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Implementation Science
Published in: Implementation Science 1/2015

Open Access 01-12-2015 | Research

Assessing the implementability of telehealth interventions for self-management support: a realist review

Authors: Ivaylo Vassilev, Alison Rowsell, Catherine Pope, Anne Kennedy, Alicia O’Cathain, Chris Salisbury, Anne Rogers

Published in: Implementation Science | Issue 1/2015

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Abstract

Background

There is a substantial and continually growing literature on the effectiveness and implementation of discrete telehealth interventions for health condition management. However, it is difficult to predict which technologies are likely to work and be used in practice. In this context, identifying the core mechanisms associated with successful telehealth implementation is relevant to consolidating the likely elements for ensuring a priori optimal design and deployment of telehealth interventions for supporting patients with long-term conditions (LTCs).

Methods

We adopted a two-stage realist synthesis approach to identify the core mechanisms underpinning telehealth interventions. In the second stage of the review, we tested inductively and refined our understanding of the mechanisms. We reviewed qualitative papers focused on COPD, heart failure, diabetes, and behaviours and complications associated with these conditions. The review included 15 papers published 2009 to 2014.

Results

Three concepts were identified, which suggested how telehealth worked to engage and support health-related work. Whether or not and how a telehealth intervention enables or limits the possibility for relationships with professionals and/or peers. Telehealth has the potential to reshape and extend existing relationships, acting as a partial substitute for the role of health professionals. The second concept is fit: successful telehealth interventions are those that can be well integrated into everyday life and health care routines and the need to be easy to use, compatible with patients’ existing environment, skills, and capacity, and that do not significantly disrupt patients’ lives and routines. The third concept is visibility: visualisation of symptoms and feedback has the capacity to improve knowledge, motivation, and a sense of empowerment; engage network members; and reinforce positive behaviour change, prompts for action and surveillance.

