The Experts below are selected from a list of 9594 Experts worldwide ranked by ideXlab platform
Long Jing - One of the best experts on this subject based on the ideXlab platform.
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management of endocrine disease effects of Telecare intervention on glycemic control in type 2 diabetes a systematic review and meta analysis of randomized controlled trials
European Journal of Endocrinology, 2015Co-Authors: Zhenru Huang, Hong Tao, Qingdong Meng, Long JingAbstract:Objective: To review the published literature on the effects of Telecare intervention in patients with type 2 diabetes and inadequate glycemic control. Design and methods: A review of randomized controlled trials on Telecare intervention in patients with type 2 diabetes, and a search of electronic databases such as The Cochrane Library, PubMed, EBSCO, CINAHL, Science Direct, Journal of Telemedicine and Telecare, and China National Knowledge Infrastructure (CNKI), were conducted from December 8 to 16, 2013. Two evaluators independently selected and reviewed the eligible studies. Changes in HbA1c, fasting plasma glucose (FPG), post-prandial plasma glucose (PPG), BMI, and body weight were analyzed. Results: An analysis of 18 studies with 3798 subjects revealed that Telecare significantly improved the management of diabetes. Mean HbA1c values were reduced by K0.54 (95% CI, K0.75 to K0.34; P!0.05), mean FPG levels by K9.00 mg/dl (95% CI, K17.36 to K0.64; PZ0.03), and mean PPG levels reduced by K52.86 mg/dl (95% CI, K77.13 to K28.58; P!0.05) when compared with the group receiving standard care. Meta-regression and subgroup analyses indicated that study location, sample size, and treatment-monitoring techniques were the sources of heterogeneity. Conclusions: Patients monitored by Telecare showed significant improvement in glycemic control in type 2 diabetes when compared with those monitored by routine follow-up. Significant reduction in HbA1c levels was associated with Asian populations, small sample size, and Telecare, and with those patients with baseline HbA1c greater than 8.0%.
Richard Curry - One of the best experts on this subject based on the ideXlab platform.
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Portsmouth Telecare model
2010Co-Authors: Penny Ross, Jim Briggs, Richard CurryAbstract:In 2006, Portsmouth City Council (PCC) commissioned the Centre for Healthcare Modelling and Informatics at the University of Portsmouth to evaluate PCC's introduction of Telecare over 3 years. PCC addressed Telecare using the Preventative Technologies Grant, provided by the Department of Health. Prior to the Telecare project there was a widely implemented community alarms service (CAS) in the city. Modern wireless technology offers a similar service but without the user having to activate the call. This is of benefit in particular areas, such as falls, where the person who has fallen may not be able to summon help. There are now a wide range of sensors that can be added to the basic infrastructure of the community alarm service that can create a comprehensive Telecare service. The project’s aim was to investigate the possibility of setting up the technology and the processes required to support the implementation of Telecare. Once Telecare has been prescribed as part of a care package, the technology is installed and connected to the existing call centre. Finally there needed to be a response service within the city to attend to the person who has activated the alarm.
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Interim report on the evaluation of the introduction of Telecare by Portsmouth City Council
2009Co-Authors: Penny Ross, Richard Curry, Jim BriggsAbstract:In 2006, Portsmouth City Council (PCC) commissioned the Centre for Healthcare Modelling and Informatics at the University of Portsmouth to evaluate PCC's introduction of Telecare over 3 years. PCC is addressing Telecare using the Preventative Technologies Grant, provided by the Department of Health. Within PCC, the Health Improvement and Development Service (HIDS) has created a steering group to manage the project.The project aims to investigate the possibility of setting up the technology and the processes required to support the implementation of Telecare. The outline project included raising awareness of Telecare so that it could become a standard part of the care package with a single point of assessment.
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implementing complex innovations in fluid multi stakeholder environments experiences of Telecare
Technovation, 2006Co-Authors: James Barlow, Steffen Bayer, Richard CurryAbstract:‘Telecare’ is the use of information and communication technology to facilitate health and social care delivery to individuals in their own homes. Governments around the world are seeking to introduce Telecare partly to help address the challenges posed by an ageing society. Telecare is inherently complex to implement and operate because it involves combination of technological and organisational innovation in an environment of diverse stakeholders. Using research on two Telecare schemes in the UK, the paper explores the way project complexity, organisational context and project management approach interacted during the planning and implementation phases. The paper discusses how insights from research in related areas, including medical technology and service sector innovation in general, could help to explain why mainstream Telecare delivery has been difficult and draws conclusions on the role of project management in the implementation of innovation. q 2005 Elsevier Ltd. All rights reserved.
