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Remote Intervention Versus Routine Monitoring in COPD Patients With Chronic Hypercapnia Receiving Home Non-invasive Respiratory Support

3. august 2026 oppdatert av: Huiqing Ge, Sir Run Run Shaw Hospital

A Randomized Controlled Trial of Remote Intervention Versus Routine Monitoring in COPD Patients With Chronic Hypercapnia Receiving Home Non-invasive Respiratory Support

This study is a randomized controlled trial designed to compare the effectiveness of active remote intervention versus passive monitoring alone in patients with Chronic Obstructive Pulmonary Disease (COPD) and chronic hypercapnic respiratory failure who are receiving home non-invasive respiratory support. The primary goal is to evaluate the impact on health-related quality of life and the frequency of acute exacerbations over a 12-month period.

Studieoversikt

Detaljert beskrivelse

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

Intervensjonell

Registrering (Antatt)

236

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

  • Navn: Huiqing Ge, MD, PhD
  • Telefonnummer: +86 13588706787
  • E-post: gehq@zju.edu.cn

Studiesteder

    • Henan
      • Zhengzhou, Henan, Kina
        • Henan Provincial People's Hospital
        • Ta kontakt med:
    • Hunan
      • Changsha, Hunan, Kina, 410006
        • The Second Xiangya Hospital of Central South University
        • Ta kontakt med:
    • Zhejiang
      • Hangzhou, Zhejiang, Kina, 310016
        • Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University
        • Ta kontakt med:
      • Wenling, Zhejiang, Kina, 317523
        • Taizhou Hospital of Integrated Traditional Chinese and Western Medicine
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.
Aktiv komparator: Monitoring Control Group
Participants will receive home non-invasive respiratory support with remote monitoring only.
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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Health-Related Quality of Life
Tidsramme: 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
Tidsramme: 12 months
The number of acute exacerbations requiring antibiotics and/or systemic corticosteroids within 12 months.
12 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in PaCO₂
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Adherence-Percentage of days with usage greater than 4 hours
Tidsramme: 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
Adverse Events
Tidsramme: 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

Samarbeidspartnere og etterforskere

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Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. august 2027

Primær fullføring (Antatt)

31. desember 2027

Studiet fullført (Antatt)

31. desember 2028

Datoer for studieregistrering

Først innsendt

30. juli 2026

Først innsendt som oppfylte QC-kriteriene

3. august 2026

Først lagt ut (Faktiske)

6. august 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

6. august 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

3. august 2026

Sist bekreftet

1. juli 2026

Mer informasjon

Begreper knyttet til denne studien

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