NIHR study tackles multiple long-term conditions in Sri Lanka

A team of health experts from the University of Birmingham and Sri Lanka have been awarded £3.8 million of funding through the NIHR's Research on Interventions for Global Health Transformation (RIGHT) programme. The RIGHT programme funds interdisciplinary applied health research in low and middle income countries (LMICs). 

The RIGHT 6 funded project will focus on developing, implementing and evaluating a digitally integrated care pathway (DIGIPATHS) within electronic health records in Sri Lanka. This will aim to improve patient experience and create an improved care plan for those with multiple long-term conditions (MLTCs). 

MLTCs, where a person has two or more ongoing health issues, are becoming more common worldwide. This is partly because people are living longer and adopting unhealthy lifestyles.

The DIGIPATHS study will use advanced digital technologies to create a comprehensive care pathway for managing combinations of conditions such as diabetes, hypertension, cardiovascular disease, chronic kidney disease, and mental health issues. 

The UK-Sri Lanka partnership will see Birmingham experts work with counterparts from the University of Jaffna, Colombo, Kelaniya and Sabaragamuwa in Sri Lanka to create and pilot the digitally integrated care pathway.

Recent research in Sri Lanka shows that 32% of people aged 50 or older had MLTCs, increasing to 46% when additional conditions were considered. Heart, metabolic, and kidney problems were common, as were depression and anxiety. 

The research project has several parts which will lead to the development and evaluation of the digitally integrated care pathway:

• Patients, doctors, and policymakers will work together to help create the digital pathway - making sure it meets the needs of patients and healthcare providers and can be used across the country
• Experts will analyse current healthcare pathways in Sri Lanka and get input from local patients and healthcare professionals to make improvements - choosing the best guidelines for care of people with MLTCs
• The digital pathway will connect to an electronic patient record system called OpenMRS and include digital guidelines for doctors, a digital referral system, automated feedback to clinicians, and a digital interface for patients to access their health information
• Researchers will test the digital pathway in 50 primary care centres, checking whether the system is worth using in other parts of the country
• The project will train and support a group of local experts to lead the use of the digital pathway