Integrated Management of Chronic Respiratory Diseases (eMEUSE-SANTE)

Integrated Management of Chronic Respiratory Diseases - eMEUSE-SANTE

Chronic respiratory diseases such as obstructive sleep apnea syndrome (OSA) and chronic obstructive pulmonary disease (COPD) constitute a major public health problem, due to their high prevalence, but especially because of their cardiovascular and metabolic morbidity and mortality and the associated costs for the health system. The organization of long-term management of these diseases is now part of the e-health process, digital health with the use of massive "big data" generated by care and follow-up. Therapeutic patient education and the integration of connected objects will allow personalized therapeutic education support with interventions by local medical staff adapted to the needs of the patients.

This will also allow to objectify the effect of treatments such as continuous positive airway pressure (CPAP) for OSA or non-invasive ventilation (NIV) and/or oxygen therapy for COPD, not only on the prevention of respiratory decompensation but also on cardiovascular and metabolic risk factors which are major elements of the prognosis. This project will therefore make it possible to demonstrate the feasibility and to deploy a multi-actor care pathway in the territory.

The investigators propose a prospective clinical study, conducted at the Verdun Hospital, with the main objective of studying the evolution of the quality of life of patients with a chronic respiratory pathology, during an integrated management at home for 6 months.

The secondary objectives:

• To study the evolution of the following parameters, before treatment (at inclusion) and after 6 months of integrated management:

  1. Treatment compliance (CPAP or NIV/oxygen therapy)
  2. Physical activity
  3. Weight
  4. Mean arterial pressure
  5. Oxygen saturation, heart rate and respiratory rate for COPD patients
  6. Severity of COPD for the patients concerned
  7. Daytime sleepiness
  8. Fatigue
  9. Patient acceptability of the use of connected objects
• To analyze the trajectories of the measures collected throughout the integrated management to identify specific profiles.
• To analyze the daily data of the different connected objects and treatments with regard to the patients' profiles (according to age, gender, comorbidities, OSA or COPD group).

Study Overview

• Status: Recruiting
• Conditions: Sleep Apnea, Obstructive; Chronic Obstructive Pulmonary Disease
• Intervention / Treatment: Device: Connected actimeter to measure physical activity in OSA patients; Device: Connected BORA Band to measure physical activity in COPD patients only; Other: IPAQ to evaluated physical activity; Device: Connected scale to measure weight; Device: Connected tensiometer to measure arterial pressure; Device: Connected BORA Band to measure oxygen saturation in COPD patients only; Device: Connected BORA Band to measure heart rate in COPD patients only; Device: Connected BORA Band to measure respiratory rate in COPD patients only; Other: EXASCORE to evaluated COPD severity; Other: Epworth scale to evaluate sleepiness; Other: Pichot scale to evaluate fatigue; Other: Usability questionnaire; Other: SF36 questionnaire

Detailed Description

Chronic respiratory diseases such as obstructive sleep apnea syndrome (OSA) and chronic obstructive pulmonary disease (COPD) constitute a major public health problem, due to their high prevalence, but especially because of their cardiovascular and metabolic morbidity and mortality and the associated costs for the health system. There is also an inequality of access to referral care linked to demographics and territorial organization. We are currently at a turning point in the understanding of these pathologies and their coordinated management by combining therapeutic modalities. The organization of long-term management of these diseases is now part of the e-health process, digital health with the use of massive "big data" generated by care and follow-up. Therapeutic patient education and the integration of connected objects measuring weight, oxygen saturation rate, heart rate, respiratory rate, skin temperature blood pressure or physical activity will allow personalized therapeutic education support with interventions by local medical staff adapted to the needs of the patients.

This will also allow to objectify the effect of treatments such as continuous positive airway pressure (CPAP) for OSA or non-invasive ventilation (NIV) and/or oxygen therapy for COPD, not only on the prevention of respiratory decompensation but also on cardiovascular and metabolic risk factors which are major elements of the prognosis. This project will therefore make it possible to demonstrate the feasibility and to deploy a multi-actor care pathway in the territory.

The investigators propose a prospective clinical study, conducted at the Verdun Hospital, with the main objective of studying the evolution of the quality of life of patients with a chronic respiratory pathology, during an integrated management at home for 6 months.

