Does a Technology Enabled Multi-disciplinary Team-based Care Model for the Management of Long COVID and Other Fatiguing Illnesses Improve Clinical Care of Patients and Represent a Sustainable Approach Within a Federally Qualified Health Center? (LC&FIRP)

The Long COVID and Fatiguing Illness Recovery Program - A Pragmatic, Quality Improvement, Professional Cluster, Randomized Controlled Trial.

The primary objective of the present research is to determine the effectiveness of Family Health Center of San Diego's Long COVID and Fatiguing Illness Recovery Program (LC&FIRP) on clinician- and patient-level outcomes. LC&FIRP is comprised of a teleECHO program focused on multi-specialty case-consultation and peer-to-peer sharing of emerging best practices to support management of complex cases associated with Long COVID, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), and other post-infectious fatiguing illnesses (PIFI). Our secondary objective is to determine the feasibility, acceptability, and sustainability of LC&FIRP. Our findings should provide a fuller understanding of the potential impact of innovative technology enabled multi-disciplinary team-based care models in low-resource, community-based primary care settings.

Study Overview

• Status: Active, not recruiting
• Conditions: Chronic Fatigue Syndrome; SARS-CoV-2 Acute Respiratory Disease; Post COVID-19 Condition; Myalgic Encephalomyelitis; Post-acute Sequelae of SARS-COV-2 Infection
• Intervention / Treatment: Other: Extension for Community Healthcare Outcomes

Detailed Description

The primary objective of the present research is to determine the effectiveness of FHCSD's Long COVID and Fatiguing Illness Recovery Program (LC&FIRP) on clinician- and patient-level outcomes. LC&FIRP is comprised of a teleECHO program focused on multi-specialty case-consultation and peer-to-peer sharing of emerging best practices to support management of complex cases associated with Long COVID, ME/CFS, and other PIFI. Our secondary objective is to determine the feasibility, acceptability, and sustainability of LC&FIRP. Our findings should provide a fuller understanding of the potential impact of innovative technology enabled multi-disciplinary team-based care models in low-resource, community-based primary care settings. This study will provide much needed high-quality evidence on the effectiveness of a technology enabled multi-disciplinary team-based care model for the management of Long COVID, ME/CFS, and other PIFI within a community clinic setting, while simultaneously providing evidence regarding the feasibility, acceptability, and sustainability of the approach. Given that LC&FIRP includes a teleECHO program that is case-based, interactive, and occurs in real-time, it has a set of distinct advantages to the traditional practice of sequential in-person specialty referrals to address complex patient cases. The investigators hypothesize that clinician exposure to weekly teleECHO sessions with monthly interactive webinars and quarterly short courses will significantly improve clinician- and patient-level outcomes compared to clinician exposure to monthly interactive webinars and quarterly short courses alone.

The investigators will evaluate LC&FIRP using an effectiveness-implementation hybrid type 2 design. Specifically, the investigators will conduct a two-arm, single-blind, pragmatic, quality improvement, professional cluster, randomized controlled trial. The target for weekly teleECHO sessions, monthly interactive webinars, and quarterly short courses are licensed health care professionals. Therefore, the present research will include professional clusters that will consist of primary care physicians, physician assistants, and nurse practitioners at FHCSD caring for patients who have had persistent symptoms and a decline in health-related quality of life associated with Long COVID, ME/CFS, and/or other PIFI.

20 consenting clinicians across primary care clinics at FHCSD will be randomized at a ratio of 1:1 to either participate in 1) weekly teleECHO sessions with monthly interactive webinars and quarterly short courses or 2) monthly interactive webinars and quarterly short courses alone (a control group). All clinicians will have the option to receive continuing medical education credit for the educational sessions they engage in. Throughout participation, the investigators expect that the clinicians will provide care for approximately 856 FHCSD patients diagnosed with Long COVID, ME/CFS, or other PIFI (approximately 42 patients per clinician). The clinicians will be consented and will receive exposure to intervention components (i.e., a professional cluster). Therefore, patient outcomes derived from routine clinical care will be evaluated according to the study arm of their respective clinicians. Outcomes will be measured at 3-, 6-, 9-,12-, 18-, 24-, and 30-months post-baseline for clinicians and for patients at 3-, 6-, 9-, and 12-months post assignment to a participating clinician.

