Improving Outcomes in PICS With Home-Based Program of Rehabilitation and Health Coaching
Pilot Clinical Trial of a Home-based Program of Rehabilitation With Health Coaching to Improve Outcomes in Post-intensive Care Syndrome Patients
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Johanna Hoult
- Phone Number: 507-293-1989
- Email: Hoult.Johanna@mayo.edu
Study Locations
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Arizona
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Scottsdale, Arizona, United States, 85259
- Mayo Clinic Arizona
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Minnesota
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Rochester, Minnesota, United States, 55905
- Mayo Clinic Minnesota
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adults (age ≥ 18) with PICS defined as admitted to the ICU for more than 48 hours with any of the following conditions: respiratory failure of any cause requiring mechanical ventilation ≥ three days, any shock requiring vasopressors and/or inotropes, development of delirium during the ICU stay, , and cardiac arrest during the index hospital admission.
- A HABC-M-SR score > 12 points.
Exclusion Criteria:
- Any mechanical ventilation in the last two months before the index ICU admission
- ≥ 5 days in the ICU over the previous month before the index ICU admission
- Receiving hospice or palliative care
- Severe uncontrolled psychological or psychiatric disorders, e.g., schizophrenia, bipolar disorder, struggling to cope as a result of their personality disorder, uncontrolled substance abuse (alcoholism, illegal drugs) homelessness would make them unsuitable for the intervention
- A co-morbidity so severe it would prevent the patient from engaging fully in the intervention/ control, e.g., progressive cancer, anoxic brain injury, severe rheumatoid arthritis or osteoarthritis, multiple sclerosis, chronic widespread pain syndrome, previous cerebral vascular event that the patient would not be able to participate in PR
- Patients with moderate/severe cognitive impairment per medical records screening
- Inability to obtain informed consent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Piolt (Aim 1) Group: Home-Based Program of Rehabilitation and Health Coaching
5-10 subjects will be assigned to complete 20 minutes of Home-based Physical Rehabilitation and Health Coaching for approximately 12 weeks to test feasibility of the home-based rehabilitation program.
This will be the initial phase of the study prior to RCT phase.
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Study-trained nurse whom utilizes participant data to guide interactions in weekly calls.
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Experimental: Home-Based Program of Rehabilitation and Health Coaching
Subjects will complete 20 minutes of Home-based Physical Rehabilitation and Health Coaching for approximately 12 weeks.
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Study-trained nurse whom utilizes participant data to guide interactions in weekly calls.
Six out of seven days a week, gentle flexibility practice (upper arm and shoulder movements) that can be done seated or standing and two slow walking sessions focused on balance.
In addition, complete a breathing practice focused on breathing in through the nose and exhaling through the mouth.
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No Intervention: Usual Care
Subjects will receive clinical standard of care.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Completion of home-based rehabilitation program
Time Frame: 12 weeks
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Total number of subjects to complete the home-based rehabilitation program per protocol
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12 weeks
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Change in health related quality of life
Time Frame: Baseline, 3 months
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Measured by the European Quality of Life 5 Dimensions 5 Level (EQ-5D-5L) score.
Questionnaire assess 5 dimensions of health (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) on a 5 level severity scale of no problems, slight problems, moderate problems, severe problems, and unable to perform or extreme problems.
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Baseline, 3 months
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change in Anxiety and Depression
Time Frame: Baseline, 3 months
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Measured using the Hospital Anxiety and Depression Scale (HADS) assessing subjects feelings in the past week.
Total score 0-21 with 0-7 = normal, 8-10 borderline abnormal; and 11-21 abnormal.
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Baseline, 3 months
|
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Change in Post-Traumatic Stress Disorder (PTSD) Symptoms
Time Frame: Baseline, 3 months
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Measured using the Impact of Events Scale-Revised (IES-R) to assess subjective distressing difficulties experienced in the past seven days after a specific stressful event.
22 questions with total scoring range of 0 to 88 with 24 or more indicating PTSD is a clinical concern; 33 and above represents probable diagnosis of PTSD; and 37 or more high enough to suppress immune system's functioning.
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Baseline, 3 months
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Change in cognition
Time Frame: Baseline, 3 months
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Measured by the Healthy Aging Brain Care (HABC)-Monitor self-reported version questionnaire to assess brain health using a scale of not all (0-1 day); several days (2-6 days); more than half the days (7-11 days); and almost daily (12-14 days).
Total score range of 0 to 81 with higher scores indicating poor cognitive, functional and behavioral brain health.
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Baseline, 3 months
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Change in Daily Steps
Time Frame: Baseline, 3 months
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Number of daily steps taken measured by wearable devices
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Baseline, 3 months
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Change in Sedentary Time
Time Frame: Baseline, 3 months
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Total sedentary time in hours measured by wearable devices
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Baseline, 3 months
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Change in Physical activity
Time Frame: Baseline, 3 months
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Total time recorded in in light, moderate, and strenuous physical activity in hours measured by wearable devices
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Baseline, 3 months
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Change in Sleep time
Time Frame: Baseline, 3 months
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Total sleep time in hours measured by wearable devices
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Baseline, 3 months
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Healthcare Utilization
Time Frame: 3 months
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Number of hospitalizations, outpatient, and ER visits
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3 months
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Rodrigo Cartin-Ceba, MD, Mayo Clinic
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 (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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 23-006637
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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