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Florence and the strangest secret of self care

posted 19 Sep 2019, 06:58 by Hollie O'Connell

19 September 2019 

The use of digital technologies in healthcare is a fast growing industry with a whole host of technology start-ups offering solutions using online video conferencing, apps and AI.  Within this crowded market, many come with a promise from the vendor of a clinically effective and sustainable service but all too often we see these solutions struggle to live up to the salesman's promise.  Healthcare by its nature of course is a tricky area for digital technology, with the need to provide independent evidence of a direct causal clinical effect and improved efficiency for healthcare providers.  This is particularly tricky within the requirements of rapid change driven by new advances in care but anchored in long established methods of care delivery.

Flo is now in her 9th year of supporting patients towards better and faster clinical outcomes and helping them to manage their own health conditions better.  Along the way the evidence from Flo’s use has enabled the introduction of her US and Australian cousins (Annie and Nellie) and although these locations are very different, Flo, Annie and Nellie have all continued to demonstrate the same positive and sustainable outcomes. 

So what makes Flo, Annie and Nellie different to other digital technologies and what’s the evidence?

In this short webinar Phil O’Connell, our founder, talks through our unique methodology and how the secret to self-care has little to do with digital technologies, and everything to do with human behaviour. 

Home and Mobile Health Monitoring Evaluation - Economic case studies

posted 13 Sep 2019, 03:15 by Hollie O'Connell   [ updated 3 Oct 2019, 05:12 ]

13 September 2019 

We are delighted to announce another exciting publication, Home and Mobile Health Monitoring Evaluation - Economic Case studies” by Digital Health & Care Scotland, who have previously published their National 3-year evaluation "Towards Scaling Up Home and Mobile Health Monitoring 2015-2018".   This report provides us with a detailed analysis of the considerable cost savings across three varying locations in Scotland; Ayrshire and Arran, Lanarkshire and the Western Isles, where the substantial outcomes were fundamental in the decision to Scale Up with Flo. 

The aim of this report was to look at the return on investment when using HMHM (Flo) to support patients with Hypertension and COPD, and explore the “monetary equivalent of capacity released, the monetary equivalent of reduction in resource demands, the cost of HMHM compared to baseline costs, and the number of cases that would need to be implemented to break-even.”

When looking at COPD patients supported by HMHM (Flo) key findings were:
  • HMHM is cost effective - Using Net Present Value, savings over a 10 year period per 100 patients:
    • Ayrshire & Arran £26 - £28 million
    • West Dunbartonshire £496k - £1.4 million
    • Highland approximately £23 million
  • Fewer NHS24, ambulance call outs and emergency admission bed days
  • The number of items prescribed increased (due to more appropriate prescribing)

Key findings when using HMHM (Flo) to support patients with Hypertension:
  • HMHM is cost effective - Using Net Present Value, savings over a 10 year period per 100 patients:
    • Ayrshire & Arran £52 - £73k
    • Lanarkshire £15 - £67k
    • Western Isles £62 - £85k
  • Capacity is released. Comparing costs and benefits shows that to break even:
    • Ayrshire & Arran need 56-76 patients to use HMHM (Flo)
    • Lanarkshire need 42-68 patients to use HMHM (Flo)
    • Western Isles need 13-18 patients to use HMHM (Flo)
  • Patient travelling time is avoided, 33 - 50 hours were saved per 100 patients
  • Productivity is increased - estimated that £1,800 in loss of earning is avoided per 100 patients by having their BP monitored remotely
  • Savings can be increased by recycling of BP monitors
“ Despite considerable local variation between the partners providing data for these case studies, all of the scenarios modelled were shown to be cost effective over a 10 year period.  Although most of the benefits are non-cash releasing, aspects such as avoided appointments do create additional capacity for staff working across primary and secondary care, many of whom work under considerable pressure. “

You can read the full report and evidence towards these savings by clicking here.

Thousands of patients in Lanarkshire evaluation

posted 3 Sep 2019, 08:29 by Hollie O'Connell

03 September 2019 

Towards Scaling Up Home and Mobile Health Monitoring in Lanarkshire - An evaluation towards 
scale-up, spread and sustainability June 2019 

We are pleased to announce the publication ofTowards Scaling Up Home and Mobile Health Monitoring in Lanarkshire - An evaluation towards 
scale-up, spread and sustainability” where the substantial high quality evidence base helped support the further £1.2 million investment into Scotland’s National BP Scale-Up with Florence. 

