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Status unknownNCT03499470Updated Jul 18, 2019

Structured Discharge and Follow-up Protocol for COPD Patients Receiving LTOT and NIV

An interventional study of Protocol for structured discharge and follow-up in COPD Exacerbation, Noninvasive Ventilation and Long Term Oxygen Therapy, sponsored by Dokuz Eylul University. Status unknown at 10 sites in Turkey. Open to participants aged 40 Years to 85 Years. Per ClinicalTrials.gov, last updated 2019-07-18.

Sponsored by Dokuz Eylul University · Not applicable, Interventional, and Prevention

The sponsor has not verified this record recently (last verified Jul 2019), so the status shown — last known as Active, not recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
160
Allocation
Randomized
Ages
40 Years to 85 Years
Sex
All
01

Study summary

Readmission to hospital is one of the most important problems in chronic obstructive pulmonary disease (COPD) patients who developed chronic respiratory failure. Patients receiving long-term oxygen therapy (LTOT) and noninvasive ventilation (NIV) constitute the most vulnerable group because of the need for comprehensive care. However, because of lack of health care support systems in Turkey, many advanced COPD patients are hospitalized due to preventable problems such as insufficient knowledge about the therapies, nonadherence to therapy and technical issues related to LTOT/NIV equipment. The aim of this multicenter randomized trial is to find out whether a structured discharge and follow-up protocol reduce the rate of unplanned, COPD-related hospital readmissions over 90 days in patients receiving LTOT or NIV.

Read the detailed description

The study is planned with Turkish Thoracic Society and Global Alliance Against Respiratory Disease-Turkey partnership and being carried out 10 centers throughout Turkey. COPD patients who are prescribed long-term oxygen therapy for hypoxemic respiratory failure and/or noninvasive ventilation for hypercapnic respiratory failure will be included in the study and will be randomized to either intervention or control arm. The intervention mainly consists of not only education about the disease and medications but also the education of the equipment and how to use it to have the best benefit. Control arm patients will receive usual care, which consists of basic education of the patient about the therapies. The primary outcome of the study is readmission in 90 days.

02

Conditions studied

  • COPD Exacerbation
  • Noninvasive Ventilation
  • Long Term Oxygen Therapy
  • Chronic Respiratory Failure

Keywords

  • copd
  • exacerbation
  • structured discharge
  • readmission
  • chronic respiratory failure
03

Who can participate

Ages eligible
40 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

COPD patients who developed chronic respiratory failure and are eligible for long-term oxygen therapy (LTOT) or noninvasive ventilation (NIV) according to Turkish National Social Security regulations

Definitions