What the study found
The SMILe integrated care model, which combines a patient app for home symptom registration with advanced practice nurse-led monitoring, self-management support, and care coordination, needed local adaptation for use in Belgian daily care. The authors report that several changes were required to fit existing technical, legal, and resource conditions.
Why the authors say this matters
The authors conclude that real-world adaptation must balance an intervention's core components with the local technical, regulatory, and resource constraints. They also state that structured adaptation and strategic implementation planning were essential to support long-term sustainability.
What the researchers tested
The researchers adapted the SMILe integrated care model to their local setting after a prior context analysis. They followed the ADAPT guidelines, involved patients, informal caregivers, and local clinical, IT, and legal teams, documented adaptations with the Framework for Reporting Adaptations and Modifications-Expanded (FRAME), and selected implementation strategies using the Expert Recommendations for Implementing Change (ERIC) taxonomy.
What worked and what didn't
Key adaptations included using the local electronic eHealth platform to improve usability and allow multiple providers to access patient-documented data. The team also reduced advanced practice nurse intervention sessions from 12 to six during the first year after allogeneic stem cell transplantation because of financial constraints. Minor adaptations included revising content and simplifying language, and 20 tailored implementation strategies were selected for context understanding, stakeholder involvement, pilot preparation, and training.
What to keep in mind
The abstract describes an adaptation project, not an evaluation of patient outcomes or effectiveness. It does not provide results from the planned pilot trial, and it does not report limitations beyond the stated technical, regulatory, and financial constraints.
Key points
- The SMILe integrated care model combines a patient app with nurse-led monitoring, self-management support, and care coordination.
- The Belgian team adapted the model for a local setting with existing eHealth infrastructure and advanced practice nurse support.
- Major changes included switching to the local eHealth platform and reducing nurse sessions from 12 to six in the first year.
- The researchers used ADAPT, FRAME, and ERIC to guide and document adaptations and implementation strategies.
- The authors say balancing core components with local constraints is important for long-term sustainability.
Disclosure
- Research title:
- Belgian adaptation of nurse-led eHealth monitoring required local changes
- Authors:
- Kristina Arnahoutova, Kathy Goris, Sabina M. De Geest, Lynn Leppla, Juliane Mielke, Frank Croes, Liesbet Zink, Linde Houbracken, Veerle Bosmans, Johan Maertens, M. Beckers, Alexandra Teynor, Sabine Valenta, Hélène Schoemans
- Institutions:
- Department of Public Health, KU Leuven, KU Leuven, KU Leuven, KU Leuven, KU Leuven, KU Leuven, SV Health Investors (United States), University Medical Center Freiburg, University of Augsburg, University of Basel, University of Basel, University of Freiburg
- Publication date:
- 2026-03-07
- OpenAlex record:
- View
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