Wednesday, 25 November 2020

Top article in the British Journal of Occupational Therapy

 Catch colleagues receive over 5,000 views and downloads in the British Journal of Occupational Therapy for their article 'Remote Home Visit: Exploring the feasibility, acceptability and potential benefits of using digital technology to undertake occupational therapy home assessments'.


Home assessments are integral to the occupational therapy role, providing opportunities to personalise and integrate care. However, they are resource intensive and declining in number. A 3-month service development within one United Kingdom National Health Service acute hospital setting explored the concept of using digital technology to undertake remote home assessments.

Four work streams explored the concept’s feasibility and acceptability: real-world testing; user consultations; narrative case study collection; traditional visit resource use exploration. Project participants were occupational therapists and patient and public representatives recruited via snowball sampling or critical case sampling. Qualitative data were thematically analysed identifying key themes. Analysis of quantitative data provided descriptive statistics.

The remote home visit concept was feasible within four specific contexts. Qualitative themes suggest acceptability depends on visitor safety, visitor training, visitor induction and standardisation of practice. Consultees perceived the approach to have potential for resource savings, personalisation and integration of care. Barriers to acceptance included data security, data governance, technology failure and threat to occupational therapists’ role and skills.

Applying digital technology to occupational therapy home assessment appears feasible and acceptable within a specific context. Further research is recommended to develop the technology, and test and investigate perceived benefits within wider contexts and stakeholder groups.

Please find the full article here.

Thursday, 12 November 2020

Re-publication with J&R Press: Consent Support Tool

 CATCH colleagues, Rebecca Palmer and Mark Jayes, developed and evaluated a tool to support professionals to engage people with communication difficulties in health research studies.


Communication disorders may be associated with acquired health conditions, including stroke, brain injury, Parkinson’s disease and dementia, and lifelong conditions such as learning disability and cerebral palsy. People with communication disorders have often been excluded from health research studies, perhaps because the process of gaining informed consent from this population is considered to be challenging. This is unethical and limits the generalizability of research findings.

The Consent Support Tool has been developed specifically to facilitate involvement of people with communication disorders in health research studies, and to help health research professionals obtain informed consent from this population. It offers researchers an easy-to-use, practical, clinically evaluated tool which has been designed to help identify individual communication needs, and recommend strategies for providing accessible information about a research study, and for supporting participation within the study.

The accompanying manual explains how and why to use this tool in the context of the Mental Capacity Act (2005), and recommends strategies to help evidence that any consent taken is informed.

The Consent Support Tool book is available to purchase here.


Wednesday, 4 November 2020

New Publication in JMIR 'Acceptability and Effectiveness of NHS-Recommended e-Therapies for Depression, Anxiety, and Stress: Meta-Analysis'

This study, co-written by The University of Sheffield colleagues and, published by the Journal of Medical Internet Research aims to conduct a meta-analytic review of the gold standard evidence of the acceptability and clinical effectiveness of e-therapies recommended for use in the National Health Service (NHS) in the United Kingdom.



There is a disconnect between the ability to swiftly develop e-therapies for the treatment of depression, anxiety, and stress, and the scrupulous evaluation of their clinical utility. This creates a risk that the e-therapies routinely provided within publicly funded psychological health care have evaded appropriate rigorous evaluation in their development.

Systematic searches identified appropriate randomized controlled trials (RCTs). Depression, anxiety, and stress outcomes at the end of treatment and follow-up were synthesized using a random-effects meta-analysis. The grading of recommendations assessment, development, and evaluation approach was used to assess the quality of each meta-analytic comparison. Moderators of treatment effect were examined using subgroup and meta-regression analysis. Dropout rates for e-therapies (as a proxy for acceptability) were compared against controls.

A total of 24 studies evaluating 7 of 48 NHS-recommended e-therapies were qualitatively and quantitatively synthesized. Depression, anxiety, and stress outcomes for e-therapies were superior to controls (depression: standardized mean difference [SMD] 0.38, 95% CI 0.24 to 0.52, N=7075; anxiety and stress: SMD 0.43, 95% CI 0.24 to 0.63, n=4863), and these small effects were maintained at follow-up. Average dropout rates for e-therapies (31%, SD 17.35) were significantly higher than those of controls (17%, SD 13.31). Limited moderators of the treatment effect were found.

