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COPE With COPD Trial

26 juli 2018 uppdaterad av: Lawson Health Research Institute

Collaborative Self-Management Patient Education Will Improve Health Outcomes in COPD

The overall objective of this study is to evaluate a collaborative self-management intervention in patients with moderate to severe COPD in a primary care population. To achieve this objective the investigators developed a diagnostic and treatment pathway for the management of COPD in primary care that is based on national guidelines and focused on patient self-management.

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Studieöversikt

Studietyp

Interventionell

Inskrivning (Faktisk)

182

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

    • Ontario
      • Amherstburg, Ontario, Kanada, N9V 0B4
        • Amherstburg FHT
      • Chatham, Ontario, Kanada, N7L 5K5
        • Chatham-Kent FHT
      • Harrow, Ontario, Kanada, NOR 1G0
        • Harrow FHT
      • Leamington, Ontario, Kanada, N8H 1N8
        • Leamington FHT

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

40 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Current or Ex-smokers
  • 40 years of age or over
  • Minimum 10 pack year smoking history
  • Post-bronchodilator FEV1 of 70% or less (4 puffs of Salbutamol) and Forced Expiratory Volume at 1sec to Forced Vital Capacity (FEV1/FVC) ratio 70% or less
  • A history of two exacerbations (involving treatment and/or visit to a health care practitioner) in the past 3 years OR 1 exacerbation in the past year
  • Provides informed consent

Exclusion Criteria:

  • COPD exacerbation in the past 4 weeks
  • Diagnosis of asthma prior to the age of 40 years
  • Co-existing illness that could interfere with study results (ie. Congestive Heart Failure with exacerbation of symptoms)
  • Scheduled for COPD rehabilitation
  • A terminal illness

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Case Management and Self-Management Education
A Certified Respiratory Educator (CRE) will obtain a detailed COPD history, provide general and self-management education, and confirm a management plan with the primary care physician. Specific elements of evidence-based management are targetted for intervention. Subjects will return for a follow-up visit in-person with the interdisciplinary care team including a CRE to review their health status including COPD symptoms, exacerbation diary, symptoms, MRC scale, etc as a minimum at 3 and 12 months. Telephone follow up will occur at a minimum at 6 and 9 months.
A Certified Respiratory Educator (CRE) will obtain a detailed COPD history, provide general and self-management education, and confirm a management plan with the primary care physician. Specific elements of evidence-based management are targetted for intervention. Subjects will return for a follow-up visit in-person with the interdisciplinary care team including a CRE to review their health status including COPD symptoms, exacerbation diary, symptoms, MRC scale, etc as a minimum at 3 and 12 months. Telephone follow up will occur at a minimum at 6 and 9 months.
Placebo-jämförare: Usual Care
A Certified Respiratory Educator (CRE) will meet with subjects to obtain a detailed COPD history and do a breathing test. Subjects will receive COPD care as usually provided by their physician.
A Certified Respiratory Educator (CRE) will obtain a detailed COPD history, provide general and self-management education, and confirm a management plan with the primary care physician. Specific elements of evidence-based management are targetted for intervention. Subjects will return for a follow-up visit in-person with the interdisciplinary care team including a CRE to review their health status including COPD symptoms, exacerbation diary, symptoms, MRC scale, etc as a minimum at 3 and 12 months. Telephone follow up will occur at a minimum at 6 and 9 months.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
COPD Assessment Test (CAT)
Tidsram: 1 Year
COPD related quality of life measure in primary care.
1 Year

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Health Care Utilization for Emergency Department visits proportion and rate per year
Tidsram: 1 year
The proportion of subjects that utilized the Emergency for a COPD exacerbation
1 year
Health Care Utilization for Hospital Admission proportion and rate per year
Tidsram: 1 year
The proportion of subjects that were admitted to hospital for a COPD exacerbation An exacerbation is defined as an increase in or the onset of more than one respiratory symptom (cough, sputum, sputum purulence, wheezing, or dyspnea) lasting 3 days or more and requiring treatment with an antibiotic or a systemic corticosteroid. Respiratory status had to return to baseline for at least 72 hours before another exacerbation would be counted.
1 year
Severe Exacerbation proportion and rate per year
Tidsram: 1 year
The proportion of subjects experiencing one or more exacerbations in the study interval. An exacerbation diary will be completed for each event.
1 year

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Quality of Life
Tidsram: 1 year
Improvement of Quality of Life using the CAT score(COPD Assessment Test)
1 year
Improvement in Knowledge of COPD and confidence in self-management
Tidsram: 1 year
Improvement in Bristol COPD Knowledge Questionnaire and patient self report
1 year
Process of Care
Tidsram: 1 year
Process of care: have written action plan, used action plan, advised to quit smoking, offered pharmacologic help with quitting, quit smoking, current packs/day, diagnosis confirmed by spirometry, vaccination rates, instructed on inhaler technique, vaccination rates
1 year
Dyspnea Improvement
Tidsram: 1 year
Change in dyspnea using the modified MRC questionnaire - Medical Research Council (MRC).
1 year
Disease control
Tidsram: 1 year
Disease control using the Clinical COPD questionnaire (CCQ)
1 year
Symptom Profile
Tidsram: 1 year
Change in Symptom profile (cough, wheeze, sputum production)
1 year
Forced Expiratory Volume at 1sec (FEV1) % predicted
Tidsram: 1 year
FEV1
1 year
Proportion of Patients on therapy appropriate to their stage of disease
Tidsram: 1 year
Evaluate medication prescribed related to stage of disease
1 year

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Samarbetspartners

Utredare

  • Huvudutredare: Christopher Licskai, Lawson Health Research Institution

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 oktober 2011

Primärt slutförande (Faktisk)

1 januari 2015

Avslutad studie (Faktisk)

1 januari 2015

Studieregistreringsdatum

Först inskickad

22 oktober 2014

Först inskickad som uppfyllde QC-kriterierna

20 januari 2015

Första postat (Uppskatta)

21 januari 2015

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

30 juli 2018

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

26 juli 2018

Senast verifierad

1 april 2015

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • 00000941

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

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Kliniska prövningar på Case Management and Self-Management Education

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