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08 September 2020

King's project part of UK Government support for global communities impacted by COVID-19

The clinical trial is one of 20 projects helping to address the challenges faced by some of the world’s most vulnerable people during COVID-19.

Smart phone and stethoscope

An international research team led by King’s College London have been awarded funding by the UK Government to investigate remote primary healthcare consulting for people with long term conditions in Tanzania and Nigeria.

The project - Determining trustworthiness and safety of REmote Consulting in primary Healthcare (REaCH) for chronic disease populations in Africa – is a clinical trial which will test whether remote appointments for patients with long term conditions in both Tanzania and Nigeria are as acceptable, safe, and trustworthy as face-to-face appointments. The project is led by Jackie Sturt, Professor of Behavioural Medicine in Nursing in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s.

The clinical trial is one of 20 new projects announced by UK Research and Innovation (UKRI) in a quest to develop solutions that will mitigate the short and long-term social, economic and health consequences of the pandemic.

Determining the trustworthiness and safety of remote healthcare consulting

During the pandemic, remote healthcare by phone or internet is advised by the World Health Organisation rather than face-to-face appointments, but this is difficult for some countries in Africa where there is limited digital infrastructure and patients often live in remote areas. Through previous research - led by Warwick Medical School, King’s College London and Saint Francis University College in Tanzania - the project team has developed a training programme for health workers that enables them to deliver trusted and safe care using the phone or limited internet availability - REmote Consulting in primary Healthcare (REaCH).

The project will use and evaluate the REaCH training and implementation model, which involves training being delivered to healthcare leaders, who then train local healthcare professionals to implement remote consulting in their communities.

The trials will take place in 40 health clinics across Nigeria and Tanzania, where the REaCH training will be implemented. The aim is to increase the number of phone and online appointments for patients with long-term conditions and to test if these remote appointments are as acceptable, safe and trustworthy as face-to-face ones.

We have a good indication through our previous research that REaCH training will result in more remote healthcare consultations and this is likely to make healthcare more accessible. However, making a telephone call to a patient is not enough. Remote consultations must be of good perceived quality and the patient has to trust them for them to be beneficial. Our funded trial will answer that question with certainty and provide evidence for health policy makers and healthcare providers across Low-Middle Income Countries about the health benefits to populations of investing in infrastructure and training to support the best possible quality remote consulting.

Professor Jackie Sturt, Principal Investigator

Dr Olugbade Omotajo, Director of Primary Health Care and Chief Epidemiologist of Ido Local Government Health Authority in Nigeria, said: ‘Having the healthcare needs of our patients being attended to without their being physically present at health facilities has the potential of reducing the risk of viral transmission and other communicable diseases, as well saving them time and money that would have been used for transportation to the healthcare facilities.’

Professor Sturt will be collaborating with experts and researchers from Warwick Medical School (UK), Saint Francis University College (Tanzania), University of Birmingham (UK), University of Ibadan (Nigeria), African Population and Health Research Centre (Kenya) and Makerere University (Uganda).

Professor Francis Griffiths, Project Co-Investigator at Warwick Medical School said: ‘I am delighted that we are able to use work we did on the use of mobile phones for healthcare to try and reduce the impact of emerging diseases such as COVID-19 in Africa. We have worked collaboratively as a team across the UK, Tanzania and Nigeria for many years now, enabling us to respond rapidly in the face of emerging diseases.’

Addressing the negative impacts of COVID-19 on vulnerable communities

The project is part of the first tranche of awards announced by UKRI funded through the Global Challenges Research Fund (GCRF) and the Newton Fund. The finding supports researchers and experts from the UK and across developing countries to work in partnership to directly address the negative impacts of COVID-19 on communities which are already vulnerable due to long-term conflict, food and water shortages and crowded living conditions.

UKRI launched its Agile COVID-19 GCRF and Newton Fund call to address the urgent need to understand the specific challenges faced by some of the world’s poorest people in the face of this global crisis.

Announcing the awards, Business Secretary Alok Sharma said: ‘The research projects we are backing today will ensure that we equip some of the most vulnerable communities with the resources they need to tackle COVID-19 and build their long-term resilience to respond to future pandemics, making us all safer.’

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In this story

Jackie Sturt

Head of Division, Care in Long Term Conditions and Professor of Behavioural Medicine in Nursing