- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03404245
an On-demand Program to EmpoweR Active Self-management (OPERAS) (OPERAS)
Empowering Active Self-management of Arthritis: Raising the Bar With OPERAS (an On-demand Program to EmpoweR Active Self-management)
Study Overview
Status
Conditions
Detailed Description
Self-management is a fundamental component in arthritis care, however, it is often neglected as most models of arthritis care focus on early access to medical consultation and surgical interventions. Patient self-management refers to the active participation of patients in a variety of activities that contribute to lessening the physical and emotional impact of illnesses. There are several factors attributing to a lack of self-management practice, such as frustration from managing health on a trial-and-error basis, a lack of knowledge to effectively monitor symptoms and disease, and being unsure about how to manage physical activities without aggravating symptoms. The variety of risk factors highlight the need for a multifaceted approach that provides support in terms of knowledge, skill development and timely advice from health professionals, as well as motivational support for patients to be engaged in their care and to stay physically active.
Our primary objective is to assess the efficacy of an e-health intervention, OPERAS, which integrates the Arthritis Health Journal and a Physical Activity Counselling program, to improve self-management ability. Our secondary objectives are to explore the effect of the intervention on disease status and physical activity levels and to assess barriers to implementation and sustainability of the e-health intervention in (rheumatoid arthritis) RA management.
The investigators will use a mixed-methods approach, involving a randomized controlled trial (RCT) and in-depth interviews. The proof-of-concept study will employ a stepped wedge RCT design, whereby the intervention will be sequentially rolled out to participants over a number of time periods. The order in which individuals receive the intervention will be determined at random. The strength of this design is that it can properly address the efficacy question, while avoiding the dilemma of withholding the intervention to some participants, as in a parallel group design.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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British Columbia
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Richmond, British Columbia, Canada, V6X 2C7
- Arthritis Research Canada
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- a physician confirmed diagnosis of RA
- no joint surgery in the past 6 months
- no history of acute injury to any joints in the past 6 months
- an email address and daily access to a computer or mobile device.
Exclusion Criteria:
- people who should not be physically active without medical supervision.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Immediate Intervention Group
Education, Fitbit/self-management web app, physiotherapist counselling.
These 3 components will be delivered to the participants in Months 1 and 2. The session will include a short presentation about physical activity in everyday life, an individual goal-setting session with a registered physical therapist (PT), and an orientation to the Fitbit device and the web app.
Participants will be provided access to a Fitbit and an app account.
The PT will review physical activity goals with participants via bi-weekly phone calls and progressively modify their activities.
In Month 3-6, participants will continue using Fitbit and the app and have access to a PT via email as needed, but no phone call.
In Months 7-12, participants may keep their Fitbit and app account, but will not have access to a PT.
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Participants will receive a brief education session, use a physical activity tracker Fitbit Flex paired with a self-management app, and remote counseling by a PT.
Intervention will be received immediately.
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Placebo Comparator: Delayed Intervention Group
Same intervention with a 6 month delay: The full intervention will be initiated in Month 7 and 8 with a brief education session, use of a Fitbit paired with the self-management web app, and counseling by a physical therapist (PT).
In Month 9-12, participants will continue the intervention without the PT phone calls, but will have email access to PT, if needed.
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The Delayed Intervention Group will receive the same intervention as the Immediate Intervention Group, but with a 6 month delay.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient Activation Measure
Time Frame: Baseline
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Patient Activation Measure is a 13-item self-reported measure of individuals' confidence in managing chronic diseases.
Each item has a 4-point response (1 "strongly disagree"; 4 "strongly agree"), with the aggregate raw score converted to 0-100.
Hibbard et al presented a 4-stage activation model derived from the standardized scores: 1) Believing an active role is important (PAM score <47); 2) Having confidence and knowledge to take action (47.1 - 55.1); 3) Taking action (55.2 - 67); 4) Maintaining healthy behaviours despite setbacks (> 67.1).
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Baseline
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Patient Activation Measure
Time Frame: 6 months
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Patient Activation Measure is a 13-item self-reported measure of individuals' confidence in managing chronic diseases.
Each item has a 4-point response (1 "strongly disagree"; 4 "strongly agree"), with the aggregate raw score converted to 0-100.
