- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00503542
Management of Vaginal Complaints: A Pilot Study Within a Practice-Based Research Network (VCAT)
January 7, 2014 updated by: Agency for Healthcare Research and Quality (AHRQ)
Many women present in primary care with vaginal complaints.
The best way of managing these complaints is unclear.
This trial will test two different methods of managing patients with vaginal complaints.
This is a pilot trial.
Study Overview
Status
Completed
Conditions
Detailed Description
Setting: The study will be carried out at two sites within the New York City Research and Improvement Network (NYC RING) an urban Practice Based Research Network comprising 21 clinical sites.
Problem: Vaginal symptoms are the most common reason for outpatient gynecological consultation, yet the management of these symptoms is not well grounded in evidence from primary care.
Purpose: To prepare for a randomized clinical trial (RCT) to test whether the current standard of care for evaluating vaginal symptoms (which involves looking for specific pathogens) produces better clinical outcomes than a simpler approach, which treats patients based on their symptoms.
Methods: 55 premenopausal non-pregnant adult women presenting with vaginal complaints will be randomized into two groups.
Women in Group A will be managed on the basis of presenting complaint without physical examination or office laboratory work.
Women in Group B will receive a physical examination and office evaluation looking for trichomonads, candida and bacterial vaginosis.
They will be managed according to the clinical and office laboratory findings.
Patients will be contacted by phone two weeks after consultation to assess symptom resolution, adverse reaction to drugs, satisfaction with care and treatment experiences.
Patients will be screened for infection with gonorrhea and chlamydia using a urine antigen test and for trichomoniasis using vaginal culture.
Patients whose tests demonstrate trichomoniasis, chlamydia or gonorrhea or who remain symptomatic at the two-week follow-up call will be re-evaluated promptly.
Outcomes: AIM 1: Feasibility: The pilot will assess 1) ability to recruit and retain patients, 2) acceptability of study protocols to subjects and 3) prevalence and detection of important sexually transmitted diseases (STD's).
AIM 2: Initial evidence of effectiveness: The pilot will provide data on key planned RCT outcome measurements including 1) treatment success rates (allowing estimation of future sample size), 2) need for reconsultation 3) adverse reactions, 4) medication usage and 5) patient satisfaction.
Benefit to public health: This pilot study will lead to a RCT of the management of vaginal complaints in primary care.
This RCT may support current practice, reinforcing the need for physical exam and laboratory testing in all patients.
On the other hand, the trial may support a more limited approach that avoids a pelvic examination.
This could result in substantial savings of health care dollars with equivalent clinical outcomes.
Study Type
Interventional
Enrollment (Actual)
46
Phase
- Early Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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New York
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Bronx, New York, United States, 10458
- Family Health Center
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 52 years (ADULT)
Accepts Healthy Volunteers
Yes
Genders Eligible for Study
Female
Description
Inclusion Criteria:
- Eligible patients will be premenopausal, non-pregnant women presenting with a chief complaint of vaginal itch, malodor, discharge, pain, irritation or rash. We will accept patient history of being pre-menopausal as valid.
Exclusion Criteria:
- We will exclude women over 45 who have undergone hysterectomy. We will exclude patients who cannot be reached by phone for follow-up interviews. We will exclude pregnant women because of concerns that the diagnosis and treatment of bacterial vaginosis plays a role in pre-term labor prevention.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Intervention
Patients primarily with itching or irritation are treated for candidal vaginitis.
Patients primarily with vaginal odor are treated for bacterial vaginosis.
Patients who did not fit either of the previous groups are treated for both candidal vaginitis and bacterial vaginosis.
|
Intravaginal terazol qhs x 5 nights; oral fluconazole 150 mg po x 1
Metronidazole 500 mg bid x 5 days; Intravaginal metronidazole bid x 5 days; intravaginal clindamycin
Other Names:
Metronidazole 2 gms po x 1
Other Names:
In this arm of the study women are treated for vaginal complaints purely on the basis of their symptoms.
Other Names:
|
ACTIVE_COMPARATOR: Control
Patient are examined and a wet mount is prepared.
If a definitive diagnosis is made patient is treated for the condition diagnosed.
If no diagnosis is made the clinician has the option of either foregoing treatment (watchful waiting) or following the protocol in the experimental group
|
Intravaginal terazol qhs x 5 nights; oral fluconazole 150 mg po x 1
Metronidazole 500 mg bid x 5 days; Intravaginal metronidazole bid x 5 days; intravaginal clindamycin
Other Names:
Metronidazole 2 gms po x 1
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Self-reported improvement in symptoms
Time Frame: within 2 weeks
|
within 2 weeks
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Adverse reactions to treatment.
Time Frame: within two weeks
|
within two weeks
|
Incidence of STD's
Time Frame: at time of presentation
|
at time of presentation
|
Vaginal Complaints Scale
Time Frame: within 2 weeks
|
within 2 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Matthew R. Anderson, MD, MSc, Montefiore Medical Center
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
February 1, 2007
Primary Completion (ACTUAL)
February 1, 2008
Study Completion (ACTUAL)
February 1, 2008
Study Registration Dates
First Submitted
July 17, 2007
First Submitted That Met QC Criteria
July 17, 2007
First Posted (ESTIMATE)
July 18, 2007
Study Record Updates
Last Update Posted (ESTIMATE)
January 8, 2014
Last Update Submitted That Met QC Criteria
January 7, 2014
Last Verified
September 1, 2007
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Vaginal Diseases
- Vaginitis
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Enzyme Inhibitors
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Anti-Bacterial Agents
- Cytochrome P-450 Enzyme Inhibitors
- Protein Synthesis Inhibitors
- Hormone Antagonists
- Antifungal Agents
- Steroid Synthesis Inhibitors
- Antiprotozoal Agents
- Antiparasitic Agents
- 14-alpha Demethylase Inhibitors
- Cytochrome P-450 CYP2C9 Inhibitors
- Cytochrome P-450 CYP2C19 Inhibitors
- Metronidazole
- Clindamycin
- Clindamycin palmitate
- Clindamycin phosphate
- Fluconazole
Other Study ID Numbers
- 1R03HS016050-01 (AHRQ)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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