Utilizing technology for diet and exercise change in complex chronic conditions across diverse environments (U-DECIDE): feasibility randomised controlled trial.

Autor: Brown RCC; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.; Centre for Research On Exercise, Physical Activity and Health, The University of Queensland, Brisbane, Australia., Keating SE; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.; Centre for Research On Exercise, Physical Activity and Health, The University of Queensland, Brisbane, Australia., Jegatheesan DK; Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia.; Faculty of Medicine, The University of Queensland, Brisbane, Australia., Mayr HL; Faculty of Medicine, The University of Queensland, Brisbane, Australia.; Department of Nutrition and Dietetics, Princess Alexandra Hospital, 199 Ipswich Road Woolloongabba, Brisbane, 4012, Australia.; Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia., Barnett A; Centre for Online Health, The University of Queensland, Brisbane, Australia.; Centre for Health Services Research, The University of Queensland, Brisbane, Australia., Conley MM; Department of Nutrition and Dietetics, Princess Alexandra Hospital, 199 Ipswich Road Woolloongabba, Brisbane, 4012, Australia., Webb L; Department of Nutrition and Dietetics, Princess Alexandra Hospital, 199 Ipswich Road Woolloongabba, Brisbane, 4012, Australia., Kelly JT; Centre for Online Health, The University of Queensland, Brisbane, Australia.; Centre for Health Services Research, The University of Queensland, Brisbane, Australia., Snoswell CL; Centre for Online Health, The University of Queensland, Brisbane, Australia.; Centre for Health Services Research, The University of Queensland, Brisbane, Australia., Staudacher HM; Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, Australia., Macdonald GA; Faculty of Medicine, The University of Queensland, Brisbane, Australia.; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia., Burton NW; School of Applied Psychology, Griffith University, Brisbane, Australia.; Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.; Centre for Mental Health, Griffith University, Brisbane, Australia., Coombes JS; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.; Centre for Research On Exercise, Physical Activity and Health, The University of Queensland, Brisbane, Australia., Campbell KL; Centre for Health Services Research, The University of Queensland, Brisbane, Australia.; Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.; Healthcare Excellence and Innovation, Metro North Health, Brisbane, Australia., Isbel NM; Department of Kidney and Transplant Services, Princess Alexandra Hospital, Brisbane, Australia.; Faculty of Medicine, The University of Queensland, Brisbane, Australia., Hickman IJ; Faculty of Medicine, The University of Queensland, Brisbane, Australia. i.hickman@uq.edu.au.; Department of Nutrition and Dietetics, Princess Alexandra Hospital, 199 Ipswich Road Woolloongabba, Brisbane, 4012, Australia. i.hickman@uq.edu.au.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2024 Aug 15; Vol. 24 (1), pp. 935. Date of Electronic Publication: 2024 Aug 15.
DOI: 10.1186/s12913-024-11383-4
Abstrakt: Background: Diet and exercise are important components of treatment for complex chronic conditions, however access to allied health support is limited. When available, support is often siloed and fragmented. Digital health incorporating patient choice may help to align health care services with preferences and goals. This study evaluated the implementation of a ubiquitously accessible patient-centred digital health diet and exercise service.
Methods: U-DECIDE was a single-centre, 26-week randomised controlled trial set in kidney and liver disease clinics in a tertiary hospital in Brisbane, Australia. Participants were adults with a complex chronic condition referred for dietetic consultation with at least one feature of the metabolic syndrome. All participants received a dietary consultation, an activity monitor and usual care. Intervention participants were offered one text message per week and access to additional digital health options (increased text message frequency, nutrition app, exercise app, group-based diet and/or exercise video consultations). The primary outcome of feasibility was determined by safety (study-related serious adverse events: SRSAEs), recruitment (≥ 50% eligible patients), retention (≥ 70%), exposure uptake (≥ 75% of intervention group had greater access to health professional contact than comparator) and video consultation adherence (≥ 80% attendance). Secondary outcomes included process evaluation metrics and clinical outcomes.
Results: Of 67 participants (intervention n = 33, comparator n = 34), 37 (55%) were men, median (IQR) age was 51 (41-58) years. The most chosen digital health options were the nutrition app (n = 29, 88%) and exercise video consultations (n = 26, 79%). Only one participant chose no additional digital health options. The intervention group had no SRSAEs. The study exceeded targets for recruitment (52%), retention (81%) and exposure uptake (94%). Video consultation adherence was 42%. Engagement across digital health options was inconsistent.
Conclusions: Digital health options incorporating patient choice were feasible and can be offered to people with complex chronic disease as a service model option.
Trial Registration: Australia and New Zealand Trials Register: Trial Registration Number: ACTRN12620001282976. Registered 27th November 2020.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje