Self-assessment to support self-care for Covid-19
Funding
BNSSCG CCG Research Capability Funding (Local development)
What is the research question?
What is the impact of assessment of vital signs by a patient or a carer on subsequent face-to-face appointments with a clinician, and on the total amount of clinical time spent on a single episode of acute care? What barriers to self-assessment of vital signs are perceived by patients and clinicians?
What is the problem?
Many people with Covid-19 can be successfully managed outside hospital, but may require monitoring for deterioration, especially between days 5-10 of the illness. Vital signs can be used for this purpose, which include blood pressure, pulse, temperature, oxygen saturation in the blood (pulse oximetry), and alertness (consciousness). Patient assessed (or by the carer, or care home staff) vital signs could assist with remote healthcare, such as online consultations, promote patient self-management, and potentially be applied to other (non-Covid-19) conditions for the management of short illnesses.
What is the aim of the research?
Data from OneCare BNSSG show that compared to Spring 2019, in Spring 2020 substantially more people were managed by remote healthcare assessment (phone or video). There are three aims of this research: to understand whether vital signs are being incorporated into a remote clinical evaluation, and the extent to which they can be assessed by the patient or a person who cares for them; to understand the practical issues associated with wider assessment of vital signs from the perspectives of clinicians and patients; and lastly to understand the impact that measurement of vital signs has on the need for face-to-face appointments and the total time in consultation with clinicians per episode of illness.
How will this be achieved?
There will be a systematic review of current evidence for self-evaluation of vital signs. Qualitative interviews with patients/care givers and clinicians will then be completed regarding remote assessment of vital signs. Finally, there will be a randomised control trial of remote vital sign recording. Self-monitoring equipment will be sent to the patient/carer to monitor vital signs (blood pressure and oxygen saturation). The patient/carer will then be prompted by text message to respond to questions about the patient’s symptoms and vital signs, and those responses will be reviewed by the clinical team at the GP practice. Participants will be adult patients with suspected Covid-19 who are at risk of admission to hospital and who have capacity to consent. The evaluation will include the number of healthcare encounters and resources used within 10 days of the intervention, and interviews with practices participating in the study.
Who is leading the research?
Dr Sam Creavin, GP and Wellcome Trust Research Training Fellow, Centre for Academic Primary Care, University of Bristol and Streamside Surgery, South Glos.
Further information:
For more information or to get involved in this project, please contact bnssg.research@nhs.net.