Effectiveness of an eHealth self-management tool for older adults with multimorbidity (KeepWell): protocol for a hybrid effectiveness–implementation randomised controlled trial
Michelle Greiver,
Sharon E Straus,
Monika Kastner,
Leigh Hayden,
Julie Makarski,
Jayna Holroyd-Leduc,
Noah Ivers,
Wanrudee Isaranuwatchai,
Jemila S Hamid,
Fok-Han Leung,
Barbara Liu,
Kadia Petricca,
Eric McArthur,
Sophie Desroches,
Margo Twohig,
Charlie Macfarlane,
Mary Trapani Hynes,
Leela Prasaud,
Barb Sklar,
Joan Honsberger,
Marilyn Wang,
Gloria Kramer,
Gerry Hobden,
Heather Armson,
Sharon Marr,
Kathryn Sibley,
Hailey Saunders,
Sarah Harvey,
Kithara Manawadu
Affiliations
Michelle Greiver
University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
Sharon E Straus
Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
Monika Kastner
Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
Leigh Hayden
Knowledge Translation and Implementation, Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
Julie Makarski
Knowledge Translation and Implementation, Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
Jayna Holroyd-Leduc
1 Department of Medicine, University of Calgary, Calgary, Alberta, Canada
Noah Ivers
Department of Family Medicine, University of Toronto, Toronto, Ontario, Canada
Wanrudee Isaranuwatchai
Centre for exceLlence in Economic Analysis Research (CLEAR), St. Michaels Hospital, Toronto, Ontario, Canada
Jemila S Hamid
Department of Mathematics and Statistics, University of Ottawa, Ottawa, Ontario, Canada
Fok-Han Leung
Family and Community Medicine, St Michael’s Hospital, Toronto, Ontario, Canada
Barbara Liu
Geriatric Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Kadia Petricca
Child Health and Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
Eric McArthur
2 Institute for Clinical Evaluative Sciences, Ontario, Canada
Sophie Desroches
Centre NUTRISS, INAF, Université Laval, Quebec City, Quebec, Canada
Margo Twohig
Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
Charlie Macfarlane
Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
Mary Trapani Hynes
Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
Leela Prasaud
Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
Barb Sklar
Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
Joan Honsberger
Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
Marilyn Wang
Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
Gloria Kramer
Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
Gerry Hobden
Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
Heather Armson
Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
Sharon Marr
Division of Geriatric Medicine, Hamilton Health Sciences, Hamilton, Ontario, Canada
Kathryn Sibley
Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
Hailey Saunders
Family and Community Medicine, St Michael’s Hospital, Toronto, Ontario, Canada
Introduction In response to the burden of chronic disease among older adults, different chronic disease self-management tools have been created to optimise disease management. However, these seldom consider all aspects of disease management are not usually developed specifically for seniors or created for sustained use and are primarily focused on a single disease. We created an eHealth self-management application called ‘KeepWell’ that supports seniors with complex care needs in their homes. It incorporates the care for two or more chronic conditions from among the most prevalent high-burden chronic diseases.Methods and analysis We will evaluate the effectiveness, cost and uptake of KeepWell in a 6-month, pragmatic, hybrid effectiveness–implementation randomised controlled trial. Older adults age ≥65 years with one or more chronic conditions who are English speaking are able to consent and have access to a computer or tablet device, internet and an email address will be eligible. All consenting participants will be randomly assigned to KeepWell or control. The allocation sequence will be determined using a random number generator.Primary outcome is perceived self-efficacy at 6 months. Secondary outcomes include quality of life, health background/status, lifestyle (nutrition, physical activity, caffeine, alcohol, smoking and bladder health), social engagement and connections, eHealth literacy; all collected via a Health Risk Questionnaire embedded within KeepWell (intervention) or a survey platform (control). Implementation outcomes will include reach, effectiveness, adoption, fidelity, implementation cost and sustainability.Ethics and dissemination Ethics approval has been received from the North York General Hospital Research and Ethics Board. The study is funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health. We will work with our team to develop a dissemination strategy which will include publications, presentations, plain language summaries and an end-of-grant meeting.Trial registration number NCT04437238.