1. DisCOVeRY: A co-designed and evidence informed model of care for people with Long Covid.
- Author
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Hitch, Danielle, Holton, Sara, Garnys, Eleanor, Waller, Ian, Said, Cathy, Haines, Kimberley, Hibbert, Elizabeth, Nelson, Helen, Thorpe, Matthew, Barker, Kathryn, Hiley, Courtney, Booth, Sarah, Pepin, Genevieve, Carter, Vanessa, Rasmussen, Bodil, Batchelor, Frances, and Karunajeewa, Harin
- Subjects
MATHEMATICAL models ,POST-acute COVID-19 syndrome ,CONVALESCENCE ,EVIDENCE-based medicine ,CONFERENCES & conventions ,THEORY ,PATIENT care - Abstract
Introduction: Most people infected by COVID-19 make a full recovery, but emerging evidence indicates that 10%-30% of patients experience sustained symptoms and other health issues. The initial identification and research into this problem was conducted by patients, and the syndrome has become known colloquially as 'Long Covid'. Long Covid has been associated with over fifty distinct symptoms, impacting on all body systems, and significantly affecting participation in daily life. Given the continuous rise in COVID cases, and the potential for reinfection by new variants, Long Covid may have a significant impact on global healthcare systems for many years to come. Aims and Methods: The aim of this project was to co-design a model of care to support recovery from COVID-19 infection in both the acute and post-acute phases. Convergent mixed methods were employed, incorporating an embedded Evidence-Based Co-Design (EBCD) process. Patient experiences of Long Covid were captured using narrative interviews (n=67), while healthcare workers participated an online survey (n=85), or interviews / focus groups (n=8). Three 2 hour workshops were completed with people experiencing Long COVID (n=5) to discuss care need and priorities. A blended approach to workshop participation was adopted to enable consumer access, with two participating in live Zoom workshops and three participated asynchronously via online workbooks. Key Findings: The DisCOVeRY model of care was explicitly designed for a practice context where evidence is limited, and the majority of expertise is held by patients. Seven patient designed best care principles provides a theoretical foundation for all aspects of the DisCOVeRY model of care. Comprehensive assessment is undertaken using standardised outcome measures, and a codesigned patient rated outcome measure developed in this study. Two streams of care are then available, with the best option for each person determined via shared decision making. The Supported Recovery stream provides intensive multidisciplinary rehabilitation (available face to face and via tele-rehabilitation) and a designated care coordinator to facilitate transition to longer term primary care. The Self-Managed stream provides a navigator service (via hotline and email) which serves as a single point of information and onward referral. The model is also supported by patient centred elements (peer support groups and consumer led steering committee) and evidence informed components (community of practice and embedded research). Conclusion: The DisCOVeRY model of care is the first to be co-designed with people experiencing Long Covid to reflect their lived experience and expertise. The differing streams of the model and emphasis on tailored care to individual needs provides a flexible and responsive approach that can leverage the input of multiple services within and beyond healthcare. Implications for applicability/transferability, sustainability, and limitations: Co-designed models of care are known to enhance implementation, given their relevance to patient priorities and real life practice contexts. The DisCOVeRY model integrates both existing and new service components, but ongoing funding sustainability is challenging for Long Covid service given their multidisciplinary and multispecialty scope. This model may only be applicable to the Australian healthcare context, and its effectiveness will be evaluated in upcoming research. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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