Inclusion criteria for clinicians includes 1) being employed by FHCSD for clinical care delivery, 2) being a licensed primary care physician, physician assistant, or nurse practitioner, 3) caring for patients who have had persistent symptoms and a decline in health-related quality of life associated with Long COVID, ME/CFS, and/or other PIFI, and 4) being willing and able to actively participate in LC&FIRP. There are no exclusion criteria. FHCSD medical leadership has verbally extended an invitation to the approximately 200 eligible clinicians at FHCSD to participate in LC&FIRP (a follow-up email will also be sent). Those who are interested will provide written informed consent, complete a baseline survey, and will be randomized to one of the two study arms. An electronic randomization list will be generated using the latest version of the statistical software platform R (version 3.3.2, http://www.r-project.org). The list will be securely integrated into the cloud-based Research Electronic Data Capture (REDCap) tool. Allocation will be concealed from all investigators and staff until the study group is assigned. Only the study manager and research assistants involved in the delivery of the intervention components will subsequently be made aware of allocation. It is not possible to mask participating clinicians, however, patients of participating clinicians will not have knowledge of their clinicians potential participation in weekly teleECHO sessions, monthly interactive webinars, and quarterly short courses. All staff that are involved in the collection of data and investigators that conduct analyses will remain blinded to allocation throughout the study.

Clinician participation in this study is voluntary. Participating clinicians may decide not to participate or may leave the study at any time. This decision will not result in any penalty or loss of benefits to which they are entitled. Information that has already been collected may still be used, but no new information will be collected. The withdrawal reason and the withdrawal date will be documented.

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • California
    • San Diego, California, United States, 92102
      • Family Health Centers of San Diego

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Inclusion criteria for clinicians includes 1) being employed by FHCSD for clinical care delivery, 2) being a licensed primary care physician, physician assistant, or nurse practitioner, 3) caring for patients who have had persistent symptoms and a decline in health-related quality of life associated with PASC, ME/CFS, and/or OPIFI, and 4) being willing and able to actively participate in LC&FIRP.

Exclusion Criteria:

• There are no exclusion criteria.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; The Control arm participates in monthly interactive webinars and quarterly short courses. Monthly interactive webinars will offer brief didactic presentations by SMEs, examples of models of care, and a facilitated Q&A. These webinars will be convened to rapidly disseminate findings and emerging best practices to a large-scale, national audience. Quarterly short courses will be developed to summarize key findings from past weekly teleECHO sessions. These quarterly short courses will be formatted as a learning module with the use of presentation slides and videos online that are accessible asynchronously.
Experimental: Intervention; The Intervention arm participates in weekly teleECHO sessions with monthly interactive webinars and quarterly short courses.	Other: Extension for Community Healthcare Outcomes; ECHO is a technology enabled multi-disciplinary team-based care model centered on case-consultation and peer-to-peer sharing of emerging best practices (i.e., teleECHO) to support management of complex cases associated with Long COVID, ME/CFS, and other PIFI.; Other Names: ECHO

