Remote Intervention Versus Routine Monitoring in COPD Patients With Chronic Hypercapnia Receiving Home Non-invasive Respiratory Support
A Randomized Controlled Trial of Remote Intervention Versus Routine Monitoring in COPD Patients With Chronic Hypercapnia Receiving Home Non-invasive Respiratory Support
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality worldwide. A subset of patients with severe COPD develops chronic hypercapnic respiratory failure, often requiring long-term home non-invasive ventilation (NIV). While NIV can improve gas exchange, optimal management strategies, particularly post-hospitalization, are still being investigated.
This study aims to determine if a proactive, remote management strategy can improve patient outcomes compared to standard care with passive monitoring.
Experimental Group (Remote Intervention): Participants will receive home NIV with remote monitoring. A respiratory therapist will actively review ventilation data, assess oxygenation, and perform remote parameter adjustments and individualized optimization based on pre-set conditions and risk predictions.
Control Group (Monitoring Control): Participants will receive home NIV with remote monitoring. However, the study team will not perform active interventions based on the monitoring data. Patients will continue with their usual care and follow-up with their primary physician. The study team will only make contact in case of a severe safety risk.
The study will enroll 236 participants who will be randomized 1:1 to one of the two groups. The primary outcomes are the change in health-related quality of life and the number of COPD exacerbations over 12 months.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Huiqing Ge, MD, PhD
- Numero di telefono: +86 13588706787
- Email: gehq@zju.edu.cn
Luoghi di studio
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Henan
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Zhengzhou, Henan, Cina
- Henan Provincial People's Hospital
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Contatto:
- Qiang Kui, MD
- Numero di telefono: +86 13460317523
- Email: syhxzzggyx@163.com
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Hunan
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Changsha, Hunan, Cina, 410006
- The Second Xiangya Hospital of Central South University
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Contatto:
- Liucun Li
- Numero di telefono: +86 0731-852959999
- Email: xyeyyibd@sina.com
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Zhejiang
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Hangzhou, Zhejiang, Cina, 310016
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University
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Contatto:
- Huiqing Ge
- Numero di telefono: +86 13588706787
- Email: gehq@zju.edu.cn
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Wenling, Zhejiang, Cina, 317523
- Taizhou Hospital of Integrated Traditional Chinese and Western Medicine
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Contatto:
- Ting Jiang
- Numero di telefono: +86 13758692956
- Email: 13758692956@139.com
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Meets the diagnostic criteria for Chronic Obstructive Pulmonary Disease (COPD) with confirmed persistent airflow limitation by spirometry.
- Hospitalized due to an acute exacerbation of COPD.
- Stable daytime arterial blood gas analysis showing PaCO₂ ≥ 50 mmHg, with hypoxemia.
- Already receiving or planned to receive long-term home non-invasive respiratory support.
- Capable of using a smartphone or tablet for video communication and has internet access.
- Willing to participate and provides written informed consent.
Exclusion Criteria:
- Concurrent severe pulmonary diseases (e.g., active tuberculosis, diffuse pulmonary fibrosis, advanced lung cancer).
- Chronic respiratory failure primarily caused by non-COPD conditions (e.g., neuromuscular disease, chest wall deformity, or severe obesity hypoventilation syndrome).
- Severe cognitive impairment or psychiatric illness that would prevent cooperation with remote management.
- Other severe systemic diseases with an expected survival of less than 1 year (e.g., advanced malignancy).
- Pregnant or lactating women.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Nessuno (etichetta aperta)
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: Remote Intervention Group
Participants will receive home non-invasive respiratory support combined with active remote management.
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Participants will receive home non-invasive respiratory support combined with active remote management.
This includes regular analysis of ventilation data, assessment of oxygenation status, risk prediction, and remote parameter adjustment by a respiratory therapist.
Participants will receive home non-invasive respiratory support with remote monitoring only.
No active intervention will be performed by the study team based on the data.
Patients will continue with standard care from their primary physician.
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Comparatore attivo: Monitoring Control Group
Participants will receive home non-invasive respiratory support with remote monitoring only.
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Participants will receive home non-invasive respiratory support with remote monitoring only.
No active intervention will be performed by the study team based on the data.
Patients will continue with standard care from their primary physician.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Change in Health-Related Quality of Life
Lasso di tempo: Baseline to 12 months
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Measured by the change from baseline in the total score of the St. George's Respiratory Questionnaire (SGRQ) questionnaire at 12 months.
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Baseline to 12 months
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Number of COPD Exacerbations
Lasso di tempo: 12 months
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The number of acute exacerbations requiring antibiotics and/or systemic corticosteroids within 12 months.
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12 months
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Change in PaCO₂
Lasso di tempo: Baseline, 1, 3, 6, 12 months
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The change from baseline in arterial partial pressure of carbon dioxide (PaCO₂) at 1, 3, 6, and 12 months.
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Baseline, 1, 3, 6, 12 months
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Changes in PaO₂
Lasso di tempo: Baseline, 1, 3, 6, 12 months
|
The change from baseline in arterial partial pressure of oxygen (PaO₂) at 1, 3, 6, and 12 months.
|
Baseline, 1, 3, 6, 12 months
|
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Change in Dyspnea Severity (mMRC Score)
Lasso di tempo: Baseline, 1, 3, 6, 12 months
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The change from baseline in the modified Medical Research Council (mMRC) dyspnea scale score to each follow up.
The scale ranges from 0 to 4, with higher scores indicating more severe dyspnea.
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Baseline, 1, 3, 6, 12 months
|
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Change in CAT Score
Lasso di tempo: Baseline, 1, 3, 6, and 12 months
|
The change from baseline in the total score of the COPD Assessment Test (CAT) at 1, 3, 6, and 12 months.
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Baseline, 1, 3, 6, and 12 months
|
|
Change in SRI Score
Lasso di tempo: Time Frame: Baseline, 1, 3, 6, and 12 months
|
The change from baseline in the total score of the Severe Respiratory Insufficiency (SRI) questionnaire at 1, 3, 6, and 12 months.
|
Time Frame: Baseline, 1, 3, 6, and 12 months
|
|
Average daily usage of Non-invasive Ventilation
Lasso di tempo: Baseline, 1, 3, 6, and 12 months
|
Average daily usage of the non-invasive ventilation device (hours per day) recorded at 1, 3, 6, and 12 months.
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Baseline, 1, 3, 6, and 12 months
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Adherence-Percentage of days with usage greater than 4 hours
Lasso di tempo: Baseline, 1, 3, 6, and 12 months
|
Percentage of days with usage greater than 4 hours, recorded at 1, 3, 6, and 12 months.
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Baseline, 1, 3, 6, and 12 months
|
|
Adverse Events
Lasso di tempo: Baseline, 1, 3, 6, and 12 months
|
The number and type of adverse events (AEs) and serious adverse events (SAEs) reported throughout the 12-month study duration.
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Baseline, 1, 3, 6, and 12 months
|
Collaboratori e investigatori
Sponsor
Sponsor
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- 20260597
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