The Burden of a Remote Trial in a Nursing Home Setting: Qualitative Study

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Title: The Burden of a Remote Trial in a Nursing Home Setting: Qualitative Study
Authors: Donnelly, Susie
Reginatto, Brenda
Kearns, Oisin
Caulfield, Brian
et al.
Permanent link: http://hdl.handle.net/10197/9737
Date: 19-Jun-2018
Online since: 2019-03-28T12:02:55Z
Abstract: Background: Despite an aging population, older adults are typically underrecruited in clinical trials, often because of the perceived burden associated with participation, particularly travel associated with clinic visits. Conducting a clinical trial remotely presents an opportunity to leverage mobile and wearable technologies to bring the research to the patient. However, the burden associated with shifting clinical research to a remote site requires exploration. While a remote trial may reduce patient burden, the extent to which this shifts burden on the other stakeholders needs to be investigated. Objective: The aim of this study was to explore the burden associated with a remote trial in a nursing home setting on both staff and residents. Methods: Using results from a grounded analysis of qualitative data, this study explored and characterized the burden associated with a remote trial conducted in a nursing home in Dublin, Ireland. A total of 11 residents were recruited to participate in this trial (mean age: 80 years; age range: 67-93 years). To support research activities, we also recruited 10 nursing home staff members, including health care assistants, an activities co-ordinator, and senior nurses. This study captured the lived experience of this remote trial among staff and residents and explored the burden associated with participation. At the end of the trial, a total of 6 residents and 8 members of staff participated in semistructured interviews (n=14). They reviewed clinical data generated by mobile and wearable devices and reflected upon their trial-related experiences. Results: Staff reported extensive burden in fulfilling their roles and responsibilities to support activities of the trial. Among staff, we found eight key characteristics of burden: (1) comprehension, (2) time, (3) communication, (4) emotional load, (5) cognitive load, (6) research engagement, (7) logistical burden, and (8) product accountability. Residents reported comparatively less burden. Among residents, we found only four key characteristics of burden: (1) comprehension, (2) adherence, (3) emotional load, and (4) personal space. Conclusions: A remote trial in a nursing home setting can minimize the burden on residents and enable inclusive participation. However, it arguably creates additional burden on staff, particularly where they have a role to play in locally supporting and maintaining technology as part of data collection. Future research should examine how to measure and minimize the burden associated with data collection in remote trials.
Funding Details: Enterprise Ireland
Science Foundation Ireland
Type of material: Journal Article
Publisher: JMIR
Journal: Journal of Medical Internet Research
Volume: 20
Issue: 6
Start page: e220
Copyright (published version): 2018 the Authors
Keywords: mHealthPatient burdenRemote trialClinical trial methodologyWearable technologyActivity monitors
DOI: 10.2196/jmir.9638
Language: en
Status of Item: Peer reviewed
Appears in Collections:Insight Research Collection

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