A Pilot Trial of a Smartphone-based Self-management Support Program for COPD Patients
A Pilot Trial of a Smartphone-based Self-management Support Program for Patients With Chronic Obstructive Pulmonary Disease
COPD patients often experience multiple symptoms (e.g. dyspnea, cough, and deteriorating quality of life) and have imposed a substantial economic and social burden on health care.
The current proposal is to evaluate the feasibility and acceptability of a pilot trial of a smartphone-based instant messaging self-management support program to improve the quality of life in patients with COPD.
調査の概要
詳細な説明
Chronic obstructive pulmonary disease (COPD) is the number 3 killer globally by 2020. COPD patients often experience multiple symptoms (e.g. dyspnea, cough, and deteriorating quality of life) and have imposed a substantial economic and social burden on health care.
Current policy for the prevention and management of long-term conditions focuses on efforts to prevent the onset or slow progression of disease early in the disease trajectory. This prevention paradigm has only recently been adopted for COPD. Systematic reviews have shown self-management support for patients with COPD is effective in improving health-related quality of life and in reducing hospital admissions, but the evidence comes largely from patients with moderate or severe disease and is predominantly recruited from secondary care. Simple and systematic strategies are needed to improve out-of-hospital support and management for people living with COPD.
An instant messaging smartphone app, which allows texts, audio, pictures and video messages to be shared in chat groups, is already available to and is the most popular in the Hong Kong general public. Mobile instant messaging can be conducted through a daily use device to increase access and efficacy, which has been suggested as a feasible approach to delivering an intervention with positive effects on health behaviours and outcomes. Text messaging via mobile phones has been shown to be effective in helping promote lifestyle change in diabetes self-management, weight loss, physical activity, smoking cessation and medication adherence with quantitative and qualitative evidence. However, the investigator has not found messaging intervention that was applied in people with COPD, except an ongoing study of using instant text message support for patients with chronic respiratory and cardiovascular diseases.
Hence, the current intervention program is to evaluate the feasibility and acceptability of a smartphone-based instant messaging self-management support program to improve the quality of life in patients with COPD.
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Asa Choi, MA
- 電話番号:852-3917-6563
- メール:asachoi@hku.hk
研究連絡先のバックアップ
- 名前:Agnes YK Lai, PhD
- 電話番号:852-3917-6328
- メール:agneslai@hku.hk
研究場所
-
-
-
Hong Kong、香港、852
- 募集
- Queen Mary Hospital
-
コンタクト:
- David Lam, PhD
- 電話番号:2255-4455
- メール:slnga@hku.hk
-
コンタクト:
- Agnes Lai, PhD
- 電話番号:93176779
- メール:agneslai@hku.hk
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion criteria
- Aged 18 years and above
- Diagnosis with COPD
- General condition stable
- Able to speak and read Chinese
- Able to complete the self-administered questionnaire
- Able to use instant messages such as WhatsApp or WeChat
- Mental, cognitive and physically fit for joining the trial as determined by the clinician or responsible investigator
- Signed informed consent
Exclusion criteria
- Skeletal fragility
- Serious active infection
- Inability to walk
- Severe respiratory insufficiency
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:支持療法
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Intervention group
The intervention group will receive a smartphone-based self-management support programme, including a 30-min face-to-face or online session at baseline, 3 phone calls (week 2, week 4 and week 6) and 2-month mobile messages in addition to usual care.
|
A smartphone-based self-management support programme includes a 30-min face-to-face or online session at baseline, 3 phone calls and 2-month mobile messages
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change from baseline COPD-related quality of life
時間枠:Baseline, Week 8
|
COPD symptoms and impacts and activity level were measured by an 8-item COPD Assessment Test.
Total scores range from 0 to 40, with higher scores denoting a more severe impact of COPD on a patient's life.
|
Baseline, Week 8
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change from baseline patient activation
時間枠:Baseline, Week 8
|
Knowledge, skills and confidence in self-management were measured by a 13-item Patient Activation Measure Scale.
The total score ranges from 0 (no activation) to 100 (high activation), with higher scores denoting the better patient activation.
|
Baseline, Week 8
|
|
Change from baseline self-efficacy for self-management
時間枠:Baseline, Week 8
|
Confidence and perceived ability of self-care were measured by a 6-item Stanford self-efficacy scale.
The score for each item ranges from 1 (not at all confident) to 10 (totally confident).
The total score of the scale is the mean of the six items, with higher number indicates higher self-efficacy.
|
Baseline, Week 8
|
|
Change from baseline acceptance of illness
時間枠:Baseline, Week 8
|
Acceptance of illness measured by a 8-item acceptance of illness scale.