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient-Reported Outcomes Measurement Information System (PROMIS)-29	Patient baseline and quarterly surveys	During 12 months of follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient symptom checklist with associated severity for those present	Patient baseline and quarterly surveys, None, Mild, Moderate, Severe	During 12 months of follow-up
If symptom is present, has patient experienced this in the past month	Patient baseline and quarterly surveys, Yes/No	During 12 months of follow-up
If symptom is present, how long has patient experienced this symptom	Patient baseline and quarterly surveys, Under 3 Months, 3 Months or longer	During 12 months of follow-up
If symptom is present during the past month, how bad was this symptom?	Patient baseline and quarterly surveys with use of Likert scale	During 12 months of follow-up
For symptoms present, do any of them get worse for at least 24 hours after engaging in activities (physical or mental) that patient was used to doing with no problems?	Patient baseline and quarterly surveys with Yes/No/Not Applicable/Don't Know	During 12 months of follow-up
If fatigue, tiredness, or exhaustion is present, doesn't patient describe it as feeling it come on all of a sudden, or slowly over time	Patient baseline and quarterly surveys with All of sudden, Slowly over time, Not applicable, Don't know	During 12 months of follow-up
If fatigue present, what month and year did the fatiguing illness begin?	Patient baseline and quarterly surveys, estimated month and year	During 12 months of follow-up
When fatigued, does rest make patient's fatigue better?	Patient baseline and quarterly surveys, Yes a lot, Yes a little, No not very much, Not applicable, Don't know	During 12 months of follow-up
When fatigued, has this fatigue substantially limited the patient's ability to occupational, educational, social, or personal activities?	Patient baseline and quarterly surveys, Yes, No, Not applicable, Don't know	During 12 months of follow-up
Patient's medical history check-list	Patient baseline survey, Yes, No, Unsure	Through study referral period, an average of 12 weeks
Patient's dietary restrictions	Patient baseline survey, No, Vegan, Vegetarian, Ketogenic, Gluten-free, Dairy-free, Intermittent fasting, Other	Through study referral period, an average of 12 weeks
Patient's food allergies or other food intolerances	Patient baseline survey, Yes/No	Through study referral period, an average of 12 weeks
Has patient's employment been impacted due to contracting COVID-19?	Patient baseline survey, Yes, No	Through study referral period, an average of 12 weeks
Patient's frequency to complete 150-minutes per week of moderate-intensity physical activity (like a brisk walk, slow biking, gardening, or ballroom dancing) prior to contracting COVID-19	Patient baseline survey, Every week, Most weeks, Some weeks, Very few weeks, Never, I do not know	Through study referral period, an average of 12 weeks
Patient's frequency to complete 150-minutes per week of vigorous-intensity physical activity (like running, swimming laps, competitive sports, or fast bicycling) prior to contracting COVID-19	Patient baseline survey, Every week, Most weeks, Some weeks, Very few weeks, Never, I do not know	Through study referral period, an average of 12 weeks
Did patient receive a COVID-19 PCR (nasal swab) test	Patient baseline survey, Yes/No	Through study referral period, an average of 12 weeks
Did patient receive a COVID-19 antibody test	Patient baseline survey, Yes/No	Through study referral period, an average of 12 weeks
Patient symptom onset	Patient baseline survey, Date	Through study referral period, an average of 12 weeks
Patient reported medications used for COVID-19 symptoms	Patient baseline survey, free text	Through study referral period, an average of 12 weeks
Patient reported prescribed supplementary oxygen support	Patient baseline survey, Yes/No	Through study referral period, an average of 12 weeks
Patient reported admittance to hospital due to COVID-19	Patient baseline and quarterly surveys, Yes/No	During 12 months of follow-up
Do any of the following activities exacerbate patients symptoms: Physical exertion, Diet Changes, Big Meal, Dehydration, Weather changes (hot and humid), Tight clothing, Stress or anxiety, Pre Menstrual period, Menstrual period, Alcohol consumption	Patient baseline and quarterly surveys, Yes/No	During 12 months of follow-up
Does patient feel fully recovered from COVID-19	Patient quarterly surveys, Yes/No	During 9 months of follow-up
Currently minutes per week of moderate-intensity physical activity patient does (like a brisk walk, slow biking, gardening, or ballroom dancing)	Patient quarterly surveys, free text	During 9 months of follow-up
Currently minutes per week of vigorous-intensity physical activity patient does (like running, swimming laps, competitive sports, or fast bicycling)	Patient quarterly surveys, free text	During 9 months of follow-up
Patient Health Questionnaire (PHQ)-2	Patient baseline and quarterly surveys	During 12 months of follow-up
Patient Health Questionnaire (PHQ)-9 (if applicable)	Patient baseline and quarterly surveys	During 12 months of follow-up
PROMIS Dyspnea Functional Limitations and Severity Short Forms	Patient baseline and quarterly surveys	During 12 months of follow-up
PROMIS Applied Cognition Abilities and General Concerns Short Forms	Patient baseline and quarterly surveys	During 12 months of follow-up
Generalized Anxiety Disorder (GAD)-7	Patient baseline and quarterly surveys	During 12 months of follow-up
2-minute step test	Physical Therapy assessment with patient	During 12 months of follow-up
30 sec sit to stand test	Physical Therapy assessment with patient	During 12 months of follow-up
Grip strength	Physical Therapy assessment with patient	During 12 months of follow-up
Functional Gait Assessment	Physical Therapy assessment with patient	During 12 months of follow-up
Balance tasks	Physical Therapy assessment with patient	During 12 months of follow-up
Post-exertional malaise follow-up	Follow-up Physical Therapy appointment with patient, Not at all, A little bit, Somewhat, Quite a bit, Very much	Per Physical Therapy encounter after PT assessment
If symptom is present, did patient have this symptom before the patient tested positive for COVID-19?	Patient baseline and quarterly surveys, Yes/No	During 12 months of follow-up
If symptom is present, during the past month how often have the patient had this symptom?	Patient baseline and quarterly surveys with use of Likert scale	During 12 months of follow-up

