SHAPES pilot: supporting multimorbid older patients
Research type
Research Study
Full title
A non-randomised pilot study of the Smart and Healthy Ageing through People Engaging in Supportive Systems (SHAPES) digital app and platform for supporting medicines optimisation in older individuals with multiple long term conditions
IRAS ID
284743
Contact name
Michael Scott
Contact email
Sponsor organisation
Northern Health and Social Care Trust
Duration of Study in the UK
1 years, 10 months, 31 days
Research summary
Research Summary
The Smart & Healthy Ageing through People Engaging in Supportive Systems (SHAPES) Innovation Action is a Horizon 2020, EU-wide project looking at how technology can enable the older population to live healthier lives at home. It involves the development, piloting and deployment of a large scale, EU-standardised open platform. This platform will integrate with a wide-range of technological, organisational, clinical, educational and societal solutions seeking to facilitate long-term healthy and active aging.
Within this project are 7 pilot themes investigating various potential uses of the platform, in Northern Ireland we are leading on medicines control and optimisation.
This pilot is focused on identifying, managing and improving deficiencies in adherence to medicines and treatments of older individuals living with permanent or temporary reduced functions or capabilities due to chronic, age-related illnesses and living at home. Digital Solutions (including blood pressure monitors, pulse oximeters, weight scales and glucometers) will be used to enable self-monitoring of the individual’s physiological parameters. Data will also be used to develop an algorithm to help predict decompensations in participants with heart failure and dynamic personal ranges will also be developed. In the future this may enable early opportunities to adjust medicines and treatments so as to deliver safer and more effective use of medicines in-home, however, in this pilot there will be no changes to treatment.
The target population is composed of older individuals (+65 years) living at home with heart failure and diabetes. We aim to recruit 30 people (for 3 months) to our pilot in Northern Ireland. We are working closely with colleagues in Spain, Czech Republic, Cyprus and Germany to run similar pilots within their healthcare systems.
Summary of Results
We aimed to investigate how the SHAPES technology was used by participants:
Half of the participants in the study used the SHAPES App every day throughout the 12 weeks of the pilot. The remaining participants used it over half of the time. Participants’ experiences with using the SHAPES App were positive and above average compared with similar technologies.
We aimed to investigate how SHAPES technology helped people self-monitor their health conditions:
When a SHAPES device is used, the reading should register on the users SHAPES App. Our results showed that, on average, there were new readings registered on more than 50% of days during the pilot per participant — this indicates that this technology works the way it should and is capable of helping people monitor their vital signs at home.
We aimed to inform the development of technology to predict episodic worsening of heart failure and assess the data collection required for this:
By collecting information via the SHAPES App, our technology partners were able to determine how likely each participant was to have a decompensation event (i.e., an episodic woresening of heart failure). They were able to do this at least once a week throughout the pilot. This suggests that this technology could feasibly be used to help clinicans closely monitor patients at home and potentially intervene before the symptoms get worse. This technology is not yet fully developed but our study indicated that it is possible to collect the information needed to assess this likelihood on a regular basis over an extended period of time.
We aimed to assess whether use of the SHAPES technology is associated with a change in unscheduled healthcare:
Thankfully, none of our participants required unscheduled healthcare related to their heart failure during the pilot. Therefore, we were unable to determine whether the using this technology could change peoples’ use of unscheduled healthcare.
We aimed improve participants’ quality of life:
We used a questionnaire that is commonly used in research to assess participants’ quality of life. We observed a slight improvement after the pilot compared with at the start of the pilot in participants’ responses with regards to their mobility, self-care, usual activities, pain/discomfort and anxiety/depression; and a slight decrease in how good or bad their health was on the day they were questioned. However, these findings were not scientifically robust enough to draw any firm conclusions about whether quality of life was improved.
We aimed to explore trust and acceptance of the SHAPES technology:
In terms of trusting the App, none of the participants surveyed had any issue or concern with it collecting, storing and displaying their health information. All participants welcomed the potential future inclusion of healthcare practitioners in viewing their data.
All participants were very accepting of the SHAPES App. They perceived the App as useful for self-monitoring their health indicators. However, they described the frequency of using the devices and App every day as too burdensome and monotonous. Most would choose to continue using the SHAPES digital solutions if it was available and if they could use it at a lower frequency than was requested of them during the pilot.
All participants perceived the App as easy to use once it was set-up on their tablet and linked to the 3rd party devices.
We aimed to determine whether the use of SHAPES technology may extend independent living:
Through this research were able to show that people who are aged over 60 years are capable and accepting of using the SHAPES technology to monitor their health conditions at home. This technology, in future, could permit your healthcare team to monitor you from your own home at times when they wish to monitor you more closely, such as just after a hospital admission or when you are feeling unwell. In the rest of Europe, the SHAPES project is investigating other ways in which older people can be supported to live independently. The results of these studies are not yet available but you can keep informed about this study via the SHAPES website, https://eur03.safelinks.protection.outlook.com/?url=https%3A%2F%2Fu2790089.ct.sendgrid.net%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbWBSSUcH73g0EI3FEbnZhIc-3DVJqn_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YKmtK9TnTnWRDJFmf-2FKhqIVlU9qS-2BeT8WmqMGHpQPtpDW6fLf2qPPbaZlP1g0kTpzbYjNgLFd-2F49xCnzkbfXasP2EVQjc1cqUZDhZ40QFj66GcDO8zmXzPMut8DhjGOHfTOkSnEJXnBtIel6XrWP0R2QNkTrz-2F8KXe-2FEf4NJ1BHDA-3D-3D&data=05%7C01%7Capprovals%40hra.nhs.uk%7Cf1bd4c7299114150ba5008dbb506e39f%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638302813439723081%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=WDnWXFhKCqROyMdCO4jA3hWwWa2tEpMQkAzJVFxfD6o%3D&reserved=0REC name
HSC REC B
REC reference
21/NI/0169
Date of REC Opinion
9 Dec 2021
REC opinion
Further Information Favourable Opinion