Many NHS-recommended e-therapies have not been through an RCT-style evaluation. The e-therapies that have been appropriately evaluated generate small but significant, durable, beneficial treatment effects.

You can read the full study here.

Thursday, 24 September 2020

The British Geriatric Society 2020

Catch PhD Researcher is Highly Commended for their entry in the 2020 British Society of Gerontology Stirling Prize competition.

 


The Stirling Prize, first awarded in 2000 at the conference held at the University of Stirling, is the best poster award for all students presenting at the annual conference. Catch PhD Researcher, Sarah Abdi, is Highly Commended for her entry in the 2020 British Society of Gerontology Stirling Prize competition for best student poster at the Annual Meeting of the Society.

Read the full article here.


Wednesday, 26 August 2020

Computerised speech and language therapy or attention control added to usual care for people with long-term post-stroke aphasia: the Big CACTUS three-arm RCT

 Dr Rebecca Palmer announces The Big CACTUS monograph has been published in Health Technology Assessment. This is a full report of the randomised controlled trial of self managed word finding therapy on a computer. Find details of the computer therapy, study protocol, detailed results, health economic evaluation, fidelity assessment, patient and public involvement and an in depth discussion of how computer therapy can contribute to delivery of speech and language therapy for aphasia. The report also contains links to resources used throughout the study.


The study found that offering therapy on a computer increased the amount of therapy practice people with aphasia achieved as compared to that available through usual face to face care leading to significant improvements in the ability to find personally relevant words. These benefits were maintained for at least 6 months after therapy. Importantly, the study showed that people were able to improve with therapy for many years after their stroke. The study highlighted that support in addition to the computer word finding practice is needed to help people to use their new words in everyday contexts. Cost effectiveness was uncertain, but the study indicated that the computer approach is more likely to be cost effective for people with mild and moderate aphasia. We hope this study will encourage uptake of computerised therapy to increase the opportunity for people with aphasia to reach their potential.
The study was funded by the NIHR HTA programme with additional support from the Tavistock Trust for Aphasia. We would like to thank the funders, Steps Consulting Ltd who designed and produced the software, and the many speech and language therapists, people with aphasia and their carers who participated in the study from across 21 UK NHS trusts.

Please view the full report here



CATCH member’s paper recognised in BJPsych Open as one of the 20 noteworthy publications

Kaufman K. (2020) BJPsych Open fifth anniversary editorial: This editorial celebrates the journal’s fifth anniversary by reviewing the history of BJPsych Open, what has been accomplished and where they strive to go (planned trajectory).


In November 2019, the paper – Social gradients in the receipt of medication for attention-deficit hyperactivity disorder in children and young people in Sheffield (Nunn, S., Kritsotakis, E., Harpin, V., & Parker, J. (2020)) was published.

CATCH is delighted to announce the paper has been recognised in BJPsych Open as one of the 20 noteworthy publications of 360 accepted papers, from more than 6000 submitted manuscripts representing over 53 countries world-wide, BJPsych_Open_fifth_anniversary_editorial_history_a (1) published in the first five years of the journal.

New Publication in JMIR ‘Emerging Technologies With Potential Care and Support Applications for Older People: Review of Gray Literature’

 This review co-written by CATCH members and published by the Journal of Medical Internet Research Aging aimed to gain an overview of emerging technologies with potential care and support applications for older people, particularly for those living at home.


The number of older people with unmet care and support needs is increasing substantially due to the challenges facing the formal and informal care systems. Emerging technological developments have the potential to address some of the care and support challenges of older people. However, limited work has been done to identify emerging technological developments with the potential to meet the care and support needs of the aging population. A scoping gray literature review was carried out by using the databases of 13 key organizations, hand searching reference lists of included documents, using funding data, and consulting technology experts. A narrative synthesis approach was used to analyze and summarize the findings of the literature review. A total of 39 documents were included in the final analysis. From the analysis, 8 emerging technologies were identified that could potentially be used to meet older people’s needs in various care and support domains. These emerging technologies were (1) assistive autonomous robots; (2) self-driving vehicles; (3) artificial intelligence–enabled health smart apps and wearables; (4) new drug release mechanisms; (5) portable diagnostics; (6) voice-activated devices; (7) virtual, augmented, and mixed reality; and (8) intelligent homes. These emerging technologies were at different levels of development, with some being trialed for care applications, whereas others being in the early phases of development. However, only a few documents mentioned including older people during the process of designing and developing these technologies. This review has identified key emerging technologies with the potential to contribute to the support and care needs of older people. However, to increase the adoption of these technologies by older people, there is a need to involve them and other stakeholders, such as formal and informal carers, in the process of designing and developing these technologies.

