Development, deployment and evaluation of digitally enabled, remote, supported rehabilitation for people with long COVID-19..., 2022, Murray et al

[Andy]

Full title: Development, deployment and evaluation of digitally enabled, remote, supported rehabilitation for people with long COVID-19 (Living With COVID-19 Recovery): protocol for a mixed-methods study

Abstract

Introduction: Long COVID-19 is a distressing, disabling and heterogeneous syndrome often causing severe functional impairment. Predominant symptoms include fatigue, cognitive impairment (‘brain fog’), breathlessness and anxiety or depression. These symptoms are amenable to rehabilitation delivered by skilled healthcare professionals, but COVID-19 has put severe strain on healthcare systems. This study aims to explore whether digitally enabled, remotely supported rehabilitation for people with long COVID-19 can enable healthcare systems to provide high quality care to large numbers of patients within the available resources. Specific objectives are to (1) develop and refine a digital health intervention (DHI) that supports patient assessment, monitoring and remote rehabilitation; (2) develop implementation models that support sustainable deployment at scale; (3) evaluate the impact of the DHI on recovery trajectories and (4) identify and mitigate health inequalities due to the digital divide.

Methods and analysis: Mixed-methods, theoretically informed, single-arm prospective study, combining methods drawn from engineering/computer science with those from biomedicine. There are four work packages (WP), one for each objective. WP1 focuses on identifying user requirements and iteratively developing the intervention to meet them; WP2 combines qualitative data from users with learning from implementation science and normalisation process theory, to promote adoption, scale-up, spread and sustainability of the intervention; WP3 uses quantitative demographic, clinical and resource use data collected by the DHI to determine illness trajectories and how these are affected by use of the DHI; while WP4 focuses on identifying and mitigating health inequalities and overarches the other three WPs.

Open access, https://bmjopen.bmj.com/content/12/2/e057408

 

[rvallee]

These symptoms are amenable to rehabilitation delivered by skilled healthcare professionals

Nope. We literally know from decades of failure that this is false. But who cares what's true when you can just imagine the possibilities of what BPS land has to offer?

Despite variability in the nature and severity of reported symptoms, there are some core symptoms experienced by nearly all those with kong COVID-19: fatigue; cognitive impairment (‘brain fog’); breathlessness; anxiety and depression.2 These core symptoms are present in numerous other long-term conditions, and treated with well established, non-pharmacological interventions, including physiotherapy, nutritional advice, cognitive behavioural approaches, sleep hygiene and improving self-management skills.

This is simply false. But they believe it's true so it's still false but more awful. They seem to suggest this is merely an issue of availability, that face-to-face services cannot meet the demands, they are assumed to be effective and simply need to be offered differently. So basically taking the failed model of LC clinics, which are reviled as useless at best, and making an interactive pamphlet out of it.

Still being stuck at rehabilitation is itself plain systemic failure. They are still far behind the patient community and just going around in circles. Hard to take seriously the claims that patients are involved in any of this. This is simply not serious and genuinely as if none of the people involved paid any attention to the issue at all, they only meant to bring the gospel of BPS rehabilitation.

We believe that our approach could help alleviate the well known delay in translating research findings into practice42 while simultaneously promoting the sustainable, scalable adoption of evidence-based interventions and adding to the research base in digital health.

Ugh. This is performative nonsense to build a mobile app that serves no purpose other than to tickle the BPS itch. It's an exercise to prove the model of digital BPS pseudoscience, they're just using LC as an excuse for it.

 

[chrisb]

I am sure this all goes down well with McKinsey. There is a whole world out there of which we know little - but some of the budget goew there McKinsey & Company hired to review NHS technology services (consultancy.uk)

 

[Snowdrop]

It does make it pretty blatant what health care is about from the POV of the provider. Health care in the past has been a money sink. But now in this new era money can be made through technology. One way or another.

 

[rvallee]

It does make it pretty blatant what health care is about from the POV of the provider. Health care in the past has been a money sink. But now in this new era money can be made through technology. One way or another.

Oh no ones makes money out of this other than business consultants and private companies. If anything health care systems lose far more money overall, but no one counts externalities, the costs that are hard to count and can be ignored, so it doesn't matter. They save a thousand dollar here, society loses a million there. Only one of those numbers get counted.

The savings from this model are as fake as the money going into NFTs. But the scam is still alive so the fake numbers get people moving anyway.

 

[Snowdrop]

Oh no ones makes money out of this other than business consultants and private companies. If anything health care systems lose far more money overall, but no one counts externalities, the costs that are hard to count and can be ignored, so it doesn't matter. They save a thousand dollar here, society loses a million there. Only one of those numbers get counted.

The savings from this model are as fake as the money going into NFTs. But the scam is still alive so the fake numbers get people moving anyway.

I take your point but we are in the age where doctors health administrators, politicians (they've always been there) and other allied health people are entrepreneurs so it amounts to the same thing sometimes. But it would be interesting to do the economics of it to see.