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- Klinische proef NCT01999816
Pressure Ulcer Prevention Study in SCI (PUPS)
Lifestyle Redesign for Pressure Ulcer Prevention in Spinal Cord Injury
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Medically serious pressure ulcers are a common complication of spinal cord injury (SCI), and are associated with high treatment costs and reduced quality of life. This study will examine the efficacy and cost-effectiveness of a promising lifestyle-based intervention designed to reduce the incidence of pressure ulcers among culturally diverse, community dwelling adults with SCI who have had serious pressure ulcers.
The intervention being tested, termed lifestyle redesign (LR), is based on prior SCI literature as well as on the results of a qualitative pilot study undertaken by our study group. This intervention targets several psychosocial mediating variables that have been shown to be important in prevention of pressure ulcers in daily living contexts. Participants assigned to the LR condition receive individualized in-home sessions, personal phone calls, and incident-based contacts for a 12-month period, followed by 12 months of no intervention. Participants in the control condition do not receive any study-based intervention, but (along with the LR group) have continuing access to the standard options for prevention and treatment that are available through Rancho Los Amigos National Rehabilitation Center.
In addition to identifying a pressure ulcer prevention strategy, the planned research will lead to the development of testable theoretical models of the intervening process mechanisms that link the intervention to pressure ulcer reduction.
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 3
Contacten en locaties
Studie Locaties
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California
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Downey, California, Verenigde Staten, 90242
- Rancho Los Amigos National Rehabilitation Center (RLANRC)
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Los Angeles, California, Verenigde Staten, 90033
- University of Southern California
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Spinal cord injury (paraplegia or tetraplegia)
- Non-ambulatory
- Able to undergo intervention and testing in English or Spanish
- At least 6 months post-injury
- History of at least one serious (Stage 3 or 4) pressure ulcer in the past 5 years
- Cognitively intact
- Personally expressed willingness to undertake recommended lifestyle changes for ulcer prevention.
- Can be reached by telephone.
- Reside in or within 100 miles of Rancho Los Amigos National Rehabilitation Center (Downey, CA) with no plans to relocate beyond this area.
- Agreement to participate and completion of consent form.
Exclusion Criteria:
- Present serious stage 4 pressure ulcer
- Participation in our preliminary research studies
- Participating in the neuromuscular stimulation study
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Preventie
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
---|---|
Geen tussenkomst: Controle
Gebruikelijke zorg
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Experimenteel: Lifestyle Redesign
Occupational therapist led lifestyle redesign program to prevent pressure ulcers
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Individualized program for lifestyle redesign aimed at decreasing the risk of medically serious pressure ulcers led by licensed occupational therapists trained in the implementation of the lifestyle redesign program
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
---|---|---|
Incidence of serious pressure ulcers
Tijdsspanne: Throughout 12-month study intervention
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New stage 3 or 4 pressure ulcers
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Throughout 12-month study intervention
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
---|---|---|
Incidence of ulcer related surgeries
Tijdsspanne: Throughout 12-month study intervention and 12-months post intervention period
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Surgical wound repair (flap, skin graft, girdlestone, other)
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Throughout 12-month study intervention and 12-months post intervention period
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Quality of life
Tijdsspanne: Throughout 12-month study intervention and 12-months post intervention period
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Measured by the Medical Outcomes Study Short Form (SF-36)
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Throughout 12-month study intervention and 12-months post intervention period
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Healthcare service utilization
Tijdsspanne: Throughout 12-month study intervention and 12-months post intervention period
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Estimated cost of healthcare services including inpatient, outpatient, ER, home healthcare, lab, imaging, etc.
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Throughout 12-month study intervention and 12-months post intervention period
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Incidence of serious pressure ulcers
Tijdsspanne: Throughout 12-months post intervention period
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New stage 3 or 4 pressure ulcers during the second study year
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Throughout 12-months post intervention period
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Life Satisfaction
Tijdsspanne: Throughout 12-month study intervention and 12-months post intervention period
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Measured by the Satisfaction with Life Scale (SWLS)
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Throughout 12-month study intervention and 12-months post intervention period
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Medewerkers en onderzoekers
Onderzoekers
- Hoofdonderzoeker: Florence Clark, PhD, University of Southern California
- Hoofdonderzoeker: Salah Rubayi, MD, Rancho Los Amigos National Rehabilitation Center
Publicaties en nuttige links
Algemene publicaties
- Pyatak EA, Blanche EI, Garber SL, Diaz J, Blanchard J, Florindez L, Clark FA. Conducting intervention research among underserved populations: lessons learned and recommendations for researchers. Arch Phys Med Rehabil. 2013 Jun;94(6):1190-8. doi: 10.1016/j.apmr.2012.12.009. Epub 2012 Dec 21.
- Blanche EI, Fogelberg D, Diaz J, Carlson M, Clark F. Manualization of occupational therapy interventions: illustrations from the pressure ulcer prevention research program. Am J Occup Ther. 2011 Nov-Dec;65(6):711-9. doi: 10.5014/ajot.2011.001172.
- Vaishampayan A, Clark F, Carlson M, Blanche EI. Preventing pressure ulcers in people with spinal cord injury: targeting risky life circumstances through community-based interventions. Adv Skin Wound Care. 2011 Jun;24(6):275-84; quiz 285-6. doi: 10.1097/01.ASW.0000398663.66530.46.
- Fogelberg D, Atkins M, Blanche EI, Carlson M, Clark F. Decisions and Dilemmas in Everyday Life: Daily Use of Wheelchairs by Individuals with Spinal Cord Injury and the Impact on Pressure Ulcer Risk. Top Spinal Cord Inj Rehabil. 2009 Fall;15(2):16-32. doi: 10.1310/sci1502-16.
- Clark F, Pyatak EA, Carlson M, Blanche EI, Vigen C, Hay J, Mallinson T, Blanchard J, Unger JB, Garber SL, Diaz J, Florindez LI, Atkins M, Rubayi S, Azen SP; PUPS Study Group. Implementing trials of complex interventions in community settings: the USC-Rancho Los Amigos pressure ulcer prevention study (PUPS). Clin Trials. 2014 Apr;11(2):218-29. doi: 10.1177/1740774514521904. Epub 2014 Feb 26.
- Carlson M, Vigen CLP, Rubayi S, Blanche EI, Blanchard J, Atkins M, Bates-Jensen B, Garber SL, Pyatak EA, Diaz J, Florindez LI, Hay JW, Mallinson T, Unger JB, Azen SP, Scott M, Cogan A, Clark F. Lifestyle intervention for adults with spinal cord injury: Results of the USC-RLANRC Pressure Ulcer Prevention Study. J Spinal Cord Med. 2019 Jan;42(1):2-19. doi: 10.1080/10790268.2017.1313931. Epub 2017 Apr 17.
Studie record data
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Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- HS-06-00064
- R01HD056267 (Subsidie/contract van de Amerikaanse NIH)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
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