None listed
Conditions
Brief summary
It is frustrating for families of children with chronic, non-life threatening health problems to have to wait a long time to see a paediatrician. This project tests an online program called eADVICE (electronic Advice and Diagnosis Via the Internet following Computerised Evaluation) that provides treatment advice to patients while they are waiting for an appointment. The program, which can be used repeatedly by families, asks questions about the sick child, and then gives personalised treatment advice to address the health problem (through a virtual character that talks to the child). The program is linked directly to the GP, who supervises the child’s treatment. We will conduct a randomised controlled trial to compare two groups of families: those given immediate access to eADVICE-continence at the time their GP refers the child to the specialist and those given access 6 months after their referral. We will follow up each participant for 12 months and assess whether the program can reduce the need to see the specialist. We will also look at the effect of the program on the child’s health, the families’ experience of the health system and cost implications.
Interventions
eADVICE (electronic Advice and Diagnosis Via the Internet following Computerised Evaluation), an interactive eHealth program that provides treatment advice to patients, supervised by their general practitioner (GP), while they are awaiting a specialist appointment. eADVICE facilitates the exchange of information between the child, parents and specialists using a virtual character (“avatar”), enabling assessment, diagnosis and provision of individualised treatment advice.
The referring doctor wi
eADVICE (electronic Advice and Diagnosis Via the Internet following Computerised Evaluation), an interactive eHealth program that provides treatment advice to patients, supervised by their general practitioner (GP), while they are awaiting a specialist appointment. eADVICE facilitates the exchange of information between the child, parents and specialists using a virtual character (“avatar”), enabling assessment, diagnosis and provision of individualised treatment advice. The referring doctor will be informed about their patient's study participation, and be invited to help in managing the child’s incontinence. As this research study is a randomised controlled trial, a computerised program will allocate some families to be given access to eADVICE straight away and some families will need to wait 6 months before they can have access. The family will be asked to complete a short online questionnaire about their child’s wetting and previous treatments used, as well as the impact of the incontinence on their life. (they will each take about 3-5 minutes to complete). The family will be asked to answer these questions again at 6 months and 12 months. For those who have been allocated to access eADVICE straight away, the study coordinator will give the family an ID number and they will be able to set their own unique password to access eADVICE program for 6 months. For those allocated to access at 6 months after referral, they will be required to wait for 6 months before being given an ID number to access eADVICE program which they will be able to use for 6 months. The eADVICE program will ask detailed questions about their child’s health and continence (similar to the questions they would be asked when attending the continence clinic) and the child's response will trigger specific advice about how to manage their child’s specific problem. Advice include advice on fluid intake, reduced caffeine intake, timed voiding, bowel program, enuresis alarm training and medication use. They will then have opportunity to access the program and enter more information every 2 weeks over the 6 month access period, and the program will tailor the treatment advice according to their child’s response. The child’s information will also be accessible to the child’s referring doctor. The program will only provide advice; it will be up to the family whether they choose to follow this advice. The advice may include the use of medication. If this occurs, the program will inform the doctor and ask the family to speak with them about it. It will be up to the doctor to decide whether medication is necessary. Treatment adherence will be monitored when the child revisits the program, by the program specifically asking the child whether they followed each of the advice given at the previous visit (always, sometimes, never) and their treatment response . Once the ID number and password have been given, there is no restriction on the number of fortnights they can access the web page during their 6 month access period. After 6 months they will no longer be able to use the ID and password to access the web page. This is the final part of the study. We will first test eADVICE in incontinence because clinics for this condition have a waiting time of over 12 months.
Sponsors
The Children's Hospital Westmead
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
5 Years to 18 Years
Healthy volunteers
Yes
Inclusion criteria
Children with urinary incontinence aged 5 to 18 years who do not have a neurological or urological cause for their incontinence and can self-initiate toileting are eligible for the study. Referral letters to the clinics will be screened and potentially eligible patients will be contacted by our study coordinator and invited to the study.
Exclusion criteria
Neurological or urological cause for their incontinence
Outcome results
None listed