NHS Lanarkshire received an exciting opportunity to be part of the National Home and Mobile Health Monitoring (HMHM) Programme which looked at how HMHM could improve clinical outcomes and explore the potential for sustainable scale-up with Florence.  This document provides an in-depth and detailed independent evaluation of evidence gathered over a number of years, where the passion and commitment of clinicians combined with Flo’s unique persona and methodology were able to over deliver on targets and demonstrate that HMHM can be successfully integrated into multiple conditions including hypertension, mental health, health lifestyle/health improvement, diabetes and pain management.

Examples of the highlighted outcomes for patients are “people have positive experiences of services, supported by HMHM”: 
  • More people self-manage their health and care - one piece of evidence gave a total of 7,455 patients supported with Flo by 28.4.2019
  • Condition control improves - “One person who refused to believe they had hypertension accepted their diagnosis after using Flo.   Their blood pressure was 183/87 before remote monitoring and 135/80 after accepting the diagnosis and medication”
  • Face to face contact are optimised - “3,545 people have texted BP readings to their GP surgery to support diagnosis and medication titration, ensuring that accurate readings are available to support diagnosis and hypertension management”
  • Access to services increase - “HMHM is particularly useful for people whose working hours clash with surgery opening, who are stressed by the time they get to their appointment, and then have high readings.  Now after an initial visit to start Flo we follow up the readings sent in remotely by phone”
  • Resources used effectively and efficiently - “An average of 4.3 blood pressure monitoring appointments were avoided per patient. For 3,545 patients each avoiding 4.3x10 minute Practice Nurse appointments = £82,467 (greater savings where GPs did the BP monitoring)”
While key learning of HMHM on effectiveness and efficiency:
  • “HMHM appears to be a catalyst for shifting responsibility away from healthcare professionals to people/patients, thus increasing the effectiveness of interventions.
  • HMHM can increase engagement with services e.g. more people start an on-line programme, it is easier to text readings from the workplace than get to a GP surgery.
  • Fewer HMHM efficiencies are observed when the service doesn’t have someone to lead or it is not highly valued by staff, even when people/patients appreciate the support.
  • Where HMHM enables more accurate diagnosis e.g. hypertension, it can also save ‘White Coat’ prescription costs.
  • HMHM has been most effective in Lanarkshire when those using it appreciate its value, the set-up is relatively straightforward, and there is expert support to resolve any issues.
  • HMHM avoids the need for some appointments e.g. remote blood pressure monitoring increases staff capacity and reduces patient travel costs. “

Sharing the Learning: Efficiencies Delivered Across Acute, Primary and Community Healthcare

posted 31 Jul 2019, 03:25 by Hollie O'Connell   [ updated 2 Aug 2019, 04:18 ]

31 July 2019 

We are pleased to publish a series of resources that encapsulate the unique outcomes and benefits realised by our members.  The collection of Efficiency Savings summaries have been developed to offer a concise overview across Primary, Acute and Community Care.

Each resource provides highlights of how Flo has delivered efficiencies in healthcare delivery based on evidence shared with us from members of the Simple Telehealth Community of Practice. 

Areas covered in the documents include;
Primary Care:
  • COPD
  • Asthma
  • Hypertension
  • Medication concordance

Acute Care:
  • Maternity
  • COPD
  • Asthma
  • Hypertension
  • Oncology

  • Medication concordance
  • Diabetes
  • Orthopaedics
  • Ascites management
  • Renal transplant
Community Care:
  • COPD
  • Children’s community nursing (enteral feeding weaning & BP monitoring)
  • Diabetes
  • Mental health
  • Wound care

Paediatric and Young Adult Member’s Network Launched

posted 30 Jul 2019, 06:01 by Hollie O'Connell

30 July 2019 

Paediatric and Young Adult Member’s Network Launched 

Over the years, Flo has supported many children and parents with their healthcare needs, with the benefits being enjoyed by both patients and clinicians.  Consequently, the Community of Practice is now seeing a sustained increase in clinical interest in this area.  Therefore, in support, we are extending the reach of our Condition Based Member’s Networks and launching a new area of interest for clinicians delivering paediatric and young adult services.  The network’s aim is to share and discover how other like-minded clinicians have been innovating with Flo, and the learning that has been created by this.  For an example of one of our other networks, please see here

To launch the Paediatric and Young Adult Member’s Network, we would like to take this opportunity to share with you an overview of some of the inspirational innovation that is being delivered across the Simple Telehealth Community of Practice.

