UK - Department of Health and Social Care (DHSC)

NIHR Global Health Research Group on developing a learning health system to address the growing burden of non-communicable diseases in Thailand

Project disclaimer

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Description

Long term conditions such as heart disease, diabetes and kidney disease are the leading causes of death in Thailand. It is estimated that reducing the number of people living with high blood pressure in Thailand can prevent 14,000 deaths, 27,000 strokes, and 18,000 heart attacks over the next five years. In Thailand, computerised medical records are used by the Ministry of Public Health to understand how whole regions deliver care. However, this information is not available to healthcare providers in a format that helps them identify people in need of earlier or more active management. Learning Health System approaches turn computerised medical data into information that allows healthcare teams to provide better health care and reduce inequalities. We will work alongside healthcare providers, decision-makers, researchers, and the public to co-develop a data supported quality improvement approach for the management of diabetes, high blood pressure, and kidney disease in primary care settings. We will begin by hosting a series of workshops to identify challenges that healthcare teams face when managing individuals living with these long-term conditions and what kinds of data tools and ways of working might help address these challenges. Building on the recommendations made in the workshops, our team of computer scientists will develop computerized tools to support healthcare teams to better manage individuals with diabetes, high blood pressure, and kidney disease. These tools will be tested in two primary care units before being rolled out to all 16 primary care units participating in our study. The rollout of the computerised tools will be accompanied by training and ongoing support by our team of clinical nurse facilitators, clinical, and community champions who will support healthcare teams to incorporate the new computerised tools into their quality improvement activities. We will evaluate the intervention using formal statistical approaches which will measure improvements in control of blood pressure, diabetes, and kidney disease over time and compare our 16 intervention practices to other practices in the region. We will also conduct a realist evaluation which will involve interviews with the healthcare teams and observation of meetings and workflows to understand which components of the quality improvement intervention have worked, under what circumstances, and for which populations. This project will run from July 2024 to July 2028 and is led by Queen Mary, University of London, and Chiang Mai University in partnership with the London School of Hygiene and Tropical Medicine and the Thai Ministry of Public Health.

Objectives

The project has 5 objectives: 1. Engage with healthcare providers, decision makers, researchers, and the public to co-design a Learning Health System, for the management of hypertension, diabetes, and kidney disease, and develop computerised data systems, decision support tools, and training materials in 16 randomly selected primary care units across two provinces in Thailand. 2. Train multidisciplinary healthcare teams, data scientists, and researchers in the design, delivery, analysis, and evaluation of a Learning Health System, and establish a cohort of clinical and community champions to support the intervention. 3. Pilot the delivery of a Learning Health System, for improving management and clinical outcomes of hypertension, diabetes, and kidney disease and generate robust new evidence around the acceptability and effectiveness of Learning Health System approaches and delivery of clinical care. 4. Compare outcomes between intervention and control practices and conduct a health economic evaluation of the costs of implementing the Learning Health System versus routine care. 5. Conduct a mixed-methods evaluations to identify provider and patient barriers and facilitators to implementing a Learning Health System to inform subsequent approaches to embedding quality improvement for hypertension, diabetes, and kidney disease care in Thai primary care settings and more widely across the region.

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Location

The country, countries or regions that benefit from this Programme.

Thailand