NCT07400133

Brief Summary

This observational, non-randomized, single-arm pilot study aims to assess the acceptability, feasibility, usability, and implementation fidelity of a co-designed multi-component digital health intervention to support the management of multiple long-term conditions (MLTCs) in Government primary health care settings. The study is conducted among adult patients with MLTCs attending rural primary health centres and the primary care providers (Medical officers and Staff Nurse) delivering services at these facilities in India and Nepal. The intervention comprises an electronic decision support system (EDSS) to facilitate evidence-based clinical decision-making, assisted telemedicine model to enable timely specialist consultations, and a patient-facing mobile application-supported by community champions to enhance care coordination, self-management, and treatment adherence. Participants will engage with these components over a three month implementation period and will complete surveys and qualitative interviews, alongside routine supervision checklists and system-usage analytics, to generate implementation and usability data. The study will be implemented across six rural primary health centres in Jodhpur (Rajasthan) and Anakapalli (Andhra Pradesh), India, and Kathmandu, Nepal, enrolling approximately 30 patients per site along with all participating health care providers. Findings from this pilot will inform refinement of the intervention, study tools, and implementation strategies, and will provide critical evidence on contextual adaptability to support the design of a subsequent cluster randomized controlled trial under the NIHR Global Health Research Centre for Multiple Long-Term Conditions.

Trial Health

47
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
180

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Feb 2026

Shorter than P25 for all trials

Geographic Reach
2 countries

6 active sites

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 18, 2026

Completed
23 days until next milestone

First Posted

Study publicly available on registry

February 10, 2026

Completed
5 days until next milestone

Study Start

First participant enrolled

February 15, 2026

Completed
3 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 15, 2026

Completed
15 days until next milestone

Study Completion

Last participant's last visit for all outcomes

May 30, 2026

Completed
Last Updated

February 10, 2026

Status Verified

February 1, 2026

Enrollment Period

3 months

First QC Date

January 18, 2026

Last Update Submit

February 3, 2026

Conditions

Outcome Measures

Primary Outcomes (1)

  • Feasibility of Intervention Implementation

    Feasibility will be assessed by successful completion of at least 70% of the planned workflow steps during the pilot phase.

    Feasibility outcomes will be tracked throughout the study period and summarized at 3 months (endline)

Secondary Outcomes (4)

  • Acceptability of Intervention

    Acceptability outcomes will be tracked throughout the study period and summarized at 3 months (endline)

  • Usability of Intervention

    Usability will be assessed at 3months (endline) based on post-intervention feedback from healthcare providers and participants

  • Fidelity of Intervention Implementation

    Fidelity will be monitored continuously using supervision checklists and system logs and summarized at 3months (endline).

  • Quality of Intervention Delivery

    Quality of delivery will be monitored continuously through documentation checks, formally assessed monthly, and summarized at 3months (endline)

Study Arms (1)

Pilot Intervention Cohort - Digital Health Intervention for MLTCs

This pilot, single-arm intervention cohort includes adult patients (aged ≥40 years) with multiple long-term conditions (MLTCs) receiving care at selected rural primary health centres in India, along with the primary care providers delivering services at these facilities. Participants will receive a multi-component digital health intervention comprising an Electronic Decision Support System (EDSS) to support guideline-based clinical decision-making for MLTC management, assisted telemedicine (facility-based and portable models) to enable specialist consultations, and a patient-facing mobile application to strengthen self-management, treatment adherence, and continuity of care. The cohort will be followed over a three-month pilot implementation period to assess the acceptability, usability, feasibility, and implementation fidelity of the intervention in routine primary care settings.

Other: Electronic Decision Support System (EDSS)Other: Assisted telemedicineOther: Patient facing mobile app and Community champions (Care coordinators)

Interventions

Algorithms were developed for hypertension, diabetes, mental health conditions, respiratory diseases, backache, substance use, and vision and hearing problems. Researchers reviewed national and LMIC guidelines and created flowcharts covering the full care pathway from screening and tests to diagnosis, treatment, referral, and follow-up. After multiple expert reviews, the final flowcharts were converted into structured datasets and workflow variables, forming the basis of the EDSS, which guides health workers step by step in delivering consistent care

Pilot Intervention Cohort - Digital Health Intervention for MLTCs

Assisted telemedicine refers to a system where participants get help to access teleconsultations through two models. A full Model, where they visit PHCs and connect with remote doctors through telemedicine hubs, and a backpack Model, where portable kits deliver telemedicine services in remote or hard to reach areas. Both models are adapted to local needs to ensure continuous care and better access to specialist consultations.

