Respiratory Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease (REHABDO)
Respiratory Rehabilitation at Home vs in the Center for Patients With Chronic Obstructive Pulmonary Disease: Efficacy, Preferences and Costs
The aim of this clinical trial is to establish the non-inferiority of home-based respiratory rehabilitation compared to respiratory rehabilitation in center in terms of exercise tolerance as evaluated by the 6 minutes Stepper test..
This trial will also 1°) evaluate the Medico-economic aspects of the home-based Respiratory rehabilitation versus respiratory Rehabilitation in center; 2°) analyse the patient preferences between home-based respiratory rehabilitation and respiratory rehabilitation in center and 3°) Compare home-based respiratory rehabilitation vs respiratory rehabilitation in center in terms of dyspnea, quality of life, anxiety and depression.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The purpose of this study is to perform a comparative analysis of the clinical and medico-economic effectiveness of center-based RR versus home-based RR in the departments of Nord and Pas de Calais in France. All COPD patients eligible for RR and willing to participate in the study will be followed.
Patient preferences will be evaluated at inclusion. After presentation of both RR modalities, patients expressing a strong preference for one or other of the terms will be taken care of according to their wishes. Indifferent patients between the two RR modalities will be randomized.
This design is justified in the light of three cases:
- It is impossible to evaluate blind intervention,
- The effectiveness of RR depends on patient preferences,
- Patients' adherence to the protocol is facilitated.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Olivier Le rouzic, MD,PhD
- Phone Number: +33 3.20.44.59.48
- Email: olivier.lerouzic@chru-lille.fr
Study Contact Backup
- Name: Benoit Wallaert, MD,PhD
Study Locations
-
-
-
Béthune, France
- Centre Hospitalier de Béthune
-
Béthune, France
- CH de Béthune
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Lille, France
- Hôpital Calmette, CHU
-
Loos, France
- CH de Loos
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Roubaix, France
- CH Victor Provot, Roubaix
-
Tourcoing, France
- CH de Tourcoing
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Wattrelos, France
- CH de Wattrelos
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:According to HAS recommendations, SPLF, ERS / ATS (3) (18) (19) can be included any patient, over 18 years old, with stage II - III - IV COPD presenting disabling dyspnoea in activities of daily living, and / or in the course of acute exacerbation of COPD (EABPCO), with no other respiratory pathology diagnosed.
Exclusion Criteria:
According to the recommendations, HAS, SPLF, ERS / ATS will not be included any patient having :
- co-morbidities including unstabilized cardiovascular disease,
- significant cognitive disorders: patients with a history of pathologies neurodegenerative with loss of mental faculties (example: Alzheimer)
- psychiatric disorders: patients with impaired judgment and perception
- neurological or orthopedic disorders that do not allow the realization of physical activities
Also, will not be included, the patient (s):
- waiting for lung transplantation,
- pregnant or nursing,
- in an emergency situation
- unable to receive enlightened information,
- unable to participate in the entire study,
- not covered by the social security scheme,
- refusing to sign the consent,
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: home group
|
Home care is individual (often with the spouse or the carer), during 1h30, one visit per week for 8 weeks, after completion of the educational diagnosis, under direct supervision of a member of the team, with continued physical activities in autonomy the others days of the week, according to a personalized action plan.
No visit is scheduled in the pulmonologist, the general practitioner or in the rehabilitation center.
The team includes pulmonologist, nurses, dietician, socio-medical beautician and a administrative assistant.
|
|
Active Comparator: center group
|
In an outpatient setting, the course is performed in groups of 6 to 8 patients, during sessions from 3 to 7 am, under the direction of health professionals, 3 to 5 times a week, for 4 to 6 weeks, for a total of 20 to 24 sessions. Internally, patients come to "complete" hospitalization for 4 weeks. This duration can be modulated according to the evolution of the patients. Supervision is carried out by the entire team including pulmonologists, nurses, physiotherapists, psychologists, activity professors adapted physicists, dietician |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from baseline the 6 minutes Stepper test at 2 months
Time Frame: At 2 months
|
The 6 minutes stepper test (ST6), performed on a Stepper allows to analyze the number of strokes (or steps) performed in 6 minutes
|
At 2 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from baseline the 6 minutes Stepper test at 6 and 12 months
Time Frame: at 6 months, at12 months
|
The 6 minutes stepper test (ST6), performed on a Stepper allows to analyze the number of strokes (or steps) performed in 6 minutes
|
at 6 months, at12 months
|
|
Percentage of patients expressing a preference marked for home-based respiratory rehabilitation or respiratory rehabilitation in center
Time Frame: Baseline
|
Baseline
|
|
|
Cost of interventions: respiratory rehabilitation in center or at home
Time Frame: At 12 months
|
At 12 months
|
|
|
Change from Baseline COPD Assessment Test (CAT) at 2,6,12 months
Time Frame: baseline, after RR (2 months); 6 months and12 months
|
The COPD assessment test (CAT) is a short questionnaire initially intended for assess quality of life and clinical impact of COPD
|
baseline, after RR (2 months); 6 months and12 months
|
|
Change from Baseline Modified Medical Research Council (MMRC) Dyspnea Scale at 2,6,12 months
Time Frame: baseline, after RR (2 months); 6 months and12 months
|
The scale measures a person's limitation base on a scale of 0-4 and uses the final value to determine how much disability is caused by shortness of breath.Five-option grading system called the Modified Medical Research Council (MMRC) Dyspnea Scale.
|
baseline, after RR (2 months); 6 months and12 months
|
|
Change from Baseline Anxiety and Depression (HAD) at 2,6,12 months
Time Frame: Baseline, after RR (2 months); 6 months and12 months
|
To determine the levels of anxiety and depression that a COPD patients are experiencing
|
Baseline, after RR (2 months); 6 months and12 months
|
|
EPICES score
Time Frame: baseline
|
EPICES score (Assessment of the precariousness and health inequalities in the Health Examination Centers, French) is an individual indicator of precariousness ,Self-administered questionnaire,quantify the level of social vulnerability and precariousness. It ranges from zero (no vulnerability) to 100 (maximum vunerability) |
baseline
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Olivier Le Rouzic, MD,PhD, University Hospital, Lille
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2017_08
- 2017-A02393-50 (Other Identifier: ID-RCB number, ANSM)
- PREPS-16-249 (Other Identifier: PREPS number, DGOS)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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