Evaluation of the nurse-assisted eHealth intervention ‘eHealth@Hospital-2-Home’ on self-care by patients with heart failure and colorectal cancer post-hospital discharge : protocol for a randomised controlled trial

• Main Authors: Storm, Marianne, Morken, Ingvild Margreta, Austin, Rosalynn, Nordfonn, Oda Karin, Wathne, Hege Bjøkne, Urstad, Kristin Hjorthaug, Karlsen, Bjørg, Dalen, Ingvild, Gjeilo, Kari Hanne, Richardson, Alison, Elwyn, Glyn, Bru, Lars Edvin, Søreide, Jon Arne, Kørner, Hartwig, Moan, Rune, Strömberg, Anna, Lurås, Hilde, Husebø, Anne Marie Lunde
• Format: Article
• Language: English
• Subjects: digital helse; hjertesvikt; kolorektal kreft

Background: Patients with heart failure (HF) and colorectal cancer (CRC) are prone to comorbidity, a high rate of readmission, and complex healthcare needs. Self-care for people with HF and CRC after hospitalisation can be challenging, and patients may leave the hospital unprepared to self-manage their disease at home. eHealth solutions may be a beneficial tool to engage patients in self-care. Methods: A randomised controlled trial with an embedded evaluation of intervention engagement and cost-effectiveness will be conducted to investigate the effect of eHealth intervention after hospital discharge on the self-efficacy of self-care. Eligible patients with HF or CRC will be recruited before discharge from two Norwegian university hospitals. The intervention group will use a nurse-assisted intervention—eHealth@Hospital-2-Home—for six weeks. The intervention includes remote monitoring of vital signs; patients’ self-reports of symptoms, health and well-being; secure messaging between patients and hospital-based nurse navigators; and access to specific HF and CRC health-related information. The control group will receive routine care. Data collection will take place before the intervention (baseline), at the end of the intervention (Post-1), and at six months (Post-2). The primary outcome will be self-efficacy in self-care. The secondary outcomes will include measures of burden of treatment, health-related quality of life and 30- and 90-day readmissions. Sub-study analyses are planned in the HF patient population with primary outcomes of self-care behaviour and secondary outcomes of medication adherence, and readmission at 30 days, 90 days and 6 months. Patients’ and nurse navigators’ engagement and experiences with the eHealth intervention and cost-effectiveness will be investigated. Data will be analysed according to intention-to-treat principles. Qualitative data will be analysed using thematic analysis. Discussion: This protocol will examine the effects of the eHealth@ Hospital-2-Home intervention on self-care in two prevalent patient groups, HF and CRC. It will allow the exploration of a generic framework for an eHealth intervention after hospital discharge, which could be adapted to other patient groups, upscaled, and implemented into clinical practice.