- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT01091974
Cognitive Behavioral Therapy +/- Armodafinil for Insomnia and Fatigue Following Chemotherapy
연구 개요
상세 설명
Treatment Protocol: CBT-I and armodafinil are being studied in a four-arm, randomized, controlled, clinical trial of 226 cancer survivors with chronic insomnia who are at least one month post treatment. The seven-week intervention is designed to determine the efficacy and acceptability of these treatment strategies in reducing insomnia in cancer survivors. Assessments will be made by questionnaires before, during, and two weeks following the study intervention. All ancillary treatments, as appropriate for control of symptoms caused by the cancer or its treatment may be administered as clinically indicated.
Withdrawal of Sleep Medications: All participants, prior to beginning the baseline data collection phase of the study, must have withdrawn from all sleep medications, including: prescription, over-the-counter, CAM and herbal remedies for at least one week prior to beginning the study.
CBT-I (Arms 3 & 4): CBT-I will be provided on an individual basis to all patients in study Arms 3 & 4 by a licensed clinical psychologist trained in CBT-I by Dr. Perlis. Subjects in these two study arms will receive 7 weeks of CBT-I, using a structured research grade protocol developed at the UR-SNRL. This manualized intervention, which exists as a published text: Perlis et al., 2005, includes four essential components: Sleep Restriction Therapy, Stimulus Control Instruction, Sleep Hygiene Guidelines, and a session of cognitive therapy.
Data Collection: Patients will complete the Insomnia Severity (ISI) at the time of consent and every Friday during weeks 3-11 of the study. A follow-up call by study personnel will be made to each participant not currently receiving CBT-I on each of these Fridays to promote compliance, prompt completion, assess potential side effects of study medication, and answer patient questions.
연구 유형
등록 (실제)
단계
- 2 단계
연락처 및 위치
연구 장소
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New York
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Rochester, New York, 미국, 14642
- University of Rochester James P. Wilmot Cancer Center
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Pennsylvania
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Philadelphia, Pennsylvania, 미국, 19104
- Behavioral Sleep Medicine Program, Department of Psychiatry, University of Pennsylvania
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Have a diagnosis of cancer.
- Be able to understand written and spoken English
- Be able to swallow medication
- Have preferred sleep phase between 7:30 pm and 11:00 am
- Be willing to discontinue any medications/OTCs/Herbals for sleep for the 11-week study period
- Be presumed to be in a state of cancer remission; use of tamoxifen, an aromatase inhibitor, and/or Herceptin is permitted
- Self-report problems with insomnia for at least three months and that the insomnia began or got worse with the onset of cancer or treatment
- Have completed chemotherapy and or radiation not less than one month ago. Note: Both types of treatment must be completed at least one month ago if patient receives chemotherapy and radiation therapy and there is no outer limit to how long ago treatments were completed.)
- Report insomnia on the SDS-CL at a frequency of at least 3 days a week
Exclusion Criteria:
- Have ever taken modafinil or had CBT-I therapy. CBT-I therapy for the sake of this protocol will be defined as any cognitive behavioral-based treatment for insomnia that includes a sleep restriction component.
- Have an unstable medical or psychiatric illness (Axis I-current or within the last 5 years)
- Have a history of seizures or severe headaches, or uncontrolled cardiac disease or hypertension
- Be presently taking an anticoagulant or a corticosteroid
- Have taken amphetamines (e.g., methylphenidate, pemoline [Cylert®] or similar psycho stimulants) within the past 30 days
- Be currently pregnant or nursing
- Have a history of substance abuse, or meet criteria for current alcohol abuse or dependence as assessed by a CAGE test score >=2 or an Alcohol Use Disorders Identification Test (AUDIT) score >=13
- Have surgery planned within the study period
- Have have ever been diagnosed with sleep apnea or have sleep apnea as indicated by endorsing either question 11 (I wake up choking or gasping for air) or question 12 (My bed partner has noticed that I seem to stop breathing) on the Sleep Disorders Symptom Check at the "Often" or "Frequently" level.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 지지 요법
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 네 배로
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
---|---|
실험적: 1 - CBT-I + placebo
CBT-I and placebo
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Placebo for 47 days
Seven weekly sessions of cognitive behavioral therapy for insomnia (CBT-I)
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실험적: 2 - CBT-I + Armodafinil
CBT-I + Armodafinil
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Seven weekly sessions of cognitive behavioral therapy for insomnia (CBT-I)
Armodafinil P.O.
daily/47 days (3-days at 50mg, then 40 days at 100mg, then 4 days at 50mg)
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위약 비교기: 3 - Placebo only
Placebo only
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Placebo for 47 days
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실험적: 4 - Armodafinil only
Armodafinil only
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Armodafinil P.O.
daily/47 days (3-days at 50mg, then 40 days at 100mg, then 4 days at 50mg)
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
Change in Insomnia Severity Index From Baseline to Post-intervention
기간: ANCOVA was employed with multiple imputation on the post-intervention score (average of the two post-intervention weeks), controlling for the score at the time of consent (pre).
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The Insomnia Severity Index (ISI) is a commonly used, 7-item psychometrically validated measure used to rate insomnia with 0-7 = absence of insomnia, 8-14 = subthreshold insomnia symptoms, 15-21 = moderate insomnia, and 22-28 = severe insomnia.
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ANCOVA was employed with multiple imputation on the post-intervention score (average of the two post-intervention weeks), controlling for the score at the time of consent (pre).
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
---|---|---|
Fatigue Will be Assessed by the Total Score of the Revised Brief Fatigue Inventory (BFI) .
기간: ANCOVA was employed with multiple imputation on the post-intervention score (average of the two post-intervention weeks), controlling for the score at the time of consent (pre).
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The revised Brief Fatigue Inventory (BFI) is a 9-item, patient-report instrument with established reliability and validity.
The BFI allows for the rapid assessment of fatigue level in cancer patients and identifies those patients with severe fatigue.
Three items ask patients to rate their fatigue "now," and fatigue at its "worst" and "usual" for the last 24 hours.
The 11-point scales are bounded by 0 = "no fatigue" and 10 = "fatigue as bad as you can imagine."
Using the same type of scales, the remaining questions ask patients to rate how their fatigue interferes with several functional domains, including general activity, walking, mood, work, and relations with others.
These scales are bounded by 0 = "does not interfere" and 10 = "interferes completely."
A global fatigue score (ranging from 0-10) can be obtained by averaging all the items on the BFI.
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ANCOVA was employed with multiple imputation on the post-intervention score (average of the two post-intervention weeks), controlling for the score at the time of consent (pre).
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공동 작업자 및 조사자
간행물 및 유용한 링크
일반 간행물
- Peoples AR, Garland SN, Pigeon WR, Perlis ML, Wolf JR, Heffner KL, Mustian KM, Heckler CE, Peppone LJ, Kamen CS, Morrow GR, Roscoe JA. Cognitive Behavioral Therapy for Insomnia Reduces Depression in Cancer Survivors. J Clin Sleep Med. 2019 Jan 15;15(1):129-137. doi: 10.5664/jcsm.7586.
- Roscoe JA, Garland SN, Heckler CE, Perlis ML, Peoples AR, Shayne M, Savard J, Daniels NP, Morrow GR. Randomized placebo-controlled trial of cognitive behavioral therapy and armodafinil for insomnia after cancer treatment. J Clin Oncol. 2015 Jan 10;33(2):165-71. doi: 10.1200/JCO.2014.57.6769. Epub 2014 Dec 1.
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (추정)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
- UCCS07090
- 1R01CA126968-01A1 (미국 NIH 보조금/계약)
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