Stroke and CPAP Outcome Study 3 (SCOUTS3)
Optimizing Adherence to the Treatment of Sleep Apnea Among Patients With Stroke Undergoing Inpatient Rehabilitation
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Sandeep Khot, MD, MPH
- Phone Number: 206-744-3251
- Email: skhot@uw.edu
Study Locations
-
-
Washington
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Seattle, Washington, United States, 98122
- University of Washington
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18 years or older
- Head CT or brain MRI demonstrating an acute ischemic infarction or intraparenchymal hemorrhage within past 30 days
- Person providing consent (patient or legally authorized representative) able to be consented in English or Spanish
Exclusion Criteria:
- Unable to obtain informed consent from participant or surrogate
- Incarcerated
- Known pregnancy
- Current mechanical ventilation, tracheostomy or supplemental oxygen use > 4L/min
- Current use of positive airway pressure or use within 14 days prior to stroke
- History of pneumothorax, bullous emphysema or other serious co-morbid conditions which limit CPAP use
- Stroke related to tumors, vascular malformations or subarachnoid hemorrhage
- Active use of sedative drugs that can interfere with testing for obstructive sleep apnea (OSA)
- Anticipated inpatient rehabilitation length of stay < 3 nights
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: SCOUTS3 Optimization Arm
In a single-arm study, participants from acute ischemic stroke or intraparenchymal hemorrhage within the past 30 days will be tested for OSA with a single-night portable OSA test during inpatient rehabilitation (IPR).
Eligible participants will then be started on continuous positive airway pressure (CPAP) therapy and exposed to a multicomponent CPAP adherence intervention, beginning during IPR and extending for 3 months.
Participants' CPAP use will be monitored, and input regarding the intervention will be sought from the participants, CPAP partners, and the research team implementing the intervention.
Data from an initial group of study participants will be reviewed in meetings with the study team and a patient advisory board, and adaptations will be devised and then implemented within the next batch of study participants.
Through this iterative process that includes input from important stakeholders, the behavioral intervention will be adapted for use among stroke patients.
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Eligible participants with a diagnosis of OSA will be set up with autotitrating CPAP by the study's sleep technologist.
The CPAP device includes an auto-titrator that adjusts the delivered pressure between 5 to 15 cm of water to eliminate obstructive events.
SCOUTS 3 sleep technologists (ST) will make mask type/size or device adjustments, as needed, and provide training to participants and CPAP partners to improve skills involved with mask placement and device maintenance.
For participants with non-acceptance of CPAP over the first night, a standardized desensitization program will be implemented.
Persistent problems with CPAP use or mask fit, or any high residual respiratory events will be discussed between the sleep technologist and the study's board-certified sleep medicine physician.
In-person Motivational Enhancement Therapy (MET) sessions by a trained sleep coach will occur within a week of starting CPAP and, with permission, conducted with a CPAP partner, when available.
The MET session recordings will be uploaded into the HIPAA compliant Lyssn platform for evaluation, including feedback to the sleep coach.
The goal will be 5 total MET sessions, either in-person or by phone, spanning the inpatient and then outpatient settings.
Study participants will be assisted in registering for and trained on the ResMed myAir app.
Participants will also receive mobile health messages based on Self-Determination Theory.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
CPAP Adherence
Time Frame: From CPAP initiation after study enrollment and sleep apnea testing to 90 days from CPAP initiation
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Mean hours of nightly CPAP use during and after inpatient rehabilitation over 3 months
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From CPAP initiation after study enrollment and sleep apnea testing to 90 days from CPAP initiation
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Stroke Severity
Time Frame: From in-person assessment at enrollment to the end of inpatient rehabilitation
|
National Institutes of Health Stroke Scale (NIHSS) [range 0-42; higher scores indicate greater neurologic impairment]
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From in-person assessment at enrollment to the end of inpatient rehabilitation
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Functional Disability
Time Frame: From in-person assessment at enrollment to follow-up timepoint of 90 +/- 14 days after enrollment
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Modified Rankin Score-9 Questions (mRS-9Q) [range 0-5; higher scores indicate lower level of function in neurological disease]
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From in-person assessment at enrollment to follow-up timepoint of 90 +/- 14 days after enrollment
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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CPAP partner burden
Time Frame: At follow-up timepoint of 90 +/- 14 days after enrollment
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Zarit Burden Interview (ZBI) [range 0-28; higher scores indicate greater caregiver burden]
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At follow-up timepoint of 90 +/- 14 days after enrollment
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Devin Brown, MD, MS, University of Michigan
- Principal Investigator: Sandeep Khot, MD, MPH, University of Washington
Publications and helpful links
Helpful Links
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 (Estimated)
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
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Vascular Diseases
- Cardiovascular Diseases
- Pathologic Processes
- Respiratory Tract Diseases
- Hemorrhage
- Respiration Disorders
- Sleep Wake Disorders
- Apnea
- Sleep Disorders, Intrinsic
- Dyssomnias
- Sleep Apnea Syndromes
- Intracranial Hemorrhages
- Stroke
- Pathological Conditions, Signs and Symptoms
- Behavior
- Health Behavior
- Ischemic Stroke
- Sleep Apnea, Obstructive
- Cerebral Hemorrhage
- Treatment Adherence and Compliance
- Therapeutics
- Health Services
- Health Care Facilities Workforce and Services
- Behavioral Disciplines and Activities
- Directive Counseling
- Counseling
- Mental Health Services
- Airway Management
- Respiratory Therapy
- Positive-Pressure Respiration
- Respiration, Artificial
- Motivational Interviewing
- Continuous Positive Airway Pressure
Other Study ID Numbers
Other Study ID Numbers
- STUDY00016907
- 1R01HL164394-01A1 (U.S. NIH Grant/Contract)
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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