- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT02940743
Behavioral Management of Phosphorus in Hemodialysis Patients
30 mai 2018 mis à jour par: NYU Langone Health
Behavioral Management of Phosphorus in Hemodialysis
The purpose of this randomized clinical trial is to evaluate alternative technology-supported behavioral approaches to engaging 42 maintenance hemodialysis (HD) patients with persistent hyperphosphatemia in phosphorus binder adherence and dietary phosphorus restriction.
Participants will be randomized to 1 of 3 intervention groups: (1) Education (Edu); (2) Edu + Self-Monitoring (SM); or (3) Edu + SM + Social Cognitive Theory (SCT)-based training program.
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Description détaillée
Investigators will evaluate the intervention in terms of feasibility and acceptability, behavior change at 12 and 24 weeks (reported phosphorus binder adherence, reported nutrient intakes, normalized protein catabolic rate), and clinical outcomes (serum phosphorus concentrations, symptoms).
In addition, the impact of the different behavioral approaches on self-efficacy at 12 and 24 weeks, and the mediating effects of self-efficacy in facilitating behavioral changes and clinical outcomes will be examined.
Type d'étude
Interventionnel
Inscription (Réel)
40
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
-
-
New York
-
New York, New York, États-Unis, 10016
- New York University School of Medicine
-
-
Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
19 ans à 89 ans (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- Receiving thrice-weekly hemodialysis treatment for at least 3 months
- 3-month average serum phosphorus concentration >5.5 mg/dL
Exclusion Criteria:
- Unable to participate meaningfully in the combined Edu + SM + SCT intervention, including:
- Unable to read and/or speak English
- Self-monitoring application is currently available in English only (patients will not be excluded from participation on the basis of race/ethnicity)
- Cognitively-impaired
- Physically-impaired
- Institutionalized or otherwise having limited control over diet
- Life expectancy of <1 year per dialysis center staff
- Women who are pregnant or become pregnant during the study
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
---|---|
Comparateur actif: Education (Edu)
|
This intervention will take place during weeks 1-4 at the dialysis center.
Each week, study staff will present participants with a brief educational video on: phosphorus binder adherence (week 1), meeting dietary protein needs (week 2), restricting dietary sources of phosphorus (week 3), and eliminating phosphorus-based food additives (week 4).
These videos will be loaded onto tablet (Personal Computers) PCs so that participants can easily view them during regular dialysis treatment.
|
Comparateur actif: Edu + Self-Monitoring (SM)
|
This intervention will take place during weeks 1-4 at the dialysis center.
Each week, study staff will present participants with a brief educational video on: phosphorus binder adherence (week 1), meeting dietary protein needs (week 2), restricting dietary sources of phosphorus (week 3), and eliminating phosphorus-based food additives (week 4).
These videos will be loaded onto tablet (Personal Computers) PCs so that participants can easily view them during regular dialysis treatment.
During the first 12 weeks of the intervention, a study dietitian will review the participants' records, and provide individualized feedback via a password-protected NYULMC email address.
Feedback will be provided twice per week during weeks 1-4, once per week during weeks 5-8, and once every two weeks during weeks 9-12.
The email messages will focus on both the importance of self-monitoring and the behavioral targets of the intervention.
Feedback will use standardized language rather than specific dietary examples to avoid providing individualized counseling to participants (which is not the purpose of the SM intervention).
|
Comparateur actif: Edu + SM + Social Cognitive Theory (SCT)
|
This intervention will take place during weeks 1-4 at the dialysis center.
Each week, study staff will present participants with a brief educational video on: phosphorus binder adherence (week 1), meeting dietary protein needs (week 2), restricting dietary sources of phosphorus (week 3), and eliminating phosphorus-based food additives (week 4).
These videos will be loaded onto tablet (Personal Computers) PCs so that participants can easily view them during regular dialysis treatment.
During the first 12 weeks of the intervention, a study dietitian will review the participants' records, and provide individualized feedback via a password-protected NYULMC email address.
Feedback will be provided twice per week during weeks 1-4, once per week during weeks 5-8, and once every two weeks during weeks 9-12.
The email messages will focus on both the importance of self-monitoring and the behavioral targets of the intervention.
Feedback will use standardized language rather than specific dietary examples to avoid providing individualized counseling to participants (which is not the purpose of the SM intervention).
This intervention will be delivered remotely online using the same tablet PCs provided for the SM intervention component of this treatment condition.
