José Côté is Principal Scientist and Professor in the Faculty of Nursing at the University of Montréal. She is also the holder of the Research Chair in Innovative Nursing Practices.
José is a founding member of the team that created TAVIE , a virtual nurse intervention program to support people with chronic conditions. TAVIE won a Care Challenge award in 2012 as part of the Connecting Nurses program. To celebrate the fifth year of success of the program we sat with José to discuss about her initiative and its evolution, as well as how winning the Care Challenge gave a boost to TAVIE’s development and helped disseminate this approach in the global nursing community.
Can you tell us about the TAVIE program and how it has evolved to help support patients with chronic conditions?
TAVIE is the French acronym for Traitement, Assistance Virtuelle Infirmière et Enseignement (Treatment Virtual Nurse Assistance and Teaching) and it also translates in English as ‘your life’. It’s a virtual nursing intervention and an innovative information technology platform.
The aim of TAVIE is to provide tailored real-time support to people living with chronic health conditions. It consists of different web-based interventions, but always at the center of TAVIE is a virtual nurse who helps patients to manage their health condition. The nurse supports the development and reinforcement of skills and self-education, and ensures that the patient is active in the process. So, in effect, the virtual nurse is a guide, a care partner and a mentor who empowers the user to take charge of their health condition.
Together with our clinicians we try to predict the patient’s trajectory in terms of the content that we offer. So if a patient has a strong intention to change his behavior, he will have a different intervention from someone without any intention of changing it. We will work differently with him.
You started with TAVIE-HIV. Can you tell us about some of the other conditions the platform is now being used for?
Using a diverse team of clinicians, computer scientists and media professionals, we started developing TAVIE in 2005, with the first program launching in 2007 to help support HIV patients with self-management of antiretroviral medication to improve adherence. We then adapted it to develop TAVIE-Women to respond to the particular needs of women living with HIV.
These were the precursors to the many TAVIE programs we now have that relate to medication adherence, such as TRANSPLANT-TAVIE to support kidney transplant patients and TAVIE@COEUR for people with heart problems. We also have TAVIE en Santé to promote healthy behaviors such as healthy eating, physical activity and smoking cessation, and to reduce the risk of cardiovascular disease and diabetes among people living with HIV.
In all we have so far created 12 interventions, with some still under development or evaluation – other disease states include epilepsy, genital cancer, chronic pain and Parkinson’s disease.
The program has been upgraded over the years in line with new technology, but the virtual nurse has always remained at the center of the intervention. We hope to keep developing new programs in order to offer self-care support for people living with all types of chronic conditions.
Can you share with us some key results on the impact that TAVIE has on patient adherence and outcomes?
For example, with VIH-TAVIE, our clinical studies show a 98% patient satisfaction rating and a clear indication that the program has helped to improve adherence rates. Patients say that the intervention helps them to take their medication as recommended. Even among groups where adherence is already high, we are finding that TAVIE can help them to continue to increase their adherence.
A study of the success of the SOULAGE-TAVIE program showed promising results in improving postoperative pain-related outcomes.
What else do patients say about the program and its benefits?
In general, patients appreciate the accuracy and the quality of information provided. They also report reassurance about side effects, better ability to adapt to their medication and a more positive attitude toward their medication, as well as other emotional benefits such as not feeling so alone.
In short, they feel better equipped to manage their condition and their medication themselves.
What would you tell your colleagues from all around the world about Care Challenge and Connecting Nurses?
Winning the Care Challenge award in 2012 played an important role in our work and in the development of new collaborations for us. TAVIE has become more and more visible in the field of chronic disease management. Care Challenge allowed us to spread innovative nursing ideas all over the world and to expand our work and impact. Since 2012, we’ve gone on to create numerous other projects and win additional awards.
Connecting Nurses has opened a lot of doors for us and we’d certainly encourage other health professionals around the world to submit their projects to the Care Challenge website. With Care Challenge, we can multiply the impact of our successes.