)

St Mary's Hospital

London, W2 1NY, United Kingdom

RECRUITING

MeSH Terms

Conditions

Frailty; Communication

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Behavior

Study Officials

• Phoebe Averill, PhD

  Imperial College London

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Phoebe Averill, PhD

CONTACT

020 7594 9038; phoebe.averill@nhs.net

Erik Mayer, PhD FRCS

CONTACT

e.mayer@imperial.ac.uk

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 10, 2024
• First Posted: July 17, 2024
• Study Start: February 14, 2024
• Primary Completion: July 31, 2024
• Study Completion: September 30, 2024
• Last Updated: July 18, 2024

Record last verified: 2024-07

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)