Hibbard et al presented a 4-stage activation model derived from the standardized scores: 1) Believing an active role is important (PAM score <47); 2) Having confidence and knowledge to take action (47.1 - 55.1); 3) Taking action (55.2 - 67); 4) Maintaining healthy behaviours despite setbacks (> 67.1).
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6 months
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Patient Activation Measure
Time Frame: 12 months
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Patient Activation Measure is a 13-item self-reported measure of individuals' confidence in managing chronic diseases.
Each item has a 4-point response (1 "strongly disagree"; 4 "strongly agree"), with the aggregate raw score converted to 0-100.
Hibbard et al presented a 4-stage activation model derived from the standardized scores: 1) Believing an active role is important (PAM score <47); 2) Having confidence and knowledge to take action (47.1 - 55.1); 3) Taking action (55.2 - 67); 4) Maintaining healthy behaviours despite setbacks (> 67.1).
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12 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rheumatoid Arthritis Disease Activity Index
Time Frame: Baseline
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Rheumatoid Arthritis Disease Activity Index consists of: 1) global disease activity; 2) joint tenderness/swelling; 3) pain; 4) morning stiffness; 5) number/severity of painful joints.
Score ranges from 0 - 10; lower = better.
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Baseline
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Rheumatoid Arthritis Disease Activity Index
Time Frame: 6 months
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Rheumatoid Arthritis Disease Activity Index consists of: 1) global disease activity; 2) joint tenderness/swelling; 3) pain; 4) morning stiffness; 5) number/severity of painful joints.
Score ranges from 0 - 10; lower = better.
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6 months
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Rheumatoid Arthritis Disease Activity Index
Time Frame: 12 months
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Rheumatoid Arthritis Disease Activity Index consists of: 1) global disease activity; 2) joint tenderness/swelling; 3) pain; 4) morning stiffness; 5) number/severity of painful joints.
Score ranges from 0 - 10; lower = better.
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12 months
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Daily Moderate/Vigorous Physical Activity time
Time Frame: Baseline
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Time spent in Moderate/Vigorous Physical Activity (MVPA) is measured with a SenseWear Mini sensor over a 7-day period.
We will calculate the mean time spent in bouted MVPA per day.
A bout is defined as >= 10 consecutive minutes or more at the level of >= 3 METs (i.e., the lower bound of MVPA), with allowance for interruption of up to one minute below the threshold.
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Baseline
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Daily Moderate/Vigorous Physical Activity time
Time Frame: 6 months
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Time spent in Moderate/Vigorous Physical Activity (MVPA) is measured with a SenseWear Mini sensor over a 7-day period.
We will calculate the mean time spent in bouted MVPA per day.
A bout is defined as >= 10 consecutive minutes or more at the level of >= 3 METs (i.e., the lower bound of MVPA), with allowance for interruption of up to one minute below the threshold.
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6 months
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Daily Moderate/Vigorous Physical Activity time
Time Frame: 12 months
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Time spent in Moderate/Vigorous Physical Activity (MVPA) is measured with a SenseWear Mini sensor over a 7-day period.
We will calculate the mean time spent in bouted MVPA per day.
A bout is defined as >= 10 consecutive minutes at the level of >= 3 METs (i.e., the lower bound of MVPA), with allowance for interruption of up to one minute below the threshold.
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12 months
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Daily sedentary time
Time Frame: Baseline
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Time spent in sedentary activity is measured with a SenseWear Mini sensor over a 7-day period.
We will calculate the mean daily time spent in sedentary activity, with an energy expenditure of <=1.5 METs, occurring in bouts of >= 20 minutes during waking hours
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Baseline
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Daily sedentary time
Time Frame: 6 months
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Time spent in sedentary activity is measured with a SenseWear Mini sensor over a 7-day period.
We will calculate the mean daily time spent in sedentary activity, with an energy expenditure of <=1.5 METs, occurring in bouts of >= 20 minutes during waking hours
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6 months
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Daily sedentary time
Time Frame: 12 months
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Time spent in sedentary activity is measured with a SenseWear Mini sensor over a 7-day period.
We will calculate the mean daily time spent in sedentary activity, with an energy expenditure of <=1.5 METs, occurring in bouts of >= 20 minutes during waking hours
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12 months
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Linda Li, PhD, professor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- H17-03424
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
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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