Deployment of Active+me for remote patient support and cardiac rehabilitation for vulnerable patients in isolation, following heart surgery.

部署 Active me，为心脏手术后隔离的弱势患者提供远程患者支持和心脏康复。

• 批准号: 53857
• 金额: $ 9.56万
• 依托单位: ASEPTIKA LIMITED
• 依托单位国家: 英国
• 项目类别: Feasibility Studies
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=53857
• 关键词: Deployment; Active+me; remote; patient; support

Prior to the Covid-19 pandemic, recovery after heart surgery was optimised by engaging the patient in a rehabilitation process, arranged in stages:* Phase I at the bedside after the procedure.* Phase II as an out-patient* Phase III as a series of exercise workouts and lifestyle education classes over 6-8 weeks (conducted by nurses and/or physiotherapists). Some Phase III classes were in hospitals, others in leisure centres.* Patients were then referred to Phase IV classes, usually in leisure centres. These are supervised by Personal Health Coaches (PHCs) trained to high standards by the British Association for Cardiovascular Prevention and Rehabilitation (BACPR).Completing a Phase III programme has proven health benefits and is mandated by NICE. Even though the Phase III classes were free, only 50% of eligible patients enrolled. The National Audit of Cardiac Rehabilitation found that women, people from low-income backgrounds and those from ethnic groups were less likely to join these life-changing programmes.Due to the pandemic, all face-to-face rehabilitation processes have ceased. Front-line care-staff have been diverted to support the treatment of patients with Covid-19 and there is no spare capacity for patients recovering from heart surgery or a heart procedure. Active+me can significantly enhance recovery of these vulnerable patients, who will otherwise have minimal support during their self-isolation. Active+me will provide remote and self-monitoring, remote education delivery, remote exercise classes and virtual chat rooms.Following a heart procedure, Active+me will support patients who are vulnerable, currently self-isolated and often have multiple medical conditions. While the risk of a second heart attack is only 10%, the risks from other conditions affecting the health of the patient is high (50%). Active+me addresses the major challenge of replacing face-to-face rehabilitation programmes with a novel "activation" service which is delivered remotely, includes a remote monitoring service, delivers a sense of community and achieves this whilst releasing NHS staff to front-line duties.121,500 patients in the UK each year are eligible for Cardiac Rehabilitation. Women, ethnic groups, patients on low-incomes and those in rural settings have not been fully engaged. Active+me can now be delivered remotely, applying "the six pillars of self-care" developed by Aseptika:1. Education;2. Physical exercise (cardiovascular/muscle strengthening/balance);3. Tools to self-monitor symptoms/physiological signs with "light-touch" remote monitoring;4. Medication adherence;5. Learning triggers, and6. Long-term behaviour change supported by family, peers and non-medical mentors ("light touch" Behaviour Change Theory).Funding from Innovate UK is required to support roll-out of Active+me.------------------------------------------------ADDITIONAL INFORMTION------------------------------------------------After successfully completing the Active+me REMOTE Cardiac Recovery project with Addenbrooke’s Hospital (Cambridge Universities Hospital NHS Foundation Trust), a development programme for a new version of our Activ8rlives App has been started by the company to support patients recovering from a heart procedure called Active+me REMOTE Recovery Ap. This was a direct outcome of our COVID-19 rapid response project which was completed in August 2020.The delivery of this new product has become ever more urgent as multiple waves of the COVID-19 virus are now anticipated. As the UK completes the transition period to leave the EU, a new regulatory standard will be applied to medical devices which are used in the UK called UKCA. Funding from this extension supports Aseptika to also implement this new standard alongside its CE mark for the EU (under MDR 2017/745) and FDA approvals for the USA.

在2019冠状病毒病大流行之前，通过让患者参与分阶段安排的康复过程，优化了心脏手术后的康复：*第一阶段在手术后的床边。*第二阶段为门诊*第三阶段为6-8周的一系列锻炼和生活方式教育课程（由护士和/或物理治疗师进行）。一些第三阶段课程在医院，其他课程在休闲中心。*患者随后被转介到第四阶段，通常在休闲中心。这些服务由经过英国心血管预防和康复协会高标准培训的个人健康教练（phc）监督。完成III期项目已被证明对健康有益，并由NICE强制执行。尽管III期药物是免费的，但只有50%的符合条件的患者参加了试验。心脏康复国家审计发现，女性、低收入背景的人和少数民族的人不太可能参加这些改变生活的项目。由于大流行病，所有面对面的康复进程都已停止。一线医护人员已被转移到支持治疗Covid-19患者，并且没有多余的能力用于心脏手术或心脏手术后的康复患者。Active+me可以显著促进这些脆弱患者的康复，否则他们在自我隔离期间将获得最少的支持。Active+me将提供远程和自我监控、远程教育交付、远程锻炼课程和虚拟聊天室。在心脏手术后，Active+me将为脆弱、目前自我隔离、通常患有多种疾病的患者提供支持。虽然第二次心脏病发作的风险仅为10%，但影响患者健康的其他条件的风险很高（50%）。Active+me解决了用一种新型的“激活”服务取代面对面康复计划的主要挑战，这种服务是远程提供的，包括远程监控服务，提供社区意识，并在将NHS员工释放到一线职责的同时实现这一目标。英国每年有121500名患者有资格接受心脏康复治疗。妇女、少数民族、低收入患者和农村地区患者尚未充分参与。Active+me现在可以远程交付，应用Aseptika开发的“自我护理的六大支柱”：教育;2。2 .体育锻炼（心血管/肌肉增强/平衡）；3 .采用“轻触式”远程监测，自我监测症状/生理体征的工具；药物治疗依从性;5。6.学习触发；由家庭、同伴和非医疗导师支持的长期行为改变（“轻触”行为改变理论）。创新英国需要资金来支持Active+me的推出。------------------------------------------------ 额外的简化 ------------------------------------------------ 成功完成活动后+我远程心脏复苏项目阿登布鲁克医院(剑桥大学医院NHS信托基金会),公司启动了新版本Activ8rlives应用程序的开发计划，以支持患者从一项名为Active+me远程恢复Ap的心脏手术中康复。这是我们于2020年8月完成的COVID-19快速反应项目的直接成果。由于目前预计将出现多波COVID-19病毒，这种新产品的交付变得更加紧迫。随着英国完成离开欧盟的过渡期，一项新的监管标准将适用于在英国使用的医疗器械，称为UKCA。这一扩展的资金支持Aseptika在欧盟的CE标志（根据MDR 2017/745）和美国的FDA批准下也实施这一新标准。