Supporting Children and Young Adults with Type 1 Diabetes

One of the most sustained applications of Flo’s support is for patients with Type 1 diabetes.  Children and young people diagnosed with Type 1 diabetes can find adapting to and managing their condition particularly challenging, as it often happens at a time in their life of already increased physical, psychological and social change.  Much like with adult diabetes pathways, Flo is on hand to provide additional support to help children and young adults: engage with their health, feel more in control of their condition and improve their education early on via an accessible and effective tool; their mobile phone.  Flo has proven to be particularly effective within younger cohorts due to their familiarity with technology and the fact that they find that receiving simple SMS text messages is discreet, uncomplicated, and does not interfere with their wider use of their handset e.g. using data.

Two patients who have benefitted from Flo’s helpful messages are Naomi and Erin.  Naomi had struggled to manage her diabetes throughout her teens resulting in raised HbA1c and the development of diabetic bulimia due to concerns over weight gain.  But with Flo’s support she was able to significantly reduce her HbA1c, which improved her long-term health outcomes.  Similarly, Erin was struggling to manage her diabetes, and had been unfortunately previously admitted to hospital with ketoacidosis.  Following her admission, Erin was introduced to Flo and was also able to reduce both her HbA1c from 112mmol to 83mmol, and also the risk of long-term complications due to poorly controlled diabetes.

Supporting Early Years Practitioners to embed changes in their clinical practice

NHS Highland have integrated Flo as part of their “Words Up” initiative.  Words Up provides training to Early Years Practitioners, Teachers and Pupil Support Assistants to ensure that adult-children interaction is of a high quality to help to improve language and communication skills.  The team have harnessed Flo via a unique and interesting approach by providing support to practitioners in reinforcing key elements of their training.  Practitioners interact with Flo around the topics covered, which in turn refreshes and compounds the key messages shared during their training.   Practitioners are also asked how easy or difficult they are finding making changes, which allows them to reflect and seek additional support if needed.  To find out more about Words Up, take a look at this blog.

Improving Compliance with Inhaler Regime for Children and Young Adults with Asthma

For patients with asthma, ensuring compliance with inhaler regimes is key in controlling the condition and symptoms.  For younger children with asthma, parents or carers usually take on the responsibility for ensuring that inhalers are taken as prescribed which can sometimes be difficult due to the competing priorities of family life.  As a helpful prompt for parents, Flo has been recruited as a timely nudge to administer their child’s inhaler.  You can find out more by watching this short video of Dr John Alexander from the University Hospital of North Midlands talking about how Flo has been helping his patients and the benefits she brings to patients, parents and his team.

Children’s Community Nursing - Enabling Remote Enteral Feeding and Blood Pressure Monitoring

The Children’s Community Nursing Team within Shropshire Community Health Care NHS Foundation Trust developed two innovative pathways around supporting parents whose children undergo enteral feeding, and also those whose children require scheduled blood pressure monitoring.   Around enteral feeding, parents are prompted to send Flo their child’s weight, instead of having to arrange their schedule around a visit from a member of the Children’s Nursing team.  For children requiring BP readings to be taken at regular intervals, Flo prompts parents to take them and reply with the reading.  For both pathways, augmenting the patient’s normal shared management plan, if any child’s readings are outside of the desirable range, the Children's Community Nursing Team would be notified, and be able to take appropriate action.

The implementation of Flo into these pathways has benefitted both staff, children and their families.  For families, sending readings into Flo gives them the freedom to not have to plan around visits from the Children’s Nursing Team.  Flo also reassures them that if there is cause for concern, a member of the team can pick this up when reviewing the readings, and initiate any required action.  For clinicians, Flo is helping to reduce the number of home visits required by some patients, enabling them to better manage their caseload and allocate resources to other patients who may require additional support.

A summary report by Children’s Community Nursing Team found that across only 7 patients, a total of 795 clinical hours were saved, which released the same capacity as an extra 1.0wte nurse working for over 21 weeks.   To find out more about these pathways, take a look at the following blog.

Capturing the Benefits: Evidence-Based Hypertension Micro Business Cases

posted 18 Jul 2019, 03:38 by Hollie O'Connell

18 July 2019 

Developed from evidenced pathways across the Simple Telehealth Community of Practice, a series of short micro business cases are available in support of understanding the benefits derived from Flo’s integration.

The micro-cases are a resource for community members to use to demonstrate savings when using Flo compared to normal care, and also as a model to adopt for local engagement and planning.  The tables within the document are editable, so can be adapted to match your local costings or pathways. 