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinician overall best part of series	Interview	Up to 8 weeks after end of study
Clinician overall worst part of series	Interview	Up to 8 weeks after end of study
Clinician challenges in participating	Interview	Up to 8 weeks after end of study
Perceived change in the relationship between clinicians and specialists in panel as a result of this series?	Interview, Yes/No with free response	Up to 8 weeks after end of study
Clinician barriers to sustained participation in series	Interview	Up to 8 weeks after end of study
Did clinician experience an improvement in the number of PASC patients they could manage at any given time as a result of the series?	Interview, Yes/No with free response	Up to 8 weeks after end of study
Did clinicians experience an increase in PASC patients in their panel composition over time as a result of participation in the series?	Interview, Yes/No with free response	Up to 8 weeks after end of study
Did clinic directors observe an increase in PASC patients in the clinicians panel composition over time as a result of their participation in the series?	Interview, Yes/No with free response	Up to 8 weeks after end of study
Did clinicians experience an improvement in the quality of care for patients as a result of participating in the series?	Interview, Yes/No with free response	Up to 8 weeks after end of study
Did clinic directors observe an improvement in the quality of care for patients as a result of a clinician participating in the series?	Interview, Yes/No with free response	Up to 8 weeks after end of study
Did clinicians participating influence other providers in their clinic?	Interview, Yes/No with free response	Up to 8 weeks after end of study
Did clinic directors observe clinicians who participated in the series influence other providers within the clinic?	Interview, Yes/No with free response	Up to 8 weeks after end of study
Clinician benefits gained from participating in the series	Interview, free response	Up to 8 weeks after end of study
Clinician recommendations for improving the scalability or sustainability of this model	Interview, free response	Up to 8 weeks after end of study
Clinic directors recommendations for improving the scalability or sustainability of this model	Interview, free response	Up to 8 weeks after end of study
Clinician satisfaction with series	Interview with Likert satisfaction	Up to 8 weeks after end of study
Knowledge improvement of appropriate PASC diagnosis as a result of participation in randomized arm (teleECHO or monthly webinar)	Clinician quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Knowledge improvement of effective PASC care and treatment as a result of participation in randomized arm (teleECHO or monthly webinar)	Clinician quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Knowledge improvement of approaches for complex cases of PASC as a result of participation in randomized arm (teleECHO or monthly webinar)	Clinician quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities related to identify tools and methods for PASC care	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities to diagnose patients with PASC	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities to screen for co-morbidities of PASC	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities to generate a patient-specific treatment plan for patients with PASC	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities related to to implement a patient-specific treatment plan for patients with PASC	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities to select appropriate special or diagnostic tests for PASC patients	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities to interpret special or diagnostic test results for my PASC patients	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities to provide appropriate patient education about their PASC condition	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities to educate clinic staff about PASC care	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities to address PASC patients using a multidisciplinary approach	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities to assess and manage concerns that PASC patients face	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities to assess severity of disease in patients with PASC	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Self-efficacy in abilities to deal with complex cases of PASC	Clinician baseline and quarterly follow-up survey with use of Likert scale agreement	During 37 months of follow-up
Utility of an encountered case presented during randomized arm (teleECHO or monthly webinar)	Clinician quarterly follow-up survey Yes/No	During 34 months of follow-up
Overall satisfaction with randomized arm (teleECHO or monthly webinar)	Clinician quarterly follow-up survey with use of Likert scale agreement	During 34 months of follow-up
Satisfaction to recommend to colleague randomized arm (teleECHO or monthly webinar)	Clinician quarterly follow-up survey with use of Likert scale likelihood	During 34 months of follow-up
Satisfaction to participate in future randomized arm (teleECHO or monthly webinar) again	Clinician quarterly follow-up survey with use of Likert scale likelihood	During 34 months of follow-up
Changes to practice in helping colleague with information learned from randomized arm (teleECHO or monthly webinar)	Clinician quarterly follow-up survey Yes/No	During 34 months of follow-up
Changes to practice by participating in randomized arm (teleECHO or monthly webinar) to understand further monitoring and follow-up plan	Clinician quarterly follow-up survey with use of Likert scale agreement	During 34 months of follow-up
Changes to practice by participating in randomized arm (teleECHO or monthly webinar) to develop more appropriate treatment plans	Clinician quarterly follow-up survey with use of Likert scale agreement	During 34 months of follow-up
Changes to practice by participating in randomized arm (teleECHO or monthly webinar) to have a better understanding of underlying disease process and the role of specialist referral	Clinician quarterly follow-up survey with use of Likert scale agreement	During 34 months of follow-up
Changes to practice by participating in randomized arm (teleECHO or monthly webinar) to more independently manage my PASC patients without referral to a specialist	Clinician quarterly follow-up survey with use of Likert scale agreement	During 34 months of follow-up
