Exploring the Impact of a Remote Monitoring System for Palliative and End-of-Life Care (CARE-PAC): Mixed Methods...

Area of Science:

• Digital Health
• Palliative and End-of-Life Care (PEOLC)
• Health Services Research

Background:

• Palliative and end-of-life care (PEOLC) in the UK exhibits significant variability, leading to avoidable hospitalizations and reduced quality of life (QoL).
• Gaps in out-of-hours support and care coordination contribute to patient and carer stress and strain on the National Health Service (NHS).
• There is a critical need for person-centered models to enhance home-based care, improve QoL, and reduce acute service utilization.

Purpose of the Study:

• To evaluate the usability, user experience, and impact of the CARE-PAC digital remote monitoring system.
• To assess CARE-PAC's effectiveness for patients in their last year of life, their informal carers, and healthcare professionals (HCPs).

Main Methods:

• A mixed-methods study involving 13 patient-carer dyads using CARE-PAC for up to 12 weeks.
• Quantitative analysis included validated Quality of Life (QoL) scales and the System Usability Scale (SUS).
• Qualitative data were collected through calls, interviews, and focus groups, analyzed thematically using the NASSS framework.

Main Results:

• Patients reported significant improvements in overall and social QoL, with a decline in physical QoL; carer QoL showed no significant change.
• High usability scores were reported by patients (87.9) and carers (94.7), indicating excellent user experience.
• Healthcare professionals (HCPs) reported lower usability scores (63.6), yet above the threshold for poor usability.

Conclusions:

• CARE-PAC is a usable, feasible, and acceptable remote monitoring system for patients, carers, and HCPs in palliative care.
• The system facilitates real-time needs identification and positively impacts patient and carer QoL.
• Findings support further research into CARE-PAC's large-scale effectiveness and implementation pathways in PEOLC.