Scaling-Up Digital Follow-Up Care Services: Collaborative Development and Implementation of Remote Patient Monitoring Pilot Initiatives to Increase Access to Follow-Up Care

Background: COVID-19 increased the demand for Remote Patient Monitoring (RPM) services as a rapid solution for safe patient follow-up in a lockdown context. Time and resource constraints resulted in unplanned scaled-up RPM pilot initiatives posing risks to the access and quality of care. Scalability and rapid implementation of RPM services require social change and active collaboration between stakeholders. Therefore, a participatory action research (PAR) approach is needed to support the collaborative development of the technological component while simultaneously implementing and evaluating the RPM service through critical action-reflection cycles. Objective: This study aims to demonstrate how PAR can be used to guide the scalability design of RPM pilot initiatives and the implementation of RPM-based follow-up services. Methods: Using a case study strategy, we described the PAR team's (nurses, physicians, developers, and researchers) activities within and across the four phases of the research process (problem definition, planning, action, and reflection). Team meetings were analyzed through content analysis and descriptive statistics. The PAR team selected ex-ante pilot initiatives to reflect upon features feedback and participatory level assessment. Pilot initiatives were investigated using semi-structured interviews transcribed and coded into themes following the principles of grounded theory and pilot meetings minutes and reports through content analysis. The PAR team used the MoSCoW prioritization method to define the set of features and descriptive statistics to reflect on the performance of the PAR approach. Results: The approach involved two action-reflection cycles. From the 15 features identified, the team classified 11 as must-haves in the scaled-up version. The participation was similar among researchers (52.9%), developers (47.5%), and physicians (46.7%), who focused on suggesting and planning actions. Nurses with the lowest participation (5.8%) focused on knowledge sharing and generation. The top three meeting outcomes were: improved research and development system (35.0%), socio-technical-economic constraints characterization (25.2%), and understanding of end-user technology utilization (22.0%). Conclusion: The scalability and implementation of RPM services must consider contextual factors, such as individuals' and organizations' interests and needs. The PAR approach supports simultaneously designing, developing, testing, and evaluating the RPM technological features, in a real-world context, with the participation of healthcare professionals, developers, and researchers.info:eu-repo/semantics/publishedVersio

Self-Care Practices for Common Colds by Primary Care Patients: Study Protocol of a European Multicenter Survey-The COCO Study.

Background. Self-care for common colds is frequent, yet little is known about the spectrum, regional differences, and potential risks of self-care practices in patients from various European regions. Methods/Design. We describe the study protocol for a cross-sectional survey in 27 primary care centers from 14 European countries. At all sites, 120 consecutive adult patients, who visit their general practitioner for any reason, filled in a self-administered 27-item questionnaire. This addresses patients' self-care practices for common colds. Separately, the subjective level of discomfort when having a common cold, knowing about the diseases' self-limited nature, and medical and sociodemographic data are requested. Additionally, physicians are surveyed on their use of and recommendations for self-care practices. We are interested in investigating which self-care practices for common colds are used, whether the number of self-care practices used is influenced by knowledge about the self-limited nature of the disease, and the subjective level of discomfort when having a cold and to identify potential adverse interactions with chronic physician-prescribed medications. Further factors that will be considered are, for example, demographic characteristics, chronic conditions, and sources of information for self-care practices. All descriptive and analytical statistics will be performed on the pooled dataset and stratified by country and site. Discussion. To our knowledge, COCO is the first European survey on the use of self-care practices for common colds. The study will provide new insight into patients' and general practitioners' self-care measures for common colds across Europe

Self-Care for Common Colds by Primary Care Patients: A European Multicenter Survey on the Prevalence and Patterns of Practices-The COCO Study.

Background. Patients use self-care to relieve symptoms of common colds, yet little is known about the prevalence and patterns across Europe. Methods/Design. In a cross-sectional study 27 primary care practices from 14 countries distributed 120 questionnaires to consecutive patients (≥18 years, any reason for consultation). A 27-item questionnaire asked for patients' self-care for their last common cold. Results. 3,074 patients from 27 European sites participated. Their mean age was 46.7 years, and 62.5% were females. 99% of the participants used ≥1 self-care practice. In total, 527 different practices were reported; the age-standardized mean was 11.5 (±SD 6.0) per participant. The most frequent self-care categories were foodstuffs (95%), extras at home (81%), preparations for intestinal absorption (81%), and intranasal applications (53%). Patterns were similar across all sites, while the number of practices varied between and within countries. The most frequent single practices were water (43%), honey (42%), paracetamol (38%), oranges/orange juice (38%), and staying in bed (38%). Participants used 9 times more nonpharmaceutical items than pharmaceutical items. The majority (69%) combined self-care with and without proof of evidence, while ≤1% used only evidence-based items. Discussion. This first cross-national study on self-care for common colds showed a similar pattern across sites but quantitative differences