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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
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Huiqing Ge, MD, PhD
- Telefoonnummer: +86 13588706787
- E-mail: gehq@zju.edu.cn
Studie Locaties
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Henan
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Zhengzhou, Henan, China
- Henan Provincial People's Hospital
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Contact:
- Qiang Kui, MD
- Telefoonnummer: +86 13460317523
- E-mail: syhxzzggyx@163.com
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Hunan
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Changsha, Hunan, China, 410006
- The Second Xiangya Hospital of Central South University
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Contact:
- Liucun Li
- Telefoonnummer: +86 0731-852959999
- E-mail: xyeyyibd@sina.com
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Zhejiang
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Hangzhou, Zhejiang, China, 310016
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University
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Contact:
- Huiqing Ge
- Telefoonnummer: +86 13588706787
- E-mail: gehq@zju.edu.cn
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Wenling, Zhejiang, China, 317523
- Taizhou Hospital of Integrated Traditional Chinese and Western Medicine
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Contact:
- Ting Jiang
- Telefoonnummer: +86 13758692956
- E-mail: 13758692956@139.com
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
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.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: Remote Intervention Group
Participants will receive home non-invasive respiratory support combined with active remote management.
|
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.
|
|
Actieve vergelijker: 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.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Change in Health-Related Quality of Life
Tijdsspanne: Baseline to 12 months
|
Measured by the change from baseline in the total score of the St. George's Respiratory Questionnaire (SGRQ) questionnaire at 12 months.
|
Baseline to 12 months
|
|
Number of COPD Exacerbations
Tijdsspanne: 12 months
|
The number of acute exacerbations requiring antibiotics and/or systemic corticosteroids within 12 months.
|
12 months
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Change in PaCO₂
Tijdsspanne: Baseline, 1, 3, 6, 12 months
|
The change from baseline in arterial partial pressure of carbon dioxide (PaCO₂) at 1, 3, 6, and 12 months.
|
Baseline, 1, 3, 6, 12 months
|
|
Changes in PaO₂
Tijdsspanne: 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
|
|
Change in Dyspnea Severity (mMRC Score)
Tijdsspanne: Baseline, 1, 3, 6, 12 months
|
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.
|
Baseline, 1, 3, 6, 12 months
|
|
Change in CAT Score
Tijdsspanne: 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.
|
Baseline, 1, 3, 6, and 12 months
|
|
Change in SRI Score
Tijdsspanne: 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
Tijdsspanne: 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.
|
Baseline, 1, 3, 6, and 12 months
|
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Adherence-Percentage of days with usage greater than 4 hours
Tijdsspanne: Baseline, 1, 3, 6, and 12 months
|
Percentage of days with usage greater than 4 hours, recorded at 1, 3, 6, and 12 months.
|
Baseline, 1, 3, 6, and 12 months
|
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Adverse Events
Tijdsspanne: 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.
|
Baseline, 1, 3, 6, and 12 months
|
Medewerkers en onderzoekers
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- 20260597
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