The secondary objectives:

• To study the evolution of the following parameters, before treatment (at inclusion) and after 6 months of integrated management:

  1. Treatment compliance (CPAP or NIV/oxygen therapy)
  2. Physical activity, measured by an actimeter for OSAS patients or by the BORA Band device for COPD patients, for one week and IPAQ
  3. Weight, measured by a connected scale
  4. Average blood pressure, measured by a connected blood pressure monitor
  5. Oxygen saturation, heart rate and respiratory rate measured by the BORA Band for COPD patients
  6. The severity of COPD by the EXASCORE questionnaire for the patients concerned
  7. Daytime sleepiness by the Epworth questionnaire
  8. Fatigue by the Pichot scale
  9. Patients' acceptability of the use of the connected objects by questionnaires of satisfaction of use at 6 months.
• To analyze the trajectories of the measures collected throughout the integrated management to identify specific profiles.
• To analyze the daily data of the different connected objects and treatments with regard to the patients' profiles (according to age, gender, comorbidities, OSA or COPD group).

• Study Type: Interventional
• Enrollment (Estimated): 400
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Marie JOYEUX-FAURE, PharmD, PhD; Phone Number: 334 767 692 65; Email: mjoyeuxfaure@chu-grenoble.fr
• Study Contact Backup: Name: Robin TERRAIL, MBA; Phone Number: 334 767 671 66; Email: rterrail@chu-grenoble.fr

Study Locations

• France
  • Grenoble, France, 38000
    • Enrolling by invitation
    • Grenoble Alpes University Hospital
  • Verdun, France, 55100
    • Recruiting
    • Verdun Hospital
    • Contact: Murielle PARENT; Email: mparent1@ch-verdun.fr
    • Contact: Céline CARDOSO-PARMENTIER, nurse; Email: ccardoso@ch-verdun.fr
    • Sub-Investigator: Jean-Claude CORNU, MD
    • Sub-Investigator: Khier AMRANI, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patient with a chronic respiratory pathology such as:
• Newly diagnosed OSA with indication for CPAP treatment
• And/or COPD with or without indication for NIV/oxygen therapy
• Have a smartphone (with Android or iOS) allowing the installation of applications for connected objects
• Be able to use a mobile application on a personal smartphone
• Person agreeing to the telemonitoring of CPAP or NIV/oxygen therapy compliance data by the healthcare provider
• Patient who has provided consent to participate in the study
• Person affiliated to the social security

Exclusion Criteria:

• Pregnant or breastfeeding woman
• Patient unable to give consent to participate in the study
• Patient under guardianship or curatorship
• Patient not affiliated to the social security system
• Patient deprived of liberty or hospitalized
• Patient protected by law
• Patient under administrative or judicial control
• Patient currently participating in another clinical research study that may have an impact on the study, this impact is left to the discretion of the investigator

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: OSA or COPD patients having an integrated management at home; OSA or COPD patients having an integrated management at home using connected devices, during 6 months

Device: Connected actimeter to measure physical activity in OSA patients; Connected actimeter worn for one week before initiation of treatment, at M3 and at M6, to measure average daily steps for OSA patients; Device: Connected BORA Band to measure physical activity in COPD patients only; Connected BORA Band worn for one week before initiation of treatment, at M3 and at M6, to measure average daily steps for COPD patients only; Other: IPAQ to evaluated physical activity; Physical activity evaluated by IPAQ (International Physical Activity Questionnaire) at the inclusion, M3 and M6; Device: Connected scale to measure weight; Weight measured by a connected scale, before CPAP or NIV treatment, at M3 and M6; Device: Connected tensiometer to measure arterial pressure; Arterial pressure measured by a connected tensiometer, before CPAP or NIV treatment, at M3 and M6; Device: Connected BORA Band to measure oxygen saturation in COPD patients only; Daily oxygen saturation measured by the connected BORA Band for COPD patients only during 6 months; Device: Connected BORA Band to measure heart rate in COPD patients only; Daily heart rate measured by the connected BORA Band for COPD patients only during 6 months; Device: Connected BORA Band to measure respiratory rate in COPD patients only; Daily respiratory rate measured by the connected BORA Band for COPD patients only during 6 months; Other: EXASCORE to evaluated COPD severity; COPD severity evaluated by the EXASCORE questionnaire at inclusion, M3 and M6 for COPD patients only; Other: Epworth scale to evaluate sleepiness; Sleepiness evaluated by the Epworth scale at baseline, M3 and M6; Other: Pichot scale to evaluate fatigue; Fatigue evaluated by the Pichot scale at inclusion, M3 and M6; Other: Usability questionnaire; Subjective assessment of each device by means of usability questionnaire at M6; Other: SF36 questionnaire; Quality of life evaluated by the SF36 questionnaire at inclusion and M6