Conclusions

Upfront consideration should be given to the mechanisms that are most likely to ensure the successful development and implementation of telehealth interventions. These include considerations about whether and how the telehealth intervention enables or limits the possibility for relationships with professionals and peers, how it fits with existing environment and capacities to self-manage, and visibility-enabling-enhanced awareness to self and others.
Literature
1.
Reeves D, Blickem C, Vassilev I, Brooks H, Kennedy A, Richardson G, et al. The contribution of social networks to the health and self-management of patients with long-term conditions: a longitudinal study. PloS one. 2014. doi:10.1371/journal.pone.0098340.
2.
Scambler G, Britten N. System, lifeworld and doctor-patient interactions. In: Habermas, Critical Theory and Health. Scambler G. London: Taylor and Francis; 2001.
3.
May C, Harrison R, Finch T, et al. Understanding the normalization of telemedicine services through qualitative evaluation. J Am Med Inform Assoc. 2003;10(6):596–604.PubMedPubMedCentral
4.
Rogers A, Vassilev I, Sanders C, Kirk S, Chew-Graham C, Kennedy A, et al. Social networks, work and network-based resources for the management of long-term conditions: a framework and study protocol for developing self-care support. Implement Sci. 2011;6:56.PubMedPubMedCentral
5.
Tran K, Polisena J, Coyle D, Kluge E-H W, McGill S, Noorani H, et al. Overview of home telehealth for chronic disease management. In: Technology overview number 46. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2008.
6.
Hoybye MT, Johansen C, Tjornhoj-Thomsen T. Online interaction effects of storytelling in an Internet breast cancer support group. Psycho-Oncology. 2005;14(3):211–20.PubMed
7.
Marziali E. E-health program for patients with chronic disease. Telemed J E Health. 2009;15(2):176–81.PubMed
8.
Sandberg J, Trief PM, Izquierdo R, Goland R, Morin PC, Palmas W, et al. A qualitative study of the experiences and satisfaction of direct telemedicine providers in diabetes case management. Telemed J E Health. 2009;15(8):742–50.PubMed
9.
LaFramboise LM, Woster J, Yager A, Yates BC. A technological life buoy patient perceptions of the health buddy. J Cardiovasc Nurs. 2009;24(3):216–24.PubMed
10.
Mackert M, Kahlor L, Tyler D, Gustafson J. Designing e-health interventions for low-health-literate culturally diverse parents: addressing the obesity epidemic. Telemed J E Health. 2009;15(7):672–7.PubMedPubMedCentral
11.
Rahimpour M, Lovell NH, Celler BG, McCormick J. Patients’ perceptions of a home telecare system. Int J Med Inform. 2008;77(7):486–98.PubMed
12.
Dinesen B, Nohr C, Andersen SK, Sejersen H, Toft E. Under surveillance, yet looked after: telehomecare as viewed by patients and their spouse/partners. Eur J Cardiovasc Nurs. 2008;7(3):239–46.PubMed
13.
Liddy C, Dusseault J, Dahrouge S, Hogg W, Lemelin J, Humbert J. Telehomecare for patients with multiple chronic illnesses: pilot study. Can Fam Physician. 2008;54(1):58–65.PubMedPubMedCentral
14.
Griffiths F, Lindenmeyer A, Powell J, Lowe P, Thorogood M. Why are health care interventions delivered over the internet? A systematic review of the published literature. J Med Internet Res. 2006;8(2):e10.PubMedPubMedCentral
15.
Murray E, Burns J, See Tai S, Lai R, Nazareth I. Interactive health communication applications for people with chronic disease (review). Cochrane Database Syst Rev. 2005;4:CD004274.PubMed
16.
Krishna S, Boren SA, Balas EA. Healthcare via cell phones: a systematic review. Telemed E Health. 2009;15(3):231–40.
17.
18.
19.
Ziebland S, Wyke S. Health and illness in a connected world: how might sharing experiences on the internet affect people’s health? Milbank Q. 2012;90(2):219–49.PubMedPubMedCentral
20.
Bashshur B, Shannon G, Krupinski E, Grigsby J. The taxonomy of telemedicine. Telemed E Health. 2011;17(6):484–94.
21.
Vassilev I, Rogers A, Kennedy A, Koestenruijter J. The influence of social networks on self-management support: a metasynthesis. BMC Public Health. 2014;14:719.PubMedPubMedCentral
22.
Pawson R. Evidence-based policy: a realist perspective. Los Angeles and London: Sage; 2009.
23.
Pawson R, Greenhalgh T, Harvey G, Walshe K. Realist review–a new method of systematic review designed for complex policy interventions. J Health Serv Res Policy. 2005;10 Suppl 1:21–34.PubMed
24.
Sanders C, Rogers A, Bowen R, Bower P, Hirani S, Cartwright M, et al. Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study. BMC Health Serv Res. 2012;12:220.PubMedPubMedCentral
25.
26.
Pilgrim D, Rogers A, Bentall R. The centrality of personal relationships in the creation and amelioration of mental health problems: the current interdisciplinary case. Health. 2009;13:235–54.PubMed
27.
Protheroe J, Bower P, Chew-Graham C. The use of mixed methodology in evaluating complex interventions: identifying patient factors that moderate the effects of a decision aid. Fam Pract. 2007;24(6):594–600.PubMed