Pilot Intervention Cohort - Digital Health Intervention for MLTCs

The patient-facing app enables participants to track key health indicators, receive medication and appointment reminders, and access educational content. Community champions help to develop patient networks to improve disease management and empower them in their self care.

Pilot Intervention Cohort - Digital Health Intervention for MLTCs

Eligibility Criteria

Age40 Years - 100 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

The study population includes adult patients with multiple long-term conditions and primary health care providers from six rural primary health centres in India and Nepal. Study sites include two centres each in Jodhpur, Rajasthan; Anakapalli, Andhra Pradesh; and Bagmathi provience, Nepal. At each site, approximately 30 patients with multiple long-term conditions and all participating health care providers will be enrolled. Patients will be recruited from routine care at participating primary health centres, and providers will be recruited from staff involved in delivering the intervention.

You may qualify if:

  • Adults aged 40 years or above
  • Attending the Primary Health Centre (PHC) during the enrollment period
  • Diagnosed with two or more of the following chronic conditions:
  • Hypertension
  • Diabetes mellitus
  • Depression
  • Anxiety
  • Chronic obstructive pulmonary disease (COPD)
  • Asthma
  • Vision impairment
  • Hearing impairment
  • Osteoarthritis
  • Chronic back pain

You may not qualify if:

  • Age \< 40 years
  • Presence of only one or none of the listed chronic conditions
  • Pregnant or breastfeeding women
  • Severe cognitive impairment or dementia that prevents informed consent or or reliable participation
  • Bedridden or terminally ill individuals with a life expectancy \< 6 month
  • Current participation in another clinical or interventional research study may interfere with study outcomes
  • Severe psychiatric illness (e.g., psychosis or bipolar disorder) other than depression or anxiety
  • Unable or unwilling to provide written informed consent
  • Severe communication barriers that prevent participation in interviews or questionnaires, even with assistance

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (6)

Makavarapalem Primary Health Care Center

Narsīpatnam, Anakapalli, 531113, India

Location

Nathavaram Primary Health Care Center

Narsīpatnam, Anakapalli, 531115, India

Location

Beru,Primary Health Care Center

Bhopālgarh, Jodupur, 342024, India

Location

Pheench, Primary Health Care Center

Phalodi, Jodupur, 342801, India

Location

Dadhikot Primary Health Care Center

Bhaktapur, Bagmati, 45206, Nepal

Location

Kathmandu, Urban health promotion center

Kathmandu, Bagmati, 1244600, Nepal

Location

MeSH Terms

Conditions

Respiration DisordersMetabolic DiseasesBehaviorNeurodevelopmental DisordersEye DiseasesEar Diseases

Condition Hierarchy (Ancestors)

Respiratory Tract DiseasesNutritional and Metabolic DiseasesMental DisordersOtorhinolaryngologic Diseases

Study Officials

  • Prabhakaran Dorairaj, M.D., DM

    Center for Chronic Disease Control

    PRINCIPAL INVESTIGATOR
  • Kamlesh Khunti, MD, DM

    University of Leicester

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Prabhakaran Dorairaj, M.D., DM

CONTACT

Sailesh Mohan, MD, PhD

CONTACT

Study Design

Study Type
observational
Observational Model
OTHER
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Executive Director

Study Record Dates

First Submitted

January 18, 2026

First Posted

February 10, 2026

Study Start

February 15, 2026

Primary Completion

May 15, 2026

Study Completion

May 30, 2026

Last Updated

February 10, 2026

Record last verified: 2026-02

Data Sharing

IPD Sharing
Will share

De-identified data collected for the study will be shared with bonafide researchers with a valid research question. Request may be addressed to Prof. Prabhakaran - dprabhakaran@ccdcindia.org

Shared Documents
STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
Time Frame
01-06-2026 till 30-12-2027
Access Criteria
Only bonafide researchers with a valid research question shall be provided data. Interested researchers shall write to Prof. Prabhakaran (dprabhakaran@ccdcindia.org) with a concept note and necessary approvals as applicable.

Locations