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change of Quality of life assessed by the SF36 questionnaire	Change of quality of life, assessed by the SF36 questionnaire, from Baseline (at inclusion) and after 6 months of an integrated management at home	at inclusion and at 6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change of Physical activity (average daily steps) for OSA patient only	Change of the physical activity using a connected actimeter for OSA patients only, from Baseline (one week before treatment) and after 3 and 6 months of an integrated management at home	One week before initiation of CPAP treatment and at Month 3 and Month 6
Change of Physical activity (average daily steps) for COPD patient only	Change of the physical activity using the connected BORA Band for COPD patients only, from Baseline (one week before treatment) and after 3 and 6 months of an integrated management at home	One week before initiation of NIV treatment and at Month 3 and Month 6
Change of Physical activity assessed by the IPAQ questionnaire	Change of Physical activity assessed by the IPAQ (International Physical Activity Questionnaire), from Baseline (at inclusion) and after 3 and 6 months of an integrated management at home	At the inclusion, Month 3 and Month 6
Change of Weight measured by a connected scale	Change of Weight measured by a connected scale, from Baseline (before CPAP or NIV treatment), and after 3 and 6 months of an integrated management at home.	Before CPAP or NIV treatment, at Month 3 and Month 6
Change of Arterial pressure measured by a connected tensiometer	Change of Arterial pressure measured by a connected tensiometer, from Baseline (before CPAP or NIV treatment), and after 3 and 6 months of an integrated management at home.	Before CPAP or NIV treatment, at Month 3 and Month 6
Daily oxygen saturation measured by the connected BORA Band for COPD patients only	Daily oxygen saturation measured by the connected BORA Band for COPD patients only	During 6 months
Daily heart rate measured by the connected BORA Band for COPD patients only	Daily heart rate measured by the connected BORA Band for COPD patients only	During 6 months
Daily respiratory rate measured by the connected BORA Band for COPD patients only	Daily respiratory rate measured by the connected BORA Band for COPD patients only	During 6 months
Change of COPD severity evaluated by the EXASCORE questionnaire for COPD patients only	Change of COPD severity evaluated by the EXASCORE questionnaire for COPD patients only, from Baseline (at inclusion), and after 3 and 6 months of an integrated management at home.	At the inclusion, Month 3 and Month 6
Change of Sleepiness evaluated by the Epworth questionnaire	Change of Sleepiness evaluated by the Epworth questionnaire, from Baseline (at inclusion), and after 3 and 6 months of an integrated management at home.	At baseline, Month 3 and Month 6
Change of Fatigue evaluated by the Pichot questionnaire	Change of Fatigue evaluated by the Pichot questionnaire, from Baseline (at inclusion), and after 3 and 6 months of an integrated management at home.	At inclusion, Month 3 and Month 6
Satisfaction and usage of the connected scale assessed by a specific questionnaire	Satisfaction and usage of the connected scale assessed by a specific questionnaire, after 6 months of an integrated management at home	At Month 6
Satisfaction and usage of the connected tensiometer assessed by a specific questionnaire	Satisfaction and usage of the connected tensiometer assessed by a specific questionnaire, after 6 months of an integrated management at home	At Month 6
Satisfaction and usage of the connected actimeter assessed by a specific questionnaire, for OSA patients only	Satisfaction and usage of the connected actimeter assessed by a specific questionnaire, for OSA patients only, after 6 months of an integrated management at home	At Month 6
Satisfaction and usage of the connected BORA Band assessed by a specific questionnaire, for COPD patients only	Satisfaction and usage of the connected BORA Band assessed by a specific questionnaire, for COPD patients only, after 6 months of an integrated management at home	At Month 6

Collaborators and Investigators

• Sponsor: University Hospital, Grenoble
• Collaborators: EFCR Department and Sleep Laboratory, Grenoble Alpes University Hospital; Pneumology Department, Verdun Hospital; BIOSENCY compagny; SEFAM compagnie; ADOR - Territorial Support Network, Device and Tools for Primary Care Teams; PULSY - Regional Support Group for the Development of e-health; eMeuse-Santé consortium
• Investigators: Principal Investigator: Jean-Louis PEPIN, MD, PhD, Grenoble Alpes University Hospital

Study record dates

Study Major Dates

• Study Start (Actual): September 10, 2021
• Primary Completion (Estimated): December 31, 2024
• Study Completion (Estimated): February 28, 2025

Study Registration Dates

• First Submitted: June 21, 2021
• First Submitted That Met QC Criteria: July 5, 2021
• First Posted (Actual): July 15, 2021

Study Record Updates

• Last Update Posted (Estimated): January 3, 2024
• Last Update Submitted That Met QC Criteria: January 2, 2024
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Nervous System Diseases; Apnea; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Wake Disorders; Lung Diseases; Disease Attributes; Sleep Apnea Syndromes; Chronic Disease; Sleep Apnea, Obstructive; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive; Respiration Disorders; Respiratory Tract Diseases
• Other Study ID Numbers: 2021-A01126-35; 38RC21.149 (Other Identifier: Grenoble Alpes University Hospital)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No