Evidence map›Paper›PMID 39609032›Full record

ArticleBMJ open2024

Using normalisation process theory to evaluate the implementation of a digital health intervention in community and secondary care long COVID clinics.

Fiona A Stevenson, Paul Pfeffer, Sarah Walker, Hadiza Ismaila, Vinosh Jegatheesan, Ibrahim Mohammad, Ann Blandford, Stuart Linke, John R Hurst, William Ricketts and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Fiona A StevensonResearch Department of Primary Care and Population Health, University College London, London, UK f.stevenson@ucl.ac.uk.ORCID http://orcid.org/0000-0003-2139-2309
Paul PfefferDepartment of Respiratory Medicine, Barts Health NHS Trust, London, UK.
Sarah WalkerUniversity of Exeter Medical School, Exeter, UK.ORCID http://orcid.org/0000-0003-4201-1093
Hadiza IsmailaUniversity College London, London, UK.
Vinosh JegatheesanUniversity College London, London, UK.
Ibrahim MohammadUniversity College London, London, UK.
Ann BlandfordUCLIC, University College London, London, UK.ORCID http://orcid.org/0000-0002-3198-7122
Stuart LinkeResearch Department of Primary Care and Population Health, University College London, London, UK.
John R HurstAcademic Unit of Respiratory Medicine, UCL Medical School, London, UK.ORCID http://orcid.org/0000-0002-7246-6040
William RickettsRespiratory Medicine, Barts Health NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-0475-0744
Fiona L HamiltonResearch Department of Primary Care and Population Health, University College London, London, UK.
David SunkersingInstitute of Health Informatics, University College London, London, UK.
Katherine BradburyPsychology, University of Southampton, Southampton, UK.
Henry GoodfellowResearch Department of Primary Care and Population Health, University College London, London, UK.ORCID http://orcid.org/0000-0002-0979-2839

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe potential and expected benefits of digital health interventions (DHI) have long been discussed, yet substantial challenges are associated with deploying DHI at scale. Insights are presented concerning the implementation of a DHI consisting of a patient-facing app and a digital dashboard for clinicians providing supported self-management for long COVID to support both clinicians and patients.

designQualitative reflexive thematic analysis, mapped against Normalisation Process Theory.

settingFifty-five and a half hours of zoom recordings of meetings between clinicians in community and secondary care long COVID clinics and members of the research team.

participantsAllied health professionals, service delivery managers and members of the core team, including representatives from industry partners.

resultsThe DHI fitted with contextual circumstances and the design supported flexibility to suit circumstances in different trusts. The DHI also aligned with existing ways of working.Healthcare professionals worked together to support the implementation of the DHI, requiring flexibility to take account of local circumstances. The DHI was appraised in both positive and negative terms by healthcare professionals. Using DHIs was said to have the potential to complement care but not be a replacement for face-to-face clinical input. The DHI was judged to have demonstrated the potential to affect long-established patterns and organisational structures of engagement between healthcare professionals and patients in terms of access to care.

conclusionsNPT provided a framework for considering both individual agency and the organisation context, enabling reflections to be made at the level of the structure of services as well as people's experiences. The discipline of considering first the context, then the work and finally the practical effects helped place order on the 'mess' involved in the rapid cycle of developing, refining and implementing a DHI in an atypical environment (a pandemic).

Indexed as

COVID-19Secondary Health CareTelemedicineCommunity Health ServicesDigital HealthHumansMobile ApplicationsPost-Acute COVID-19 SyndromeQualitative ResearchSARS-CoV-2Self-ManagementCOVID-19Digital TechnologyeHealthOrganisation of health servicesQUALITATIVE RESEARCH

Identifiers

PMID39609032
PMCPMC11603829

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.