- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06077994
Enhanced Pulmonary Rehabilitation With Digital Remote Home Monitoring
The Enhanced Pulmonary Rehabilitation Program With Digital Remote Patient Monitoring: A Feasibility Randomized Clinical Trial
Study Overview
Status
Conditions
Detailed Description
Background Chronic obstructive pulmonary disease (COPD) represents a major challenge to health and well-being, necessitating the development of effective management strategies. Pulmonary rehabilitation (PR) has emerged as a crucial approach. However, due to the complexity of COPD and the presence of comorbidities, there is a need for an advanced PR program that can address the diverse needs of patients, including better self-management. In response to this challenge, clinicians and researchers at the G.F. MacDonald Centre for Lung Health have created BEPR+. This program addresses the needs of comorbid COPD patients via a more comprehensive comorbidities assessment, collaborative goal setting process to adopt healthier lifestyle behaviors (with a strong emphasize in physical activity), and a protocolized referral process to facilitate a more comprehensive care approach.
A proposed solution to address better patient self-management following PR involves integrating digital remote patient monitoring (dRPM) into BEPR+ (dRPM+), effectively bridging the gap between self-care and healthcare. The dRPM system will collect and transmit patient-generated data to healthcare providers, enabling timely detection of exacerbations and ultimately reducing hospitalizations. Participants will be educated on monitoring trends in their daily vital signs, allowing early identification of abnormalities that may correlate with changes in symptoms and general health status.
Primary Objective: To assess the feasibility and acceptability of the dRPM+ intervention in individuals undergoing PR. More specifically, the primary objectives are as follows:
- To assess adherence to and completion of the intervention (i.e., do participants complete the PR classes and take daily physiological readings as prescribed?).
- To assess recruitment and retention rates.
- To assess the acceptability of the intervention to individuals undergoing PR.
- To assess the impact on staff workflow and program resources.
Secondary Objectives: To estimate the impact of the program on self-management, self-efficacy, and standard PR outcomes (i.e., functional capacity, health status, general quality of life, psychosocial health, and physical activity) by generating preliminary estimates of the mean difference between groups over time for each outcome measure.
Study design: A randomized parallel-controlled trial will be implemented at the G.F. MacDonald Centre for Lung Health where entire PR classes I(i.e., delivered Tuesday/Thursday or Monday/Wednesday/Friday) will be block randomized according to a random numbers table to receive the intervention (dRPM+) or the control (BEPR+). Both groups will complete survey and questionnaire data at baseline, post-program, and 12-week follow-up using a REDcap database.
Study design A randomized parallel-controlled trial will be implemented at the G.F. MacDonald Centre for Lung Health. Entire PR classes I(i.e., delivered Tuesday/Thursday for 8 weeks or Monday/Wednesday/Friday for 6 weeks.) will be block randomized according to a random numbers table to receive dRPM+ or BEPR+. In addition to the BEPR+ program, both groups will complete survey and questionnaire data at baseline, specific points throughout the program, post-program, and 12-week follow-up using a REDcap database.
Data Analysis: Data will be presented descriptively and encompass all key relevant summary statistics (such as mean, median, standard deviation, and range). These data will cover various aspects, including participant characteristics, the primary feasibility outcome (dRPM data collection rate), study recruitment and retention, program attendance, patient satisfaction, staff time, questionnaire completion rate and time required. Regression analyses will explore changes in the secondary outcomes while controlling for the effects of potential covariates, including age, sex, disease severity, comorbidities and physical activity.
Data Handling and Record Keeping: Data will be stored in a central Redcap database. Patients will all have a unique study code number, the unique identifier in the Redcap database. A comparison of participants who consented, those who declined to join the trial, and those who completed or dropped out of the program will be conducted using student t-tests. The occurrence of adverse events, relevant staffing time, and resource details will be reported as counts along with qualitative descriptions.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Michael K Stickland, PhD
- Phone Number: 780-492-3995
- Email: michael.stickland@ualberta.ca
Study Contact Backup
- Name: Evelyn M Etruw, MPT, MClSc
- Phone Number: 780-342-8981
- Email: etruw@ualberta.ca
Study Locations
-
-
Alberta
-
Edmonton, Alberta, Canada, T5K 0L5
- Recruiting
- G. F. MacDonald Centre for Lung Health
-
Principal Investigator:
- Michael K Stickland, PhD
-
Contact:
- Evelyn M Etruw, MPT, MClsc
- Phone Number: 780-342-8163
- Email: etruw@ualberta.ca
-
Contact:
- Michael K Stickland, PhD
- Phone Number: 780-342-8981
- Email: michael.stickland@ualberta.ca
-
Sub-Investigator:
- Evelyn M Etruw, MPT, MClSc
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- patients must be enrolled into pulmonary rehabilitation at the G.F. MacDonald Centre for Lung Health with a diagnosis of chronic lung disease (COPD confirmed by post-bronchodilator forced expiratory volume in 1 second by forced vital capacity (FEV1/FVC) ratio of less than 0.7).