Please note: to edit and input your own costing values, double click on the table within the document which will open an editable Excel spreadsheet. Please be aware that any edits you make will be transferred to the Word document.

The new group of micro-cases focus on hypertension, including (Membership required)
Micro-cases are available within the Member’s Zone on our website.  If your organisation is part of the SSHC Community of Practice, but you are not able to access the Members’ Zone, please contact Hannah.Mountford@simple.uk.net or Kylie.Dentith@simple.uk.net to get you started.   If you would like to learn more about developing your own local micro-cases, please do not hesitate to contact one of the team.

Digitally Transforming Primary Care – Making it Happen at Scale

posted 27 Jun 2019, 01:20 by Hollie O'Connell   [ updated 28 Jun 2019, 01:47 ]

Karen Moore 
Advanced Capability Lead SSHC 

27 June 2019 

On Wednesday 19th June we were delighted to be invited to speak on the main stage at Facebook HQ in London for the “Digitally Transforming Primary Care – Making it Happen at Scale” conference, where Phil shared Simple Telehealth’s journey from its inception to the unique international Community of Practice we support today.

The event was hosted jointly by Facebook and the NHS Stoke-on-Trent and Staffordshire CCG Digital Nurse Ambassador Programme.  Who following a hugely successful pilot, were granted funding to embark on a series of action learning events to support the spread and adoption of technology and social media tools across Primary Care Networks in England.

The agenda for the day was led by Dr Ruth Chambers OBE, Clinical Lead for Technology Enabled Care Services in the Staffordshire STP, and offered valuable insight and practical advice for NHS Leaders, commissioners and clinicians about how technology and digital tools can be used at scale to support the care delivered to patients.

Delegates were also given the opportunity to ask questions of the Digital Nurse Ambassadors and heard from both clinical teams and patient groups across the UK who shared their enthusiasm and experiences; with examples of where they have been able to successfully incorporate technology in their local practice to improve outcomes, and engage with patients with education about their health and wellbeing.

Phil spoke about the need for a reality check before engaging with any of the thousands of digital ‘solutions’ being promoted for healthcare and talked about how today’s market is rife with ‘snake oil’.   He went on to encourage delegates to look for technologies with substantial independent evidence of efficacy and to be clear about how and why they will use digital.  Phil endorsed the Digital Nurse programme with it’s clear and uncomplicated agenda and it’s aim of helping patients to help themselves in the simplest of ways, which consistent with the researched evidence base behind Simple Telehealth, can consistently deliver better and faster clinical outcomes.

Ann Hughes, who is a Digital Nurse Ambassador from Stoke-on-Trent and is part of the team facilitating the National Action Learning Event programme, joined Phil for his session to share her own personal experiences of using Flo to support her patients.

Ann had an elderly patient who needed to have cataract surgery, however disappointingly the surgery was cancelled due to a high blood pressure reading taken at her pre-op appointment.  To determine whether this patient had hypertension or white coat syndrome, Ann signed her up to Flo and the patient sent in her BP readings.  With Flo, the patient’s BP was shown to be within the normal range which then enabled the surgery to go ahead despite the white-coat readings at pre-op.  “.. by the middle of the week I’d got enough readings to be able to print them off and fax them over to the pre-op team...and they did the operation based on those readings.”

More from Ann:

“.. I use Flo extensively in my practice… it’s just so easy to use and saves time..”

“.. the impact for this lady was massive… it changed her life.”

“.. that’s as simple as it is. It’s so easy to use, patients feel at home with it… and trust in it.“

We’d like to thank Facebook for their hospitality and congratulate Ruth and the team on a really fantastic day, hopefully the first of many!  You can find out more about the event and view the presentations from the day via this link Digitally Transforming Primary Care – Making it Happen at Scale Conference.