Changes to practice by participating in randomized arm (teleECHO or monthly webinar) to apply specialist recommendations to patient care.	Clinician quarterly follow-up survey with use of Likert scale agreement and free text	During 34 months of follow-up
Unable to apply learnings from randomized arm (teleECHO or monthly webinar)	Clinician quarterly follow-up survey with use of Likert scale agreement and free text	During 34 months of follow-up
Other changes to practice by participating in randomized arm (teleECHO or monthly webinar)	Clinician quarterly follow-up survey with free text	During 34 months of follow-up
Knowledge gained about topic presented during teleECHO before and after	Clinician intervention teleECHO survey	During 37 months after each weekly ECHO session
Knowledge gained about topic presented during teleECHO before and after	Clinician intervention teleECHO survey with use of Likert scale knowledge	Through study completion, an average of 37 months
Satisfaction with stated objectives being met	Clinician intervention teleECHO survey with use of Likert scale quality	Through study completion, an average of 37 months
Satisfaction with session delivering balanced and objective, evidence-based content	Clinician intervention teleECHO survey with use of Likert scale quality	Through study completion, an average of 37 months
Satisfaction with pace of session	Clinician intervention teleECHO survey with use of Likert scale quality	Through study completion, an average of 37 months
Satisfaction with opportunities to ask questions	Clinician intervention teleECHO survey with use of Likert scale quality	Through study completion, an average of 37 months
Satisfaction with organization of the presenters' presentations	Clinician intervention teleECHO survey with use of Likert scale quality	Through study completion, an average of 37 months
Satisfaction with presenters' ability to clearly communicate	Clinician intervention teleECHO survey with use of Likert scale quality	Through study completion, an average of 37 months
Desired content for future sessions	Clinician intervention teleECHO survey, free text	Through study completion, an average of 37 months
Satisfaction with source evidence presented	Clinician intervention teleECHO survey Yes/No	Through study completion, an average of 37 months
Satisfaction with commercial bias present	Clinician intervention teleECHO survey Yes/No and free text	Through study completion, an average of 37 months
Recommendations for program improvement	Clinician intervention teleECHO survey free text	Through study completion, an average of 37 months
Relevance of session to clinicians current work	Clinician intervention teleECHO survey with use of Likert scale relevance	Through study completion, an average of 37 months
Intent to change practice based on learnings from session	Clinician intervention teleECHO survey Yes/No and free text	Through study completion, an average of 37 months
Best part of session	Clinician intervention teleECHO survey free text	Through study completion, an average of 37 months
Worst part of session	Clinician intervention teleECHO survey free text	Through study completion, an average of 37 months
Recommend this session to a colleague	Clinician intervention teleECHO survey with use of Likert scale likelihood	Through study completion, an average of 37 months
Changes to practice planned	Clinician intervention teleECHO survey free text	Through study completion, an average of 37 months
If no changes to practice are planned, barriers	Clinician intervention teleECHO survey free text	Through study completion, an average of 37 months
Participating clinician retention	Mean number of months clinicians participate in the trial (intervention and control groups)	Semi-annually during 37 months of follow-up
Participating clinic settings	Number of clinic settings in which providers see patients (intervention and control groups)	Semi-annually during 37 months of follow-up
Participation in intervention	Number of weekly sessions each RCT (intervention) provider attends, and mean number	Weekly during 37 months of follow-up
Exposure of weekly teleECHO topics	Number of topics covered in Weekly ECHO sessions RCT (intervention) provider attends	Weekly during 37 months of follow-up
Monthly webinar attendance	Number of monthly webinars RCT providers attends	Monthly during 37 months of follow-up
Quarterly short course attendance	Number of quarterly short courses RCT providers attends	Quarterly during 37 months of follow-up
Exposure of monthly webinar topics	Number of topics covered in monthly webinars provider attends	Monthly during 37 months of follow-up
Exposure of quarterly short course topics	Number of topics covered in quarterly short courses provider attends	Quarterly during 37 months of follow-up
Participation in case consultation	Number of patient cases presented by RCT (intervention) provider	Quarterly during 37 months of follow-up
Participation in post-session survey	Proportion of participants that complete each session poll (disaggregated by monthly webinar, weekly session, RCT vs. non-RCT provider)	Weekly during 37 months of follow-up
Volume of total patient case load	Number of patients seen by RCT provider, and mean number (intervention and control)	Monthly during 37 months of follow-up
Volume of PASC patient case load	Number of PASC patients seen by RCT provider, and mean number (intervention and control)	Monthly during 37 months of follow-up
Volume of patient referrals to specialists	Number of referrals to specialists by RCT provider, and mean number (intervention and control)	Monthly during 37 months of follow-up
Application of specialist recommendations	Number of specialist recommendations applied by RCT (intervention) providers from weekly ECHO sessions	Quarterly during 37 months of follow-up
Average consultation duration	Mean duration of consultation for PASC patients by RCT providers, intervention and control	Monthly during 37 months of follow-up
Volume of specialists seen by patients	Number of specialists seen by patient	Monthly during 37 months of follow-up
Specialty types patient was exposed to	Number of specialty types the patient was exposed to	Monthly during 37 months of follow-up
Clinician session drop-off	How long an (intervention) provider attended an ECHO session	Weekly during 37 months of follow-up
Quarterly attendance	Number of individuals who attended and watched short course	Quarterly during 37 months of follow-up