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flexible homes flexible care inflexible organisations the role of Telecare in supporting independence
Housing Studies, 2005Co-Authors: James Barlow, Steffen Bayer, Richard CurryAbstract:‘Telecare’ involves the use of information and communications technologies to provide support for vulnerable individuals living in the community. The UK government wishes to make Telecare available in all homes that need it by 2010. This expansion is seen as central to the improvement of older people's independence and quality of life by enabling them to live at home whenever possible. The paper discusses the range of initiatives now in place to facilitate the introduction of Telecare in the UK. It argues that while there is now experience of Telecare through pilot and demonstration schemes, moving to mainstream service delivery is far from straightforward. Using a case study of a Telecare scheme, along with supplementary data from other schemes, the paper explores the reasons why it may be hard to meet government objectives. These include the organisational and cultural characteristics of local care institutions and the complexity of scheme objectives. It draws conclusions on the challenges in meeting as...
Yogish C Kudva - One of the best experts on this subject based on the ideXlab platform.
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Telecare for patients with type 1 diabetes and inadequate glycemic control a randomized controlled trial and meta analysis
Diabetes Care, 2004Co-Authors: Victor M Montori, Pamela K Helgemoe, Gordon H Guyatt, Diana S Dean, Teresa W Leung, Steven A Smith, Yogish C KudvaAbstract:OBJECTIVE —To determine the efficacy of Telecare (modem transmission of glucometer data and clinician feedback) to support intensive insulin therapy in patients with type 1 diabetes and inadequate glycemic control. RESEARCH DESIGN AND METHODS —Thirty-one patients with type 1 diabetes on intensive insulin therapy and with HbA1c >7.8% were randomized to Telecare (glucometer transmission with feedback) or control (glucometer transmission without feedback) for 6 months. The primary end point was 6-month HbA1c. To place our findings in context, we pooled HbA1c change from baseline reported in randomized trials of Telecare identified in a systematic review of the literature. RESULTS —Compared with the control group, Telecare patients had a significantly lower 6-month HbA1c (8.2 vs. 7.8%, P = 0.03, after accounting for HbA1c at baseline) and a nonsignificant fourfold greater chance of achieving 6-month HbA1c ≤7% (29 vs. 7%; risk difference 21.9%, 95% CI −4.7 to 50.5). Nurses spent 50 more min/patient giving feedback on the phone with Telecare patients than with control patients. Meta-analysis of seven randomized trials of adult patients with type 1 diabetes found a 0.4% difference (95% CI 0–0.8) in HbA1c mean change from baseline between the Telecare and control groups. CONCLUSIONS —Telecare is associated with small effects on glycemic control in patients with type 1 diabetes on intensive insulin therapy but with inadequate glycemic control.
Forsyth Kirsty - One of the best experts on this subject based on the ideXlab platform.
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Making use of evidence in commissioning practice: insights into the understanding of a Telecare study’s findings
'Bristol University Press', 2020Co-Authors: Woolham John, Steils Nicole, Fisk Malcolm, Forsyth Kirsty, Porteus JeremyAbstract:From Crossref via Jisc Publications RouterBackground. This paper discusses findings from a study of English Local Authority (LA) Adult Social Care Departments (ASCDs) that explored how managers use Telecare. A decade earlier, a large clinical trial, the ‘Whole System Demonstrator’ project (WSD), funded by the Department of Health (DH) investigated Telecare’s effectiveness in promoting and maintaining independence among users. It found no evidence that Telecare improved outcomes. Despite these conclusions, the DH did not change its policy or guidance, and LAs did not appear to scale back investment in Telecare.<br />Aims and objectives. The present study explores how English ASCDs responded to WSD findings and why investment continued despite evidence from the WSD.<br />Methods. Data were obtained from an online survey sent to all Telecare lead managers in England. The survey achieved a final response rate of 75%.<br />Findings. The survey asked questions focused on awareness and use of research in general, and specifically knowledge about the findings of the WSD. Most respondents were highly critical of the WSD methods, and its findings.<br />Discussion. Critical examination of Telecare manager views found widespread inaccurate information about the trial methodology and findings, as well as the wider political and policy context that shaped it.<br />Conclusions. The WSD could not explain why Telecare did not deliver better outcomes. A more nuanced understanding of the circumstances in which it might achieve good outcomes has received little consideration. LA difficulties in using evidence in Telecare commissioning potentially leaves the sector at risk of market capture and supplier induced demand.<br />key messages<br /><ol><li>Social care services in England continue to invest in Telecare despite evidence it does not produce better outcomes for older users.</li><br /><li>Generalizable evidence for Telecare effectiveness is not well understood by commissioners/providers.</li><br /><li>Better use of evidence is needed for Telecare to be effective for older people.</li><br /><li>Without independent evidence there is a risk of ‘market capture’ by manufacturers.</li></ol><br />
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Making use of evidence in commissioning practice: Insights into the understanding of a Telecare study’s findings
