- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03958331
Behavioral Economics and Adherence in Teens (BEAT!) (Beat!)
September 2, 2022 updated by: Children's Hospital Medical Center, Cincinnati
Beat!: A Randomized Controlled Clinical Trial
Non-adherence to antiepileptic drug therapy is a significant problem for adolescents with epilepsy and has a critical impact on health and patient-reported outcomes.
Evidence-based adherence interventions are lacking in this population and are critically needed.
This proposal seeks to develop and evaluate a mHealth social norms adherence intervention for adolescents with epilepsy.
Study Overview
Status
Completed
Conditions
Detailed Description
Non-adherence to antiepileptic drugs (AEDs) is a common problem (i.e., 58% of patients have some level of non-adherence) for youth with epilepsy, with potentially devastating consequences.
Adolescents with epilepsy represent a particularly vulnerable group, given their increased independence, decreased parental supervision, higher risk for deficits in organization and memory, busy and changing schedules, low motivation, and increased susceptibility to peer influence.
Existing adherence interventions in epilepsy are not designed to meet the unique challenges faced by adolescents, and there are no efficacious interventions for adolescents with epilepsy.
Not surprisingly, without efficacious interventions, adherence worsens during adolescence, further increasing the risk of poor health outcomes during this developmental period.
While reminder strategies (e.g., automated digital reminders) are effective for the most common adherence barriers of forgetting and busy schedules, they are likely to be ineffective in increasing motivation.
Leveraging social norms comparison methods (i.e., feedback about someone else's behavior related to one's own behavior) offers an opportunity to capitalize on the increased importance of peer influence while simultaneously targeting the low motivation characteristic of adolescents.
Recent data in adolescents indicates that social norms interventions have incremental value and improve health behaviors above and beyond standard feedback without peer comparisons.
Consistent with the ORBIT model for behavioral intervention development, our aims are to: 1) develop a feasible, accessible, and acceptable mHealth social norms intervention for improving AED adherence in adolescents with epilepsy and 2) obtain preliminary efficacy data and effect sizes for a future clinical trial.
We conducted a pilot RCT of an mHealth social norms intervention (ORBIT Phase II).
Adolescents with epilepsy who demonstrate non-adherence (< 95% adherence based on PI's previous RCTs; 58% of sample) during baseline will be randomized to either 1) mHealth social norms (automated digital reminders, individualized adherence feedback, and social norms feedback) or 2) control (automated digital reminders and individualized adherence feedback).
Both groups will receive active intervention for five months.
Primary (i.e., electronically-monitored adherence) and secondary outcomes (i.e., seizure severity, HRQOL) will be assessed post-treatment and 3 months later, respectively.
If successful, the results of this study would have a large impact on pediatric epilepsy, with the potential to change clinical practice for treating non-adherence by reducing common barriers to behavioral health care.
Because minimal clinician time is required, our mHealth social norms intervention also has potential for sustainability and broad dissemination for epilepsy and other pediatric conditions
Study Type
Interventional
Enrollment (Actual)
104
Phase
- Not Applicable
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
-
-
Ohio
-
Columbus, Ohio, United States, 43205
- Nationwide Children's Hospital
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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
13 years to 17 years (Child)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Ages 13-17
- Confirmed diagnosis of epilepsy
- Antiepileptic drug monotherapy
- Ability to read and speak English
Exclusion Criteria:
- No significant developmental delay (e.g., autism, moderate/severe developmental or intellectual disability) or comorbid medical diagnoses (e.g., diabetes)
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 Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Control Group
Automated reminders and individualized adherence feedback reports
|
Reminders from electronic monitors via texts or alarms/lights
Feedback report on individual adherence behaviors
|
Experimental: Treatment Group
Automated reminders and individualized adherence feedback reports with social norms comparisons
|
Reminders from electronic monitors via texts or alarms/lights
Feedback report on individual adherence behaviors compared to other adolescents with epilepsy
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Electronically Monitored Adherence
Time Frame: Month 7
|
A total mean adherence rates will be calculated based on daily adherence rates captured through the SimpleMed Pillboxes or AdhereTech bottles.
Scores range from 0-100%, with higher scores representing better adherence.
|
Month 7
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Seizure Severity-Clinician Report
Time Frame: Month 9
|
The Global Assessment of Severity of Epilepsy (GASE) is a one item clinician-rated measure of seizure severity.
The total score ranges from 1-7, with higher scores representing more severe epilepsy
|
Month 9
|
Seizure Severity-Parent Report
Time Frame: Month 9
|
The Seizure Severity Scale-Adapted for Children is a caregiver-reported questionnaire, which is 9-items and assess seizure severity, including intrusiveness, frequency, length, and disruptiveness of seizures.
A total score is calculated, ranging from 0-3, with higher scores representing worse seizure severity.
|
Month 9
|
PedsQL Epilepsy Module - Parent Report
Time Frame: Month 9
|
The PedsQL-Epilepsy Module is a 29 item measure with several subscales (Impact, Cognitive, Executive Functioning, Sleep, Mood/Behavior) will be used.
Scores range from 0-100 for each subscale, with higher scores representing better quality of life.
|
Month 9
|
PedsQL Epilepsy Module-Adolescent Report
Time Frame: 9-month
|
The PedsQL Epilepsy Module is a 29-item health-related quality of life instrument with five subscales, including Impact, Cognitive, Executive Functioning, Sleep, and Mood/Behavior).
Scores range from 0-100, with higher scores representing better quality of life.
|
9-month
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Satisfaction-Teen Report Total Score
Time Frame: Month 7
|
Adolescents completed this study specific Satisfaction measure, which was 23-items.
This measure assesses satisfaction with the intervention content, relevance, helpfulness, and ease of use.
Assessment of perceptions of the impact of what was learned from the intervention were also assessed.
Eighteen of the items used a Likert format with the following ratings: Strongly Disagree, Disagree, Agree, and Strongly Agree.
A total scale was calculated for the 18 items, which ranges from 18-72, with higher scores reflecting higher satisfaction.
Finally, five open-ended items assessing what was most and least helpful about the intervention, what changes adolescents want to see in the intervention, and any additional input.
|
Month 7
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
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 (Actual)
September 1, 2019
Primary Completion (Actual)
March 31, 2021
Study Completion (Actual)
August 16, 2021
Study Registration Dates
First Submitted
May 20, 2019
First Submitted That Met QC Criteria
May 20, 2019
First Posted (Actual)
May 22, 2019
Study Record Updates
Last Update Posted (Actual)
September 23, 2022
Last Update Submitted That Met QC Criteria
September 2, 2022
Last Verified
September 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2018-8412
- R21NR017633 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
This project will have psychosocial, adherence, demographic, and medical data for children with epilepsy.
Deidentified data can be used for many secondary analyses.
Prior to sharing, all data will be de-identified in a HIPAA-compliant fashion.
Data sets will be carefully reviewed to make sure that information such as age and gender cannot be used to gather additional information that could potentially identify individual subjects.
For example, only year of birth, rather than the full birth date, will be made available.
All categorical demographic variables will be collapsed into categories large enough so that combinations of demographic categories for age, gender, geographic location, etc., will have 10 or more individuals in each cell.
All modalities of data will be shared, including raw and aggregate data.
Descriptors for all variables shared will be included to prevent misuse or confusion.
Any analytical methods utilized to assess the data will be defined in shared formats.
IPD Sharing Time Frame
12 months following completion of the study
IPD Sharing Access Criteria
PI will provide the information
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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