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Community-based Intervention for Fibromyalgia: A Pilot Trial

2019年10月7日 更新者:Nelly Oelke、University of British Columbia

A Multi-disciplinary, Community-based Group Intervention for Fibromyalgia: A Pilot Randomized Controlled Trial

Fibromyalgia (FM) is a multi-factorial chronic pain condition characterized by fluctuating and heterogeneous symptoms. This leads to both reduced patient function and quality of life and consequentially, significant economic burden on the society. Although numerous pharmaceutical and multi-treatment approaches exist, there is lack of an integrated multidisciplinary model of care for these patients. Such a system is hypothesized to be beneficial for the patients and would help them regain function and significantly improve their quality of life. The primary aim of this pilot clinical trial is to evaluate the effectiveness of an integrated community-based multidisciplinary model of care for FM patients in Penticton and surrounding areas. The comprehensive 10 week intervention will provide care from a team of health care providers (psychiatrist, physiotherapist, certified exercise therapist, dietitian, rheumatologist, and mental health clinician). Patients will also attend a peer led pain self-management support group provided by the Arthritis Society. The study aims at educating these patients about self-management of their symptoms such as chronic pain, weight, sleep and mood disorders. The integration of health care between the different providers will be achieved by "huddle" sessions that will be conducted on a monthly basis. The evaluation of the study outcomes will be based on the RE-AIM framework. Data will be collected through patient questionnaires, healthcare utilization data, and interviews with providers. Data analysis will involve thematic analysis of qualitative data and statistical methods for quantitative data.

研究概览

地位

完全的

条件

研究类型

介入性

注册 (实际的)

84

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

    • British Columbia
      • Penticton、British Columbia、加拿大、V2A 4Z1
        • Balfour Medical Centre

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

19年 及以上 (成人、年长者)

接受健康志愿者

有资格学习的性别

全部

描述

Inclusion Criteria:

  • formal diagnosis of FM
  • resident of Penticton or surrounding area
  • adults, aged 19 and older
  • fluent in English or bring a family member/friend to assist with translation
  • capacity to provide informed consent

Exclusion Criteria:

  • patients with a severe and/or chronic medical or psychiatric condition that would impact ability to participate in the intervention
  • patients who are pregnant or lactating

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:卫生服务研究
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
实验性的:Multidisciplinary intervention
The 10-week intervention will include twice weekly 1-2 hours sessions with multiple professional team members to undergo education and exercise sessions. The multidisciplinary team will consist of a rheumatologist, rheumatology nurse, dietitian, physiotherapist, a trained exercise therapist, a physiologist who specializes in pain management, a psychiatrist and a mental health clinician. All intervention team members have expertise in working with individuals with chronic pain conditions. General disease information, current best practices and techniques such as self-pain management, pacing, sleep hygiene, approach to a healthy lifestyle and weight loss will be discussed. The total number of hours for the 10 week intervention is 31 hours.
10 week multidisciplinary education and exercise
无干预:Usual care
Usual care involves being referred to the local rheumatologist involved in the study. The rheumatologist and the rheumatology nurse will see the control group patients during a one hour one on one consultation appointment. During that time the patient's history will be taken, physical exam performed and investigations analyzed. If a diagnosis of fibromyalgia is confirmed, the rheumatologist and nurse will counsel the patient and provide resources for self directed management. Unless there is a concern of an alternative diagnosis, follow up will not be arranged.

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Patient-perceived quality of care
大体时间:Change from baseline in perceived quality of care at 10 weeks and 6 months
Patient assessment of care received as measured by the Patient Assessment of Chronic Illness Care Questionnaire
Change from baseline in perceived quality of care at 10 weeks and 6 months

次要结果测量

结果测量
措施说明
大体时间
Daily function #1
大体时间:Change from baseline in daily function at 10 weeks and 6 months
Physical disease and mental health related functioning as measured by Revised-Fibromyalgia Impact Questionnaire
Change from baseline in daily function at 10 weeks and 6 months
Daily function #2
大体时间:Change from baseline in daily function at 10 weeks and 6 months
Mental health related functioning as measured by Hospital Anxiety and Depression scale
Change from baseline in daily function at 10 weeks and 6 months
Health care utilization (physician visits)
大体时间:Change from baseline in physician visits at 6 months
Number of physician visits
Change from baseline in physician visits at 6 months
Health care utilization (emergency visits)
大体时间:Change from baseline in emergency department visits at 6 months
Number of emergency department visits
Change from baseline in emergency department visits at 6 months

其他结果措施

结果测量
措施说明
大体时间
Sleep quality
大体时间:Change from baseline in sleep quality at 10 weeks
Quality of sleep as measured by Sleep scale - medical outcome scale
Change from baseline in sleep quality at 10 weeks
Sleep quality
大体时间:Change from baseline in sleep quality at 6 months
Quality of sleep as measured by Sleep scale - medical outcome scale
Change from baseline in sleep quality at 6 months
Attitudes of pain
大体时间:Change from baseline in pain attitudes at 10 weeks and 6 months
Measurement of pain through Survey of brief attitudes of pain
Change from baseline in pain attitudes at 10 weeks and 6 months
Irritability
大体时间:Change from baseline in irritability at 10 weeks
Irritability measured by Brief Irritability Test (BITe) questionnaire
Change from baseline in irritability at 10 weeks
Irritability
大体时间:Change from baseline in irritability at 6 months
Irritability measured by Brief Irritability Test (BITe) questionnaire
Change from baseline in irritability at 6 months
Patient perspectives on self-management resources
大体时间:10 weeks
Questionnaire to be administered to gather patient perspectives on self-management resources offered via hard copy, online, and social media
10 weeks
Patient perspectives on self-management resources
大体时间:6 months
Questionnaire to be administered to gather patient perspectives on self-management resources offered via hard copy, online, and social media
6 months
Provider perspectives on quality of care
大体时间:18 months
Interviews will be conducted to gather providers' perspectives on the model of care
18 months

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 首席研究员:Michelle Teo、University of British Columbia

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2017年9月15日

初级完成 (实际的)

2019年6月30日

研究完成 (实际的)

2019年6月30日

研究注册日期

首次提交

2017年8月21日

首先提交符合 QC 标准的

2017年8月31日

首次发布 (实际的)

2017年9月1日

研究记录更新

最后更新发布 (实际的)

2019年10月9日

上次提交的符合 QC 标准的更新

2019年10月7日

最后验证

2019年10月1日

更多信息

与本研究相关的术语

药物和器械信息、研究文件

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研究美国 FDA 监管的设备产品

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Multidisciplinary intervention的临床试验

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