'Bristol University Press', 2019Co-Authors: Woolham John, Steils Nicole, Fisk Malcolm, Forsyth Kirsty, Porteus JeremyAbstract:Item not available in this repository.Background. This paper discusses findings from a study of English Local Authority (LA) Adult Social Care Departments (ASCDs) that explored how managers use Telecare. A decade earlier, a large clinical trial, the ‘Whole System Demonstrator’ project (WSD), funded by the Department of Health (DH) investigated Telecare’s effectiveness in promoting and maintaining independence among users. It found no evidence that Telecare improved outcomes. Despite these conclusions, the DH did not change its policy or guidance, and LAs did not appear to scale back investment in Telecare. Aims and objectives. The present study explores how English ASCDs responded to WSD findings and why investment continued despite evidence from the WSD. Methods. Data were obtained from an online survey sent to all Telecare lead managers in England. The survey achieved a final response rate of 75%. Findings. The survey asked questions focused on awareness and use of research in general, and specifically knowledge about the findings of the WSD. Most respondents were highly critical of the WSD methods, and its findings. Discussion. Critical examination of Telecare manager views found widespread inaccurate information about the trial methodology and findings, as well as the wider political and policy context that shaped it. Conclusions. The WSD could not explain why Telecare did not deliver better outcomes. A more nuanced understanding of the circumstances in which it might achieve good outcomes has received little consideration. LA difficulties in using evidence in Telecare commissioning potentially leaves the sector at risk of market capture and supplier induced demand. key messages Social care services in England continue to invest in Telecare despite evidence it does not produce better outcomes for older users. Generalizable evidence for Telecare effectiveness is not well understood by commissioners/providers. Better use of evidence is needed for Telecare to be effective for older people. Without independent evidence there is a risk of ‘market capture’ by manufacturers.https://doi.org/10.1332/174426419X15730452200823inpressinpres
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Outcomes for older Telecare recipients: The importance of assessments
'SAGE Publications', 2019Co-Authors: Woolham John, Steils Nicole, Fisk Malcolm, Porteus Jeremy, Forsyth KirstyAbstract:Item not available in this repository.Summary This article explores the role of Telecare assessment, review and staff training in meeting the needs of older people living at home. Using original empirical data obtained from an online survey of English local authorities it reveals considerable variation in assessment and review practice and in training given to social work and other staff who assess and review, which may impact on outcomes for Telecare users. The study findings are situated within an English policy context and earlier findings from a large, government funded randomised controlled trial. This trial concluded that Telecare did not lead to better outcomes for users.Findings Our survey findings suggest that it may be the way in which Telecare is used, rather than Telecare itself that shapes outcomes for people who use it, and that ‘sub-optimal’ outcomes from Telecare may be linked to how Telecare is adopted, adapted and used; and that this is influenced by staff training, Telecare availability and a failure to regard Telecare as a complex intervention.Application The findings may help to reconcile evidence which suggests that Telecare does not deliver better outcomes and local authority responses to this which either discount or contest its value. The article suggests that to use Telecare to achieve optimal outcomes for older people, social workers, care managers and other professionals involved in assessing for Telecare will need to be given enhanced training opportunities, and their employers will need to perceive Telecare as a complex intervention rather than simply a ‘plug and play’ solution.The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This article presents independent research funded by the National Institute for Health Research/School for Social Care Research (NIHR/SSCR; grant ref.CO88/T15-011/KCLJW-P89). The views expressed in this publication are those of the authors and not necessarily those of NIHR/SSCR and the study was supported by the Association of Directors of Adult Social Services (ADASS RG16-007).https://doi.org/10.1177/1468017319883499inpressinpres
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Outcomes for Older Telecare Recipients: The Importance of Assessments
'SAGE Publications', 2019Co-Authors: Woolham John, Steils Nicole, Fisk Malcolm, Porteus Jeremy, Forsyth KirstyAbstract:The article explores both Telecare in relation to its composition of assistive technologies, including sensors; and associated services that use such technologies as a means by which, often vulnerable, people can obtain help through their activation - with signals being routed to monitoring centres. The context is one where there are changes to such technologies and ongoing growth in the use of Telecare services - despite there being no indicated benefits from a major study (the Whole System Demonstrators). The 'curious' investment in such technologies and services by Adult Social Care Departments in England is investigated through an interview survey that elicited over 100 valid responses. Iy gave particular attention to the assessment process by which effective targeting (to those who would be most likely to benefit) would, it had been assumed, have taken place. Key outcomes point to needed improvements to social care practice - including the need to balance a narrow focus on risk (determined in a largely top-down way) with other Telecare offerings that could more proactively address (e.g. loneliness) and involve the user more proactively in relation to technology and service options. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Summary This article explores the role of Telecare assessment, review and staff training in meeting the needs of older people living at home. Using original empirical data obtained from an online survey of English local authorities it reveals considerable variation in assessment and review practice and in training given to social work and other staff who assess and review, which may impact on outcomes for Telecare users. The study findings are situated within an English policy context and earlier findings from a large, government funded randomised controlled trial. This trial concluded that Telecare did not lead to better outcomes for users. Findings Our survey findings suggest that it may be the way in which Telecare is used, rather than Telecare itself that shapes outcomes for people who use it, and that ‘sub-optimal’ outcomes from Telecare may be linked to how Telecare is adopted, adapted and used; and that this is influenced by staff training, Telecare availability and a failure to regard Telecare as a complex intervention. Application The findings may help to reconcile evidence which suggests that Telecare does not deliver better outcomes and local authority responses to this which either discount or contest its value. The article suggests that to use Telecare to achieve optimal outcomes for older people, social workers, care managers and other professionals involved in assessing for Telecare will need to be given enhanced training opportunities, and their employers will need to perceive Telecare as a complex intervention rather than simply a ‘plug and play’ solution
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Carers’ Involvement in Telecare Provision for Older People in England: Perspectives of Council Telecare Managers and Stakeholders
'Cambridge University Press (CUP)', 2019Co-Authors: Steils Nicole, Woolham John, Fisk Malcolm, Porteus Jeremy, Forsyth KirstyAbstract:open access articleThis paper explores Telecare manager and other ‘stakeholder’ perspectives on the nature, extent and impact of family and other unpaid/informal carers’ involvement in the provision of Telecare equipment and services for older people. Data used in the paper are derived from a larger study on Telecare provision by local councils in England. The paper aims to add to the growing evidence about carers’ engagement with electronic assistive technology and Telecare, and considers this in the context of typologies of professionals’ engagement with carers. How carers are involved in Telecare provision is examined primarily from the perspectives of senior managers responsible for Telecare services who responded to an online survey and/or were interviewed in 2016 as part of a wider study. The perspectives of three unpaid carers were captured in a separate strand of the main study, which comprised more detailed case study interviews within four selected councils. Thematic and comparative analysis of both qualitative and quantitative survey data revealed the varied involvements and responsibilities that carers assumed during the Telecare provision process, the barriers that they needed to overcome and their integration in local council strategies. Findings are discussed in the context of Twigg and Atkin's typology of carer support. They suggest that carers are mainly perceived as ‘resources’ and involvement is largely taken for granted. There are instances in which carers can be seen as ‘co-workers’: this is mainly around responding to alerts generated by the Telecare user or by monitored devices, but only in those councils that fund response services. Though some participants felt that Telecare devices could replace or ‘supersede’ hands-on care that involved routine monitoring of health and wellbeing, it was also acknowledged that its use might also place new responsibilities on carers. Furthermore, the study found that meeting carers’ own rights as ‘co-clients’ was little acknowledged
Zhenru Huang - One of the best experts on this subject based on the ideXlab platform.
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management of endocrine disease effects of Telecare intervention on glycemic control in type 2 diabetes a systematic review and meta analysis of randomized controlled trials
European Journal of Endocrinology, 2015Co-Authors: Zhenru Huang, Hong Tao, Qingdong Meng, Long JingAbstract:Objective: To review the published literature on the effects of Telecare intervention in patients with type 2 diabetes and inadequate glycemic control. Design and methods: A review of randomized controlled trials on Telecare intervention in patients with type 2 diabetes, and a search of electronic databases such as The Cochrane Library, PubMed, EBSCO, CINAHL, Science Direct, Journal of Telemedicine and Telecare, and China National Knowledge Infrastructure (CNKI), were conducted from December 8 to 16, 2013. Two evaluators independently selected and reviewed the eligible studies. Changes in HbA1c, fasting plasma glucose (FPG), post-prandial plasma glucose (PPG), BMI, and body weight were analyzed. Results: An analysis of 18 studies with 3798 subjects revealed that Telecare significantly improved the management of diabetes. Mean HbA1c values were reduced by K0.54 (95% CI, K0.75 to K0.34; P!0.05), mean FPG levels by K9.00 mg/dl (95% CI, K17.36 to K0.64; PZ0.03), and mean PPG levels reduced by K52.86 mg/dl (95% CI, K77.13 to K28.58; P!0.05) when compared with the group receiving standard care. Meta-regression and subgroup analyses indicated that study location, sample size, and treatment-monitoring techniques were the sources of heterogeneity. Conclusions: Patients monitored by Telecare showed significant improvement in glycemic control in type 2 diabetes when compared with those monitored by routine follow-up. Significant reduction in HbA1c levels was associated with Asian populations, small sample size, and Telecare, and with those patients with baseline HbA1c greater than 8.0%.
