Improving Medication Adherence in Pediatric Inflammatory Bowel Disease (TEAM)
24 de enero de 2020 actualizado por: Children's Hospital Medical Center, Cincinnati
Telehealth Enhancement of Adherence to Medication in Pediatric Inflammatory Bowel Disease
The purpose of the study is to test an online behavioral intervention to improve medication adherence in children diagnosed with Inflammatory Bowel Disease.
Interested families will be monitored for four weeks to determine how frequently their child's IBD medication is taken.
Patient's taking less than 90% of medications will be randomized to one of two intervention conditions to complete intervention sessions online.
The study consists of 4 online intervention sessions with topics differing by condition and 5 online assessments to complete quality of life questionnaires over a 14 month time frame.
Descripción general del estudio
Estado
Terminado
Condiciones
Intervención / Tratamiento
Descripción detallada
The purpose of the study is to test the efficacy of a telehealth behavioral treatment (TBT) protocol to improve medication adherence in children and adolescents with IBD via a randomized controlled clinical trial.
Participants in the TBT condition will be compared to those in an education only (EO) condition.
In order to examine clinical significance of the intervention, treatment outcomes will include disease severity, HRQOL, and health care utilization.
This randomized controlled clinical trial for nonadherence to medication randomizes participants to either the TBT or EO intervention condition, with assessments occurring at baseline, post-treatment, and 3-, 6-, and 12-month follow-up.
Both conditions will participate in a self-guided educational intervention during week 6 of enrollment, with three intervention sessions at weeks 8, 10, and 12.
A 4-week run-in phase immediately preceding randomization is utilized to establish participants' baseline adherence.
Assessments will occur at week 5 (Baseline Assessment 1), week 14 (Post-treatment Assessment 2), and 3-, 6-, and 12-month post-treatment follow-up (Assessments 3, 4, and 5).
Intervention topics will differ for each condition; however, the frequency of contact is equivalent across conditions.
Tipo de estudio
Intervencionista
Inscripción (Actual)
140
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
-
-
California
-
San Francisco, California, Estados Unidos, 94143
- University of California San Francisco Benioff Children's Hospital
-
-
Connecticut
-
Hartford, Connecticut, Estados Unidos, 06106
- Connecticut Children's Medical Center
-
-
Missouri
-
Kansas City, Missouri, Estados Unidos, 64108
- Children's Mercy Hospitals and Clinics
-
-
Ohio
-
Cincinnati, Ohio, Estados Unidos, 45229
- Cincinnati Children's Hospital Medical Center
-
Cincinnati, Ohio, Estados Unidos, 45221
- University of Cincinnati
-
Columbus, Ohio, Estados Unidos, 43205
- Nationwide Children's Hospital
-
-
Oklahoma
-
Stillwater, Oklahoma, Estados Unidos, 74074
- Oklahoma State University
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, Estados Unidos, 19104
- Children's Hospital of Philadelphia
-
Pittsburgh, Pennsylvania, Estados Unidos, 15224
- Childrens Hospital Of Pittsburgh Of Upmc
-
-
Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
11 años a 18 años (Niño, Adulto)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- Patient is currently seen for care at one of the collaborating research sites: Cincinnati Children's Hospital Medical Center, Connecticut Children's Medical Center, Children's Hospital of Philadelphia, Nationwide Children's Hospital, University of California San Francisco Benioff Children's Hospital, or Children's Mercy Hospitals and Clinics
- Patient diagnosed with Crohn's disease, ulcerative colitis, or indeterminate colitis
- Patient age between 11-18 years
- Patient currently living at home
- Patient currently prescribed at least one daily oral immunomodulator (e.g., 6-MP/azathioprine) and/or 5-ASA (e.g., mesalamine)in pill form
- English fluency for patient and parents
- Inclusion for Randomization: <90% adherence to immunomodulator and/or 5-ASA during four week run-in phase
Exclusion Criteria:
- Diagnosis of pervasive developmental disorder in patient or parent
- Diagnosis of serious mental illness (e.g., schizophrenia) in patient or parent
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Experimental: Telehealth Behavioral Treatment
|
Families in the TBT condition will receive three individually-tailored behavioral intervention sessions in addition to the online education intervention with 1) guided problem-solving and behavior management training tailored to the unique needs and/or barriers of the family, and 2) discussion of the patient's adherence since the previous session.