Each item ranges from 1 to 5. The total score of the scale is between 8 and 40, with low score showing a lack of adjustment to the disease, no acceptance of the condition, and mental discomfort, while high score indicating good disease acceptance.
|
Baseline, Week 8
|
|
Change from baseline medication adherence
時間枠:Baseline, Week 8
|
Medication adherence measured by a 4-item Morisky Medication-Taking Adherence Scale.
The scale consists of four items with a scoring scheme of "Yes" = 0 and "No" = 1.
All items are summed to give a range of scores from 0 to 4, with higher score indicating a low level of medication adherence.
|
Baseline, Week 8
|
|
Change from baseline physical activity level
時間枠:Baseline, Week 8
|
Physical activity measured by a 7-item International Physical Activity Questionnaire-short form.
Number of days and duration (in hours and minutes) engaging in vigorous activities, moderate activities, and walking in past 7 days will be collected.
Duration (in hours and minutes) of sitting time on week days and weekends will be collected.
|
Baseline, Week 8
|
|
Change from dyspnea severity
時間枠:Baseline, week 8
|
Dyspnea severity measured by a 1-item MRC dyspnea scale.
The scale consists of five statements about perceived breathlessness: grade 1, "I only get breathless with strenuous exercise"; grade 2, "I get short of breath when hurrying on the level or up a slight hill"; grade 3, "I walk slower than people of the same age on the level because of breathlessness or have to stop for breath when walking at my own pace on the level"; grade 4, "I stop for breath after walking 100 yards or after a few minutes on the level"; grade 5, " I am too breathless to leave the house".
Patients selected the grade that applied to them.
|
Baseline, week 8
|
|
Change from baseline Health status
時間枠:Baseline, Week 8
|
Health status measured by a 5-item EuroQol 5-Dimension questionnaire.
The scale comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression.
Each dimension was scored by five levels, with 1 representing no problem and 5 representing extreme problem.
|
Baseline, Week 8
|
|
Change from anxiety and depressive symptoms
時間枠:Baseline, Week 8
|
Anxiety and depressive symptoms measured by a 14-item Hospital Anxiety and Depression Scale.
Each item ranges from 0-3.
The total scores of both Anxiety and Depression subscales range from 0-21, with higher scores indicating higher level of anxiety and depression respectively.
|
Baseline, Week 8
|
|
Change in baseline social support
時間枠:Baseline, Week 8
|
Social support measured by a 6-item Multidimensional Scale of Perceived Social Support.
Each item ranges from 1 (very strongly disagree) to 7 (very strongly agree).
The total score is the sum across all items divided by 6, with higher score indicating more social support.
|
Baseline, Week 8
|
|
Change in from baseline sleep quality
時間枠:Baseline, Week 8
|
Sleep quality measured by a 7-item Insomnia Severity Index.
The total score range from 0 (absence of insomnia) to 28 (severe insomnia).
|
Baseline, Week 8
|
|
Change in baseline grip strength
時間枠:Baseline, Week 8
|
Grip strength of both hands measured by dynamometer
|
Baseline, Week 8
|
|
Change in baseline balance
時間枠:Baseline, Week 8
|
Balance assessed by a single-leg stance test.
|
Baseline, Week 8
|
協力者と研究者
出版物と役立つリンク
一般刊行物
- Hall AK, Cole-Lewis H, Bernhardt JM. Mobile text messaging for health: a systematic review of reviews. Annu Rev Public Health. 2015 Mar 18;36:393-415. doi: 10.1146/annurev-publhealth-031914-122855.
- Buttery SC, Zysman M, Vikjord SAA, Hopkinson NS, Jenkins C, Vanfleteren LEGW. Contemporary perspectives in COPD: Patient burden, the role of gender and trajectories of multimorbidity. Respirology. 2021 May;26(5):419-441. doi: 10.1111/resp.14032. Epub 2021 Mar 9.
- Jolly K, Sidhu MS, Hewitt CA, Coventry PA, Daley A, Jordan R, Heneghan C, Singh S, Ives N, Adab P, Jowett S, Varghese J, Nunan D, Ahmed K, Dowson L, Fitzmaurice D. Self management of patients with mild COPD in primary care: randomised controlled trial. BMJ. 2018 Jun 13;361:k2241. doi: 10.1136/bmj.k2241.
- Redfern J, Hyun K, Singleton A, Hafiz N, Raeside R, Spencer L, Carr B, Caterson I, Cullen J, Ferry C, Santo K, Hayes A, Leung RWM, Raadsma S, Swinbourne J, Cho JG, King M, Roberts M, Kok C, Jenkins C, Chow C. ITM support for patients with chronic respiratory and cardiovascular diseases: a protocol for a randomised controlled trial. BMJ Open. 2019 Mar 1;9(3):e023863. doi: 10.1136/bmjopen-2018-023863.
便利なリンク
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
IPD 共有時間枠
IPD 共有アクセス基準
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。