A 10-year follow up of a paging service for people with memory and planning problems within a healthcare system: How do recent users differ from the original users?

Abstract

In 2003 Wilson, Scott, Evans, and Emslie published a report of a new healthcare resource; a paging system designed to reduce the everyday problems of people with neurological deficits who experience memory and/or planning problems. The system was established following several research studies carried out to evaluate its effectiveness. Information was collected on the first 40 clients recruited to the service. The purpose of the present study is to determine how the service might have changed over a 10-year period. The most recent users of the service (N = 40) have been compared with the original cohort of 40 clients. In addition, in 2007 clients were given the opportunity to use their mobile telephones to receive messages; 17 chose to do so. There was no difference in age between the telephone users compared to the pager users, but those using a pager were less likely to have sustained a traumatic brain injury (TBI) and were more likely to be longer post-insult. There were no significant differences in the gender or ages of the people using the pager compared with those using the telephone service. However, the mean overall time since injury for the last 40 referrals was 9.48 years compared to 4.56 years for the original cohort. Both cohorts comprised several diagnostic groups; clients with TBI formed the largest subgroup, followed by those with stroke. This is typical of patients seen for rehabilitation, with other diagnostic groups forming a smaller percentage. We wanted to determine whether the range of diagnoses was similar over the 10-year period. Despite slight differences, we found a similar range of patients referred. In both cohorts the most frequent messages sent each week related to medication (27.9% in the first compared to 28.6% in the second). More messages were sent regarding mood management in the second cohort. No such messages were sent to the first 40 clients, whereas over 27 per week were sent to the last 40. Fewer health authorities (N = 21) were referring after 10 years in comparison with 26 referrers for the first cohort.

Keywords:

• Memory
• Planning problems
• Independence
• Traumatic brain injury
• Paging system

Acknowledgments

Declaration of interest: The service is run from the Oliver Zangwill Centre at the Princess of Wales Hospital, Ely, UK. The subscription cost of the pager system for each client is £60 per month (about $99), with an £89 (about $147) refundable deposit for the unit itself. The subscription for the mobile telephone service for each client is £40 per month (about $65); no deposit is required as clients provide and use their own phone. The cost covers an unlimited number of alerts that can be sent 24 hours a day, 365 days a week, plus air time. The authors of this paper are employed under standard UK National Health Service terms and conditions and receive no additional incentive for subscriptions. The service is run as a not-for-profit service. Income generated contributes to the day-to-day running of the Centre, contributing toward staff salaries and the local health authority (management and facilities costs). Staff contributing to the running of the service include two administrative staff and a clinical lead (Martin-Saez), who advises referrers, carers and service users on how to set up the alerts. The system comprises a standard Windows computer running a bespoke NeuroPage software package with a broadband connection in addition to a specialised mobile phone modem.