In addition, patients in the TBT condition will be signed up for text message reminder service offered free of charge via www.mymedschedule.com.
These are generic reminder text messages are used to assist with adherence in adolescents.
Intervention sessions will be conducted via telehealth delivery with trained postdoctoral psychology fellows or masters-level graduates using webcams, supplied by the study, and SkypeTM free software.
|
|
Comparador activo: Education Only
|
Families in the EO condition will receive three individual sessions in addition to the online education intervention to review 1) online educational intervention material to answer questions participants have, 2) educational brochures from the Crohn's and Colitis Foundation of America (CCFA), which contain additional information (e.g., Guide for Parents, Living with IBD, Guide for Kids and Teenagers), and 3) general healthy lifestyle recommendations (e.g., sleep, exercise, etc.).
Sessions will be conducted via telehealth delivery with trained postdoctoral clinical psychology fellows or masters-level graduates using webcams, supplied by the study, and SkypeTM free software.
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Medication adherence
Periodo de tiempo: 15 months
|
Medication adherence will be measured using electronic monitoring.
The specific device is the MEMS TrackCap.
Immunomodulators and/or mesalamine medications will be assessed.
|
15 months
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Health-related quality of life
Periodo de tiempo: 15 months
|
The IMPACT III measure will be used for this assessment.
This is an IBD-specific HRQOL assessment tool.
|
15 months
|
|
Disease Severity
Periodo de tiempo: 15 months
|
The Pediatric Crohn's Disease Activity Index (PCDAI) and Partial Harvey-Bradshaw Index (PHBI) will be used to assess disease severity in patients with Crohn's disease.
The Pediatric Ulcerative Colitis Index (PUCAI) will be used in patients with ulcerative colitis.
|
15 months
|
|
Health care utilization
Periodo de tiempo: 15 months
|
Health care utilization will be assessed via medical chart review and all IBD-related hospital admissions, procedures, communications, clinic appointments, and other encounters with the health care system will serve as indicators of utilization.
|
15 months
|
Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Investigadores
- Investigador principal: Kevin Hommel, Ph.D., Children's Hospital Medical Center, Cincinnati
- Silla de estudio: Robert Baldassano, M.D., Children's Hospital of Philadelphia
- Silla de estudio: Wallace Crandall, M.D., Nationwide Children's Hospital
- Silla de estudio: Francisco Sylvester, M.D., Connecticut Children's Medical Center
- Silla de estudio: Lee Denson, M.D., Children's Hospital Medical Center, Cincinnati
- Silla de estudio: Michele Maddux, Ph.D., Children's Mercy Hospital Kansas City
- Silla de estudio: Melvin Heyman, M.D., University of California San Francisco Benioff Children's Hospital
- Silla de estudio: David Keljo, M.D., University of Pittsburgh
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio
1 de febrero de 2012
Finalización primaria (Actual)
31 de mayo de 2016
Finalización del estudio (Actual)
31 de mayo de 2016
Fechas de registro del estudio
Enviado por primera vez
16 de febrero de 2012
Primero enviado que cumplió con los criterios de control de calidad
21 de febrero de 2012
Publicado por primera vez (Estimar)
22 de febrero de 2012
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
28 de enero de 2020
Última actualización enviada que cumplió con los criterios de control de calidad
24 de enero de 2020
Última verificación
1 de enero de 2020
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- R01HD067174 (Subvención/contrato del NIH de EE. UU.)
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .