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Co-design, Social
selectivity 
Cost-effectiveness

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The complex and costly care needs of the large and growing population of older persons with long-term conditions is a critical challenge in health care worldwide. To meet this challenge, health care organizations, researches funding agencies, as well as enterprises have invested numerous resources in the development of person-centered e-health tools using Information and Communications Technology (ICT).

In many countries there are high expectations on a governmental level that this development, in which people take more responsibility for their self-care by using ICT support, will simplify and increase access to care and reduce health care costs.

The European Commission’s investments in research on ICT will increase by 46% under Horizon 2020, compared to FP7. Positive effects of ICT have been found in groups in need for a large degree of self-care such as patients with heart failure or asthma. Projects involving change for health care organizations geared towards more focus on self-care and improved patient-provider collaboration also show positive results. However, despite the potential of ICT for supporting self-care, a major challenge is that it has not been widely used. There are several gaps in the evidence that may explain why ICT tools seldom are implemented in clinical practice and every-day life of people with long-term conditions:

  • The development of ICT tools has often not been user-driven involving references and experiences of older persons with long-term illness, their carers and health care professionals
  • The learning process of how older people can learn to perform self-care with support from ICT has not been fully explored.
  • Social selectivity and inequality issues have very seldom been addressed in previous research The purpose of this program is therefore to build evidence-based knowledge and practice about innovative person-centered ICT tools for support to older people with long-term conditions and their family carers in order to manage self-care independently and stay healthy, independent and socially active for as long as possible, delay/avoid institutionalization and improve quality of life.

The program has four overall aims:

  1. To explore how older people with long-term illness, family carers, health care professionals, patient/carers organizations and small and medium enterprises (SMEs) can be involved in the design, evaluation and implementation of different ICT tools in order to support self-care.
  2. To address presuppositions and consequences of social selectivity in the development and evaluation of ICT tools for self-care.
  3. To evaluate the effectiveness of ICT tools to support self-care in older people with long-term conditions and their family carers through intervention studies.
  4. To explore how to facilitate the implementation of the ICT tools in clinical practice when found to improve health, activity, quality of life and/or cost-effectiveness of care.

Our goal for the coming four-year period is to develop a research program that will build evidence- based knowledge and practice of the use of ICT tools in order to achieve more effective self-care. The program has a person-centered approach applying a participatory framework involving users (older people with long-term conditions, their family carers and health care professionals) as co-designers in the development and evaluation phases of ICT tools. Patient and carer organizations as well as SMEs are also collaborators in the program. The co-design approach will be tested in four interdisciplinary intervention studies aimed at evaluating different ICT tools for supporting self-care in older persons with different types of long-term conditions. The ICT solutions in the projects target symptom monitoring, memory reminders, motivation to physical activity in patients, and psycho-educational support to family carers. Both qualitative and mixed methods will be used and all projects will include a Randomised Controlled Trial (RCT) design. Transverse studies on co-design, social selectivity and cost-effectiveness will be conducted throughout all projects. Presuppositions and social selectivity will be studied in order to explore inequality issues in the evaluation of ICT-based measures, tools or services. Social selectivity has bearing for the generalizability, dissemination and implementation of the research findings. Cost-effectiveness will include Quality of Life Adjusted Years – QALYs, different patient reported outcome measures as well as costs. The figure on top of this Internet page shows of the elements in the program.