Collaborators and Investigators

• Sponsor: Family Health Centers of San Diego
• Investigators: Principal Investigator: Christian Ramers, MD, Family Health Centers of San Diego; Principal Investigator: Job Godino, PhD, Family Health Centers of San Diego

Study record dates

Study Major Dates

• Study Start (Actual): November 30, 2021
• Primary Completion (Estimated): October 31, 2024
• Study Completion (Estimated): October 31, 2024

Study Registration Dates

• First Submitted: December 17, 2021
• First Submitted That Met QC Criteria: December 20, 2021
• First Posted (Actual): December 22, 2021

Study Record Updates

• Last Update Posted (Actual): November 7, 2023
• Last Update Submitted That Met QC Criteria: November 3, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: CFS; Long COVID; ME; PASC; PCC
• Additional Relevant MeSH Terms: Pathologic Processes; Central Nervous System Diseases; Nervous System Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Pneumonia, Viral; Pneumonia; Lung Diseases; Disease Attributes; Musculoskeletal Diseases; Muscular Diseases; Neuromuscular Diseases; Central Nervous System Infections; Chronic Disease; Neuroinflammatory Diseases; Post-Infectious Disorders; COVID-19; Fatigue Syndrome, Chronic; Respiration Disorders; Respiratory Tract Diseases; Encephalomyelitis; Post-Acute COVID-19 Syndrome
• Other Study ID Numbers: HS-2021-0241

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