To keep up-to-date with the latest news, blogs and case studies in our community, you can follow us on Facebook @Simple Telehealth

Flo continues to grow: Mental Health

posted 21 Jun 2019, 05:42 by Hollie O'Connell

21 June 2019 

Mental health use and diversification with Flo maintains momentum into 2019 

Following on from our overview "Innovative Clinicians Drive 20x Growth in Maternity: Supporting Mums and Mums-to-be" clinicians continue to innovate with more patients being introduced to Flo for increasingly diverse applications.  In particular, the integration of Flo in mental health care has seen substantial growth in use and diversity.   Back in 2012, mental health application of Flo was divided roughly 30/70% between appointment reminders and medication reminders with positive outcomes demonstrated; take a look at the following case study and video for some of the work that has taken place within the community of practice.   However, since 2012, clinicians have built on these early foundations to apply Flo as a beneficial interactive tool to support patients receiving mental health care. 
Members of the Simple Telehealth Community of Practice have received recognition for their application of Flo in their delivery of mental health care.  In 2015, the Primary Care Mental Health Service in Tameside and Glossop were recognised as winners of a national Health Business Awards for Innovation in Mental Health, while in 2016 East London Foundation Trust were selected by The Health Foundation to be part of a £1.5 million innovation programme, focussing on integrating Flo to support mental health recovery and self-care for those with severe mental illness.

Newly Developing Areas

Flo’s use in mental health has continued to grow, and by 2017, the number of patients had increased by 16x those in 2012.   While such an increase is worth celebrating, the real change to note is the diversification in the innovative approaches that clinicians are developing to integrate Flo into their care delivery. While medication and appointment prompts make up around 9% of usage in 2017, a number of new applications are now in use.  These include:
  • Cancer support pathways – much of the care that patients with a cancer diagnosis receive focuses on treating the disease, however support pathways are now being used to provide care which supports the patient’s mental health in these difficult circumstances.
  • Mood monitoring – these are interactive pathways that allow clinicians to remotely monitor the mood of their patients based on the readings they send to Flo.  This means that clinicians are able to check the patient’s scores regularly and tailor care to patients, providing additional timely support if required.
  • Dementia and Mild Cognitive Impairment/Depression and Low mood – pathways have been introduced that offer support and information to patients with these conditions, which aim to support memory strategies and improve patient confidence and emotional well-being.  One example of this is North Staffordshire Combined Healthcare’s Autographer project.
  • Course/group support – pathways have been developed to support patients who are attending groups or taking courses to help them improve their mental health.  Flo supports patients throughout the length of the sessions by helping them to register and get started or attend their first session, reminding them when certain modules may be due or sessions are scheduled, as well as sending motivational messages which aim to consolidate their learning from their therapy.
  • Personalised interactive pathways - a number of pathways have been co-designed between the patient and clinician to maximise Flo’s personal nature. Clinicians have been working closely with their patients to design specific, meaningful responses, personal to each patient, that Flo will reply with dependent upon symptoms reported in real time.

Course & group support pathways

The latter group of pathways now accounts for almost 90% of the use of Flo within mental health.  They represent an increasing trend towards a holistic approach to mental health, aiming to treat the patient’s well-being as a whole.   For example, patients with depression have traditionally been medically treated via antidepressant medication, but many patients are now being referred to CBT courses or other talking therapies. These treatment pathways aim to address the root cause of any mental health issues the patient may have, and in doing so, encourage proactive steps to change the patient’s behaviour; Flo is now being used to maximise the impact of these treatments to further support and encourage positive actions by the patient.  For example, South Tyneside Foundation Trust have been seeing promising results using Flo to support patients who attend appointments with Gateshead Talking Therapies.

Health authorities are increasingly looking towards online courses to do this, as they are both time and cost efficient, as well as convenient for patients.  One such standout example being used by members of the Simple Shared community is “Beating the Blues”.
NHS Lanarkshire has had great success using Flo to further support those patients who they have been referred to “Beating the Blues”.   You can read more about their approach here. Lanarkshire’s success using Flo alongside the “Beating the Blues” programme has been noted, and community members from Powys are now looking to implement a similar approach to help patients with their mental health.  It is exciting to see community members sharing their success and best practise with members from other areas, as this continually improves services for patients.

A personalised approach to mental health with Flo:

Flo has also been used in Nottingham to support patients attending CBT sessions.  Patients joined a “Stress Spiral” pathway with Flo, where Flo would ask the patient how they were feeling, and then reply with a response dependent on this. For this pathway, the patients worked with their talking therapy clinicians to devise their own personalised stress spiral that identified certain personal behaviours as their anxiety and stress increased, and the responses Flo sent were also written by the patients.  Ensuring that Flo’s responses were personalised is an innovative approach, it made Flo’s replies even more impactful and helped patients to further reflect on their progress during therapy. 

East London Foundation Trust (ELFT) are another organisation who have incorporated Flo into their mental health pathways to great effect. Flo is used in ELFT’s REFRAME telehealth project, which aims to support patients with severe mental illness, including chronic psychosis, self-manage and maintain independence.   Flo prompts patients to take their medication as prescribed, as well as enquiring about their well-being indicators, which are personalised measures developed by the patient and clinician to recognise behaviours specific to the individual to indicate a decline in their mental health wellbeing.  Similar to the Stress Spiral protocol in use in Nottinghamshire, this personalised approach ensures that the messages have meaning and impact for each individual.  For more information about ELFT REFRAME, click here

Scotland Scales Up Flo with 1.2m investment

posted 7 Jun 2019, 06:05 by Hollie O'Connell

07 June 2019 

Scottish Health Secretary Jeane Freeman visits Hunter Health Centre in East Kilbride to formally launch Scale Up BP nationally across Scotland. Backed with £1.2m investment from the Scottish Government over the next 2 years. 

Measuring blood pressure is the third most common reason for attending primary care appointments in Scotland, with £1.2 million appointments every year.  During her visit, the Health Secretary had the opportunity to see Flo first hand and find out more from patients and clinicians about their experience.

This technology brings significant benefits to patients. It enables them to have more control over how they manage their condition, and greatly cuts down on the number of appointments they have to attend…
By investing in improved technology across health and social care, we can improve patients’ experience and outcomes, and free up capacity in the system at the same time.

Jeane Freeman - MSP, Cabinet Secretary for Health and Sport

Scale up BP is part of the wider Technology Enabled Care (TEC) Programme established in Scotland in 2015/16 and to date, more than 150 practices have used Flo to support patients requiring blood pressure monitoring either to diagnose hypertension, monitor BP or titrate medication, with over 10,000 patients benefiting so far.

Simple Shared Healthcare are thrilled to offer our congratulations to the NHS 24 TEC Programme along with all of the teams and clinicians who have been involved in the fantastic success of their Scale Up BP programme. 

We’re delighted that Flo with her #TotallyUnique methods and patented technology has already supported so many and we’re really excited to see her continue to offer support to many more patients across Scotland in the future, supported by this fantastic investment from the Scottish Government.

To find out more about the Health Secretary's visit you can access the full news item on the Scottish Government’s website here.

Urgent Care Coping: Supporting Patients with Severe Health Anxiety

posted 14 Mar 2019, 04:12 by Hollie O'Connell   [ updated 10 Jun 2019, 02:03 by Philip O'Connell ]

14 March 2019 

In June 2018, findings from the study ‘Helping Urgent Care Users Cope with Distress about Physical Complaints’, lead by Professor Richard Morriss of the University of Nottingham, were first presented and then subsequently published in January 2019.

The purpose of the study was to compare the clinical and economic outcomes of using remote cognitive behavioural therapy (RCBT) to treatment as usual (TAU) for repeat unscheduled care users with severe health anxiety.  Dr Sam Malins, Clinical Psychologist at Nottinghamshire NHS Foundation Trust, integrated Flo as an additional support tool to the RCBT group following their participation in the study.

What is Health Anxiety?
“Health anxiety is an anxiety condition that is often housed within the Obsessive Compulsive Disorder (OCD) spectrum of disorders.  Those affected by health anxiety have an obsessional preoccupation with the idea that they are currently (or will be) experiencing a physical illness.... the person experiencing health anxiety may fixate on any type of illness….  Those who are affected by health anxiety/illness phobia are convinced that harmless physical symptoms are indicators of serious disease or severe medical conditions.  For example, if a person experiencing health anxiety feels their chest is getting tight, they may believe that they are having a heart attack.  Those with health anxiety frequently misinterpret physical symptoms of anxiety as a sign of an impending physical health problem.” 

We were delighted to hear about Flo supporting the provision of RCBT in Nottinghamshire by providing additional support for participants in the study.  Following prompts asking how they were feeling, Flo interacted with participants around how they felt by sending personalised messages.  The messages were written by the participants themselves to maximise the impact of interactions.

The inclusion of Flo within the study aimed to reinforce positive changes made during RCBT sessions and to support long-term behaviour changes amongst those with Health Anxiety and as a result, reduce the number of contacts with unplanned/urgent care providers.

In total, 156 participants were recruited, half of whom received treatment as usual, while the other half received RCBT.  For those in the latter group, CBT sessions took place either by phone, or through a WebEx video call.  It was found that those in the RCBT had significantly improved outcomes for generalised anxiety, depression and overall health at 12 months when compared with those receiving treatment as usual.

The findings from this study were officially published in BMC Medicine in January 2019 and is available to download here (Membership required).

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