Please find the published paper here.

Tuesday, 25 August 2020

New Publication in JMIR ‘The Use of a Smartphone App and an Activity Tracker to Promote Physical Activity in the Management of Chronic Obstructive Pulmonary Disease: Randomized Controlled Feasibility Study’


The feasibility study was recently published by the Journal of Medical Internet Research mHealth based on research undertaken by the CATCH team working with colleagues from the NHS and collaborating Universities.

Chronic obstructive pulmonary disease (COPD) is highly prevalent and significantly affects the daily functioning of patients. Self-management strategies, including increasing physical activity, can help people with COPD have better health and a better quality of life. Digital mobile health (mHealth) techniques have the potential to aid the delivery of self-management interventions for COPD. We developed an mHealth intervention (Self-Management supported by Assistive, Rehabilitative, and Telehealth technologies-COPD [SMART-COPD]), delivered via a smartphone app and an activity tracker, to help people with COPD maintain (or increase) physical activity after undertaking pulmonary rehabilitation (PR).

This study aimed to determine the feasibility and acceptability of using the SMART-COPD intervention for the self-management of physical activity and to explore the feasibility of conducting a future randomized controlled trial (RCT) to investigate its effectiveness.

mHealth shows promise in helping people with COPD self-manage their physical activity levels. mHealth interventions for COPD self-management may be more acceptable to people with prior experience of using digital technology and may be more beneficial if used at an earlier stage of COPD. Simplicity and usability were more important for engagement with the SMART-COPD intervention than personalization; therefore, the intervention should be simplified for future use.

Please find the published paper here

Spotlight on Telemedicine in ongoing Heart Failure Care


Professor Mark Hawley has contributed to a new policy paper, 'Telemedicine in ongoing Heart Failure Care', from the Heart Failure Policy Network.


There is a need for innovation in ongoing heart failure (HF) care, as traditional models have not been able to fully address the challenges of HF management. Telemedicine seems to be able to support HF care and help address some of the challenges of traditional models. Despite reported benefits, there are many barriers to the wider adoption of telemedicine in HF. The need for new infrastructure and accountability protocols has also been a barrier to the wide adoption of telemedicine. Reimbursement is another significant challenge in the development and implementation of telemedicine services in HF. There are clear actions that can be taken to support the development and implementation of telemedicine services for HF care in Europe.

Please find the full paper here

Publication: ‘Usability, Acceptability, and Effectiveness of Web-Based Conversational Agents to Facilitate Problem Solving in Older Adults: Controlled Study’



Our colleagues at the University of Sheffield have released a new publication in the Journal of Medical Internet Research. The results of the study support the potential of chatbots to deliver psychotherapy during Covid-19 and to play a key role in helping people with issues around their health and wellbeing.

The usability and effectiveness of conversational agents (chatbots) that deliver psychological therapies is under-researched. This study aimed to compare the system usability, acceptability, and effectiveness in older adults of two Web-based conversational agents that differ in theoretical orientation and approach.

In a randomized study, 112 older adults were allocated to one of the following two fully automated interventions: Manage Your Life Online (MYLO; ie, a chatbot that mimics a therapist using a method of levels approach) and ELIZA (a chatbot that mimics a therapist using a humanistic counseling approach). The primary outcome was problem distress and resolution, with secondary outcome measures of system usability and clinical outcome.

MYLO participants spent significantly longer interacting with the conversational agent. Posthoc tests indicated that MYLO participants had significantly lower problem distress at follow-up. There were no differences between MYLO and ELIZA in terms of problem resolution. MYLO was rated as significantly more helpful and likely to be used again. System usability of both the conversational agents was associated with helpfulness of the agents and the willingness of the participants to reuse. Adherence was high. A total of 12% (7/59) of the MYLO group did not carry out their conversation with the chatbot.

The paper concludes that controlled studies of chatbots need to be conducted in clinical populations across different age groups and discusses the potential integration of chatbots into psychological care in routine services.

Read the full study here.