STIMULATE-ICP-Delphi (Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways Delphi): Study protocol

Christina M van der Feltz-Cornelis; Jennifer Sweetman; Gail Allsopp; Emily Attree; Michael G Crooks; Daniel J Cuthbertson; Denise Forshaw; Mark Gabbay; Angela Green; Melissa Heightman; Toby Hillman; Lyth Hishmeh; Kamlesh Khunti; Gregory Y H Lip; Paula Lorgelly; Hugh Montgomery; W David Strain; Emma Wall; Caroline Watkins; Nefyn Williams; Dan G Wootton; Amitava Banerjee; STIMULATE-ICP Consortium

doi:10.1371/journal.pone.0277936

STIMULATE-ICP-Delphi (Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways Delphi): Study protocol

PLoS One. 2022 Nov 30;17(11):e0277936. doi: 10.1371/journal.pone.0277936. eCollection 2022.

Authors

Christina M van der Feltz-Cornelis^{1

2

3}, Jennifer Sweetman¹, Gail Allsopp^{4

5}, Emily Attree⁶, Michael G Crooks^{7

8}, Daniel J Cuthbertson⁹, Denise Forshaw¹⁰, Mark Gabbay^{11

12}, Angela Green⁸, Melissa Heightman¹³, Toby Hillman^{13

14}, Lyth Hishmeh¹⁵, Kamlesh Khunti¹⁶, Gregory Y H Lip^{17

18}, Paula Lorgelly^{19

20}, Hugh Montgomery²¹, W David Strain²², Emma Wall^{23

24}, Caroline Watkins^{10

25}, Nefyn Williams¹¹, Dan G Wootton^{26

27}, Amitava Banerjee^{3

28}; STIMULATE-ICP Consortium

Affiliations

¹ Dept of Health Sciences, University of York, York, United Kingdom.
² Hull York Medical School, (HYMS), University of York, York, United Kingdom.
³ Institute of Health Informatics, University College London, London, United Kingdom.
⁴ Royal College of General Practitioners, London, United Kingdom.
⁵ National Institute of Health and Care Excellence, London, United Kingdom.
⁶ CCG NHS Camden, London, United Kingdom.
⁷ Hull York Medical School, University of Hull, Hull, United Kingdom.
⁸ Hull University Teaching Hospitals NHS Trust, Hull, United Kingdom.
⁹ Institute of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, United Kingdom.
¹⁰ Lancashire Clinical Trials Unit, University of Central Lancashire, Preston, United Kingdom.
¹¹ Department of Primary Care & Mental Health, University of Liverpool, Liverpool, United Kingdom.
¹² NIHR ARC NWC, Liverpool, United Kingdom.
¹³ Department of Respiratory Medicine, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
¹⁴ UCL Respiratory, University College London, London, United Kingdom.
¹⁵ Long COVID SOS, Oxford, United Kingdom.
¹⁶ Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, United Kingdom.
¹⁷ Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.
¹⁸ Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
¹⁹ School of Population Health and Department of Economics, University of Auckland, Auckland, New Zealand.
²⁰ Institute of Epidemiology and Health Care, University College London, London, United Kingdom.
²¹ Department of Medicine, University College London, London, United Kingdom.
²² Diabetes and Vascular Medicine Research Centre, Institute of Biomedical and Clinical Science and College of Medicine and Health, University of Exeter, Exeter, United Kingdom.
²³ Francis Crick Institute, London, United Kingdom.
²⁴ National Institute for Health Research (NIHR) University College London Hospitals (UCLH) Biomedical Research Centre and NIHR UCLH Clinical Research Facility, London, United Kingdom.
²⁵ Faculty of Health and Care, University of Central Lancashire, Preston, United Kingdom.
²⁶ Institute of Infection Veterinary and Ecological Sciences and NIHR HPRU in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom.
²⁷ Liverpool University Hospitals NHS Foundation Trust, Liverpool, United Kingdom.
²⁸ Department of Cardiology, University College London Hospitals NHS Trust, London, United Kingdom.

Abstract

Introduction: As mortality rates from COVID-19 disease fall, the high prevalence of long-term sequelae (Long COVID) is becoming increasingly widespread, challenging healthcare systems globally. Traditional pathways of care for Long Term Conditions (LTCs) have tended to be managed by disease-specific specialties, an approach that has been ineffective in delivering care for patients with multi-morbidity. The multi-system nature of Long COVID and its impact on physical and psychological health demands a more effective model of holistic, integrated care. The evolution of integrated care systems (ICSs) in the UK presents an important opportunity to explore areas of mutual benefit to LTC, multi-morbidity and Long COVID care. There may be benefits in comparing and contrasting ICPs for Long COVID with ICPs for other LTCs.

Methods and analysis: This study aims to evaluate health services requirements for ICPs for Long COVID and their applicability to other LTCs including multi-morbidity and the overlap with medically not yet explained symptoms (MNYES). The study will follow a Delphi design and involve an expert panel of stakeholders including people with lived experience, as well as clinicians with expertise in Long COVID and other LTCs. Study processes will include expert panel and moderator panel meetings, surveys, and interviews. The Delphi process is part of the overall STIMULATE-ICP programme, aimed at improving integrated care for people with Long COVID.

Ethics and dissemination: Ethical approval for this Delphi study has been obtained (Research Governance Board of the University of York) as have approvals for the other STIMULATE-ICP studies. Study outcomes are likely to inform policy for ICPs across LTCs. Results will be disseminated through scientific publication, conference presentation and communications with patients and stakeholders involved in care of other LTCs and Long COVID.

Registration: Researchregistry: https://www.researchregistry.com/browse-the-registry#home/registrationdetails/6246bfeeeaaed6001f08dadc/.

Copyright: © 2022 van der Feltz-Cornelis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Critical Pathways
Delivery of Health Care, Integrated*
Humans
Mental Health
Post-Acute COVID-19 Syndrome

Grants and funding

All authors were involved in funding acquisition for this project. This work is independent research funded by the National Institute for Health and Care Research (NIHR) (COV-LT2-0043) as part of the STIMULATE-ICP study. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.