The behavioral training program will focus on building a sense of self-efficacy with emphasis on mastery experiences that will include emphasizing past successes; setting incremental, easily achievable goals; self-monitoring to stay on track; identifying modifiable barriers to healthy behavior; positive feedback in goal achievement; and developing participant expertise in both the regimen and in problem solving around barriers to adherence.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Proportion of Hemodialysis (HD) patients that are eligible for the study
Délai: 24 Weeks
|
Measure of feasibility
|
24 Weeks
|
Proportion of eligible patients who agree to participate
Délai: 24 Weeks
|
Measure of feasibility
|
24 Weeks
|
Proportion of enrolled participants who complete the study
Délai: 24 Weeks
|
Measure of Acceptability
|
24 Weeks
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
8-item Morisky Medication Adherence Survey (MMAS-8)
Délai: 24 Weeks
|
Used to measure Binder Adherence, has been shown to be a valid and reliable measure of antihypertensive medication adherence
|
24 Weeks
|
Reported dietary energy, protein and phosphorus intake
Délai: 2 Weeks
|
participants will be directed to complete three, non-consecutive food records over the two-week period.
Diet record days will include two weekdays (1 dialysis day and 1 non-dialysis day), and one non-dialysis weekend day.
|
2 Weeks
|
Normalized protein catabolic rate (nPCR)
Délai: 24 Weeks
|
The nPCR is an objective measure of protein intake in HD patients based on the accumulation of urea nitrogen in blood between dialysis treatments
|
24 Weeks
|
Serum phosphorus.
Délai: 24 Weeks
|
Pre-dialysis serum phosphorus concentrations are a key secondary clinical endpoint for this intervention.
Serum phosphorus is already being measured in participants as part of the routine monthly laboratory blood work, so this information will be obtained from the participant's medical charts.
|
24 Weeks
|
Frequency and severity of participant symptoms assessed via an investigator-developed questionnaire
Délai: 24 Weeks
|
(itching, bone and joint pain, cramping) and phosphorus binders (difficulty defecating, loose or watery stools) will be self-reported via an investigator-developed questionnaire.
|
24 Weeks
|
Balance Wise Self-Efficacy for Restricting Dietary Sodium in Hemodialysis Scale
Délai: 24 Weeks
|
be adapted to focus on adherence to phosphorus binders, dietary phosphorus restrictions and adequacy of protein intake.
The self-efficacy questionnaire asks participants' to report their confidence in the next month that they will be able to complete various tasked related to the study intervention.
An overall scale, and subscale scores for phosphorus binders, dietary phosphorus restriction and adequacy of protein intake will be computed by summing pertinent items for analyses.
|
24 Weeks
|
Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Chercheur principal: Mary Sevick, MD, New York University Medical School
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
23 avril 2018
Achèvement primaire (Réel)
1 mai 2018
Achèvement de l'étude (Réel)
1 mai 2018
Dates d'inscription aux études
Première soumission
17 octobre 2016
Première soumission répondant aux critères de contrôle qualité
19 octobre 2016
Première publication (Estimation)
21 octobre 2016
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
31 mai 2018
Dernière mise à jour soumise répondant aux critères de contrôle qualité
30 mai 2018
Dernière vérification
1 mai 2018
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 16-00817
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .
Essais cliniques sur Education (Edu)
-
Universidad San SebastiánUniversidad de Valparaiso; Fondo de Fomento al Desarrollo Científico y Tecnológico...RecrutementGain de poids gestationnel | Obésité maternelleChili
-
Groupe d'Etude Therapeutique des Affections Inflammatoires...ComplétéLa maladie de Crohn | Rectocolite hémorragiqueFrance
-
University of RochesterNational Institutes of Health (NIH)ComplétéMaladies rénales chroniquesÉtats-Unis
-
University of RochesterNational Institutes of Health (NIH)Pas encore de recrutement
-
University of CadizPas encore de recrutement
-
VA Office of Research and DevelopmentComplétéTrouble de stress post-traumatique | Lésion cérébrale traumatique légère, commotion cérébraleÉtats-Unis
-
Case Western Reserve UniversityNational Institute of Mental Health (NIMH)ComplétéTrouble bipolaire | Non-observance du traitementÉtats-Unis
-
Clear Guide MedicalUniversity of MiamiComplétéApprentissage des procédures d'anesthésieÉtats-Unis
-
Assistance Publique - Hôpitaux de ParisUniversity of Paris 5 - Rene DescartesComplétéCirrhose du foie, biliaireFrance
-
Oregon Research InstituteComplétéTrouble lié à l'utilisation de substances | DélinquanceÉtats-Unis