Patients must be able to read and communicate in English and willing and able to use digital devices.
Exclusion Criteria:
- Patients with cognitive impairments who are unable to accurately complete questionnaires will also be excluded.
- As part of standard rehabilitation referral procedures, all patients must be ambulatory and not have unstable cardiovascular disease.
Study Plan
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: Enhanced Breathe Easy Pulmonary Rehabilitation Program (BEPR+)
6 or 8 weeks BEPR+ program
|
Patients will attend the BEPR+ program 3 days per week for 6 weeks or 2 days per week for 8 weeks (total of 16 sessions).
Patients will receive 90 minutes of personalized and supervised exercise training (aerobic and resistance) and 60 minutes of education designed to promote self-management.
Patients will also received one-on-one sessions with a therapist to review their medical action plan for exacerbation management, program and lifestyle goals (including physical activity), determine referral needs for other health services (i.e.
smoking cessation, weight management, and psychological support).
Patients will use an activity monitor for feedback and motivation for physical activity.
|
Experimental: digital Remote Patient Monitoring + BEPR+ (dRPM+)
6 or 8 weeks BEPR+; daily vitals readings (blood pressure, heart rate, oximetry, body temperature, and body weight) and an additional 12 weeks of dRPM reading once the BEPR+ program concludes
|
In addition to the BEPR+ program as described, patients will use the Cloud Dx Connect Health System to take daily physiological readings (Blood pressure, heart rate, oximetry, body temperature and body weight).
These data will be transmitted to a secured server supported by the provincial health care system.
Participants and therapists will interact with these data in their respective dashboards and in conjunction with participants' determined medical action plan, engage in or make changes to participants current self-management regimens.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility of recruitment and participant retention
Time Frame: 18 months
|
A measure of the recruitment and retention of study participants
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18 months
|
Adherence
Time Frame: 18 months
|
adherence to vital sign monitoring during the 6 or 8 week pulmonary rehabilitation trial and the 12 week follow-up period.
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18 months
|
Acceptability
Time Frame: 18 months
|
Using a fit for purpose questionnaire to evaluate participant acceptance of the remote patient monitoring system.
|
18 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Staffing time and resources
Time Frame: 18 months
|
An assessment of the time requirement to monitor and respond to remote patient monitoring notifications
|
18 months
|
Self-efficacy for managing chronic disease-6 items
Time Frame: Baseline, post-program, and 12-week follow-up
|
A generic 6-item tool used to measure of patient's confidence in self-managing their chronic health condition(s).
Patients are score each item from 0-10,and the average is reported as the score.
Higher scores indicate higher self-efficacy.
|
Baseline, post-program, and 12-week follow-up
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Partners in Health Self-Management tool
Time Frame: Baseline, post-program, and 12-week follow-up
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A generic self-reported questionnaire used to assess the self-management knowledge and behaviors or people with chronic diseases.
Higher scores indicate better self management knowledge and behaviors.
|
Baseline, post-program, and 12-week follow-up
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Self-efficacy for exercise and physical activity
Time Frame: Baseline, post-program, and 12-week follow-up
|
A nine item self-reported scale describing different situations (weather, boredom, pain, exercising alone, not pleasurable, too busy, feel tired, stress, depressed) that might effect participation in exercise.
The scale asks patients to report their confidence to exercise (from 0- not confident to 10-very confident) 3 times a week for 20 minutes each time despite the above situations.
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Baseline, post-program, and 12-week follow-up
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Physical activity levels
Time Frame: Baseline, post-program, and 12-week follow-up
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Using the Fitbit Versa 4 and measuring step count, active minutes, and sleep
|
Baseline, post-program, and 12-week follow-up
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Functional exercise capacity assessed by the 6-minute walk test
Time Frame: Baseline, post-program, and 12-week follow-up
|
A self-paced standardized walking test with the primary outcome of 6-minute walk distance as proxy for patients' exercise capacity
|
Baseline, post-program, and 12-week follow-up
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Health status as assessed by the COPD Assessment Tool
Time Frame: Baseline, post-program, and 12-week follow-up
|
A unidimensional 8-items questionnaire to evaluate the impact of symptoms on patients' health status.
Higher scores indicate higher degree of symptoms and a poorer health status.
|
Baseline, post-program, and 12-week follow-up
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General health related quality of life as assessed by the EuroQol 5 dimensions 5 level (EQ5D5L) questionnaire.
Time Frame: Baseline, post-program, and 12-week follow-up
|
A unidimensional tool that assessed the impact of disease on 5 areas of general health
|
Baseline, post-program, and 12-week follow-up
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Michael K Stickland, PhD, University of Alberta
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
- Pro00066560-2
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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