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Telehealth Program in Chronic Patients

F

Fondazione Salvatore Maugeri

Status

Completed

Conditions

Pulmonary Disease, Chronic Obstructive
Heart Failure

Treatments

Other: Home-based rehabilitation
Other: Home-based telehealth program
Other: Usual care

Study type

Interventional

Funder types

Other

Identifiers

Details and patient eligibility

About

The aim of this randomized control study is to determine the feasibility and efficacy of an innovative multidisciplinary telehealth program in chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) patients. 120 patients (1:1) will be included in the study and followed for 4 months and for additional 2 months of follow-up. The primary outcome is to improve tolerance capacity

Full description

COPD and CHF frequently coexist, causing a significant worsening in the quality of life of the patients and increasing morbidity and mortality. The prevalence of COPD in the CHF patients ranges from 20% to 32% of cases, and CHF is prevalent in more than 20% of patients with COPD.

COPD and CHF patients are complicated and frail with a high risk of re-hospitalizations; for this reason an individualized and multidisciplinary program need to be implemented in these patients. The chronic disease trend is fluctuating, burdened by many exacerbations through a vicious circle with dyspnoea, decreased activity, new exacerbations, depression and social isolation, leading to death.

The weight of evidence from a meta-analysis of randomized trials indicates that a multidisciplinary disease-management approach has the best outcomes in terms of prolonged survival and reduced hospital-readmission rates. Home-based management might, arguably, be the preferred approach after hospitalization of chronic diseases patients.

Home-base management might provide an opportunity to prevent clinical deterioration and hospitalizations by a comprehensive, long-term intervention with regular reinforcement of patient adherence, knowledge, and skills. A personalized hospital-discharge programme seems to be the best approach to plan the follow-up care of patients with chronic diseases.

These programmes, particularly important in the care of patients with multiple comorbidities, should include a routine self-management support, consisting in education to recognize symptoms early, to manage medical devices, to identify barriers to adherence to therapy such as adverse effects of drugs, and to check that the intensity of physical therapy is appropriate.

Our study want to investigate feasibility and efficacy of a multidisciplinary telehealth and tele-rehabilitation home based program in patients with COPD and CHF. This is an integrated, multidisciplinary nurse and therapist oriented program; these two figures have a central role during home based intervention and became an essential interface in the dialogue between patient and specialist. The nurse and therapist, each for their competence, collect information, carry out education and training, verify adherence to drug and physical therapy, verify the quality of caregiver assistance. When needed, they require intervention of specialist for consultation or second-opinion.

After drug therapy optimization and physical rehabilitation program definition, the patient will be allocated randomly into 2 groups: 1. Group A (usual care): the patients will be followed in the usual care manner by General Practitioner (GP) and routine specialist visits. 2. Group B (Home-based intervention): the patients will be monitored at home for 4 months by nurse and therapist and they will perform an individual rehabilitative program including at least 3 sessions/week of mini-ergometer and exercises and 2 sessions/week of walking with pedometer.

At baseline, after 4 months and further 2 months of follow-up all patients in both groups will undergo to follows clinical and physical evaluations:

  1. ECG (T0; T4 if needed)
  2. Echocardiogram (T0, T4 if needed
  3. Spirometry (T0 or a spirometry available in the previous year)
  4. Arterial blood gases (T0; T4)
  5. Walking test (T0; T4; T6)
  6. Metabolic Holter monitoring using the Body Monitoring Multi-Sensor Armband (BMSA) (SenseWear) worn at the triceps of the right arm for at least 72 h. (T0; T4; T6)

The questionnaires and scale :

  1. Minnesota (T0;T4;T6)
  2. COPD Assessment Test (CAT) (T0;T4;T6)
  3. Barthel (T0;T4;T6)
  4. Dyspnoea and muscle fatigue by Borg scale evaluation, referred by patient during his regular day (T0;T4;T6)
  5. Medical Research Council (MRC) scale for dyspnoea during regular day (T0;T4;T6)
  6. Physical activity scale for the elderly (PASE) (T0;T4;T6)
  7. Customer satisfaction (T4, only group B)

Enrollment

113 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • COPD new GOLD classification (B, C and D class) and a spirometry in the previous year and
  • Systolic and/or diastolic CHF defined at least by an echocardiogram performed in clinical stability; II, III and IV New York Heart Association class and optimized drug therapy.
  • Informed consent signed

Exclusion criteria

  • Physical activity limitations caused by non-cardiac and/or pulmonary problems
  • Obstructive Cardiomyopathies and/or myocarditis
  • Non cardiac and/or pulmonary pathologies that would cause the death of the patient during the study
  • Poor adherence and compliance of the patient

Trial design

Primary purpose

Health Services Research

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

113 participants in 2 patient groups

Control group (Group A)
Active Comparator group
Description:
The patients will be followed in the usual care manner by GPs and by routine specialist visits, if needed
Treatment:
Other: Usual care
Intervention group (Group B)
Other group
Description:
Group B (Home-based intervention): the patients will be followed at home for 4 months by nurse and therapist and will perform an individual rehabilitative program. The interventions will be: 1. Home-based telehealth program 2. Home-based rehabilitation
Treatment:
Other: Usual care
Other: Home-based telehealth program
Other: Home-based rehabilitation

Trial contacts and locations

3

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Data sourced from clinicaltrials.gov

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