28.
Segar J, Rogers A, Salisbury C, Thomas C. Roles and identities in transition: boundaries of work and inter-professional relationships at the interface between telehealth and primary care. Health Soc Care Commun. 2013;21(6):606–13.
29.
Fairbrother P, Pinnock H, Hanley J, McCloughan L, Sheikh A, Pagliari C, et al. Continuity, but at what cost? The impact of telemonitoring COPD on continuities of care: a qualitative study. Prim Care Respir J. 2012;21(3):322–8.PubMed
30.
Froisland DH, Arsand E, Skarderud F. Improving diabetes care for young people with type 1 diabetes through visual learning on mobile phones: mixed-methods study. J Med Internet Res. 2012;14(4):113–25.
31.
Dinesen B, Huniche L, Toft E. Attitudes to COPD patients towards tele-rehabilitation: a cross-sector case study. Int J Environ Res Public Health. 2013;10:6184–98.PubMedPubMedCentral
32.
Burner E, Menchine M, Taylor E, Arora S. Gender differences in diabetes self-management: a mixed-methods analysis of a mobile health intervention for inner-city Latino patients. J Diabetes Sci Technol. 2013;7:111.PubMedPubMedCentral
33.
Fairbrother P, Ure J, Hanley J, McCloughan L, Denvir M, Sheikh A, et al. Telemonitoring for chronic heart failure: the views of patients and healthcare professionals - a qualitative study. J Clin Nurs. 2013;23:132–44.PubMed
34.
Watson A, Kvedar JC, Rahman B, Pelletier AC, Salber G, Grant RW. Diabetes connected health: a pilot study of a patient- and provider shared glucose monitoring web application. J Diabetes Sci Technol. 2009;3:345.PubMedPubMedCentral
35.
Pols J, Willems D. Innovation and evaluation: taming and unleashing telecare technology. Sociol Health Illn. 2011;33(3):484–98.PubMed
36.
Guilcher SJT, Bereket T, Voth J, Haroun VA, Jaglal SB. Spanning boundaries into remote communities: an exploration of experiences with telehealth chronic disease self-management programs in rural Northern Ontario, Canada. Telemed E Health. 2013;19(12):904–9.
37.
Jones MI, Greenfield SM, Bray EP, Baral-Grant S, Hobbs FDR, Holder R, et al. Patients’ experiences of self-monitoring blood pressure and self-titration of medication: the TASMINH2 trial qualitative study. Br J Gen Pract. 2012;62:e135–42.PubMed
38.
Fairbrother P, Pinnock H, Hanley J, McCloughan L, Sheikh A, Pagliari C, et al. Exploring telemonitoring and self-management by patients with chronic obstructive pulmonary disease: a qualitative study embedded in a randomized controlled trial. Patient Educ Couns. 2013;93:403–10.PubMed
39.
Ure J, Pinnock H, Hanley J, Kidd G, Smith EM, Tarling A, et al. Piloting tele-monitoring in COPD: a mixed methods exploration of issues in design and implementation. Prim Care Respir J. 2012;21(1):57–64.PubMed
40.
Dennison L, Morrison L, Conway G, Yardley L. Opportunities and challenges for smartphone applications in supporting health behaviour change: qualitative study. J Med Internet Res. 2013;15(4):e86.PubMedPubMedCentral
41.
Voncken-Brewster V, Moser A, van der Weijden T, Nagykaldi Z, de Vries H, Tange H. Usability evaluation of an online, tailored self-management intervention for chronic obstructive pulmonary disease patients incorporating behaviour change techniques. JMIR Res Protoc. 2013;2(1):e3.PubMedPubMedCentral
42.
Arora S, Kurji AK, Tennant MTS. Dismantling sociocultural barriers to eye care with tele-ophthalmology: lessons from an Alberta Cree community. Clin Invest Med. 2013;36(2):E57–63.PubMed
43.
Taylor J, Coates E, Brewster L, Mountain G, Wessels B, Hawley MS. Examining the use of telehealth in community nursing: identifying the factors affecting frontline staff acceptance and telehealth adoption. J Adv Nurs. 2015;71(2):326–37.PubMed
44.
Burner ER, Menchine MD, Kubicek K, Robles M, Arora S. Perceptions of successful cues to action and opportunities to augment behaviour triggers in diabetes self-management: qualitative analysis of mobile intervention for low income Latinos with diabetes. J Med Internet Res. 2014;16(1):e25.PubMedPubMedCentral
45.
Beattie A, Shaw A, Kaur S, Kessler D. Primary-care patients’expectations and experiences of online cognitive behavioural therapy for depression: a qualitative study. Health Expect. 2009;12(1):45–59.PubMed
46.
Armstrong N, Hearnshaw H, Powell J, Dale J. Stakeholder perspectives on the development of a virtual clinic for diabetes care: qualitative study. J Med Internet Res. 2007;9(3):e23.PubMedPubMedCentral
47.
Swinton JJ, Robinson WD, et al. Telehealth and rural depression: physician and patient perspectives. Fam Syst Health. 2009;27(2):172–82.PubMed
Metadata
Title
Assessing the implementability of telehealth interventions for self-management support: a realist review
Authors
Ivaylo Vassilev
Alison Rowsell
Catherine Pope
Anne Kennedy
Alicia O’Cathain
Chris Salisbury
Anne Rogers
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2015
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-015-0238-9

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