Publications by authors named "S J Brownsell"

16 Publications

TElehealth in CHronic disease: mixed-methods study to develop the TECH conceptual model for intervention design and evaluation.

BMJ Open 2015 Feb 6;5(2):e006448. Epub 2015 Feb 6.

Nottingham Clinical Trials Unit, University of Nottingham, Nottingham Health Science Partners, Nottingham, UK.

Objective: To develop a conceptual model for effective use of telehealth in the management of chronic health conditions, and to use this to develop and evaluate an intervention for people with two exemplar conditions: raised cardiovascular disease risk and depression.

Design: The model was based on several strands of evidence: a metareview and realist synthesis of quantitative and qualitative evidence on telehealth for chronic conditions; a qualitative study of patients' and health professionals' experience of telehealth; a quantitative survey of patients' interest in using telehealth; and review of existing models of chronic condition management and evidence-based treatment guidelines. Based on these evidence strands, a model was developed and then refined at a stakeholder workshop. Then a telehealth intervention ('Healthlines') was designed by incorporating strategies to address each of the model components. The model also provided a framework for evaluation of this intervention within parallel randomised controlled trials in the two exemplar conditions, and the accompanying process evaluations and economic evaluations.

Setting: Primary care.

Results: The TElehealth in CHronic Disease (TECH) model proposes that attention to four components will offer interventions the best chance of success: (1) engagement of patients and health professionals, (2) effective chronic disease management (including subcomponents of self-management, optimisation of treatment, care coordination), (3) partnership between providers and (4) patient, social and health system context. Key intended outcomes are improved health, access to care, patient experience and cost-effective care.

Conclusions: A conceptual model has been developed based on multiple sources of evidence which articulates how telehealth may best provide benefits for patients with chronic health conditions. It can be used to structure the design and evaluation of telehealth programmes which aim to be acceptable to patients and providers, and cost-effective.
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http://dx.doi.org/10.1136/bmjopen-2014-006448DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322202PMC
February 2015

Home telehealth uptake and continued use among heart failure and chronic obstructive pulmonary disease patients: a systematic review.

Ann Behav Med 2014 Dec;48(3):323-36

Department of Psychology, University of Sheffield, Western Bank, Sheffield, S10 2TP, UK.

Background: Home telehealth has the potential to benefit heart failure (HF) and chronic obstructive pulmonary disease (COPD) patients, however large-scale deployment is yet to be achieved.

Purpose: The aim of this review was to assess levels of uptake of home telehealth by patients with HF and COPD and the factors that determine whether patients do or do not accept and continue to use telehealth.

Methods: This research performs a narrative synthesis of the results from included studies.

Results: Thirty-seven studies met the inclusion criteria. Studies that reported rates of refusal and/or withdrawal found that almost one third of patients who were offered telehealth refused and one fifth of participants who did accept later abandoned telehealth. Seven barriers to, and nine facilitators of, home telehealth use were identified.

Conclusions: Research reports need to provide more details regarding telehealth refusal and abandonment, in order to understand the reasons why patients decide not to use telehealth.
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http://dx.doi.org/10.1007/s12160-014-9607-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4223578PMC
December 2014

A home daily activity simulation model for the evaluation of lifestyle monitoring systems.

Comput Biol Med 2013 Oct 20;43(10):1428-36. Epub 2013 Jul 20.

The University of Sheffield, School of Health and Related Research (ScHARR), Sheffield, S1 4DP, UK. Electronic address:

Lifestyle monitoring (LM) technology is part of a new generation of telecare which aims to observe the daily activities of older or vulnerable individuals and determine if a medical or care intervention would be beneficial. The development and validation of new LM systems should ideally involve extensive trials with users in real conditions. Unfortunately, effective user trials are very challenging, generally limited in scope and costly. In this paper, a simulator is proposed that can serve to generate synthetic data of daily activity which can then be used as a tool for the validation and development of LM systems. The most challenging part of the simulator is to replicate people's behaviour. In the paper, a novel model of daily activity simulation is proposed. Such daily activities are dependent on a number of external factors that control the need or desire to perform the activity. The proposed simulator aims to reproduce behaviour such that the probability of performing an activity increases until the need is fulfilled. It is possible to parameterise the behavioural model according to a set of features representing a particular individual. The simulator parameters have been populated using real world experiments through hardware testing and data collection with older people. Experimental verification that the desired features are reasonably reproduced by the simulator is provided.
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http://dx.doi.org/10.1016/j.compbiomed.2013.07.007DOI Listing
October 2013

Emotive computing may have a role in telecare.

J Telemed Telecare 2011 ;17(6):279-80

School of Computing and Engineering Systems, University of Abertay Dundee, Bell Street, Dundee, UK

This brief paper sets out arguments for the introduction of new technologies into telecare and lifestyle monitoring that can detect and monitor the emotive state of patients. The significantly increased use of computers by older people will enable the elements of emotive computing to be integrated with features such as keyboards and webcams, to provide additional information on emotional state. When this is combined with other data, there will be significant opportunities for system enhancement and the identification of changes in user status, and hence of need. The ubiquity of home computing makes the keyboard a very attractive, economic and non-intrusive means of data collection and analysis.
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http://dx.doi.org/10.1258/jtt.2011.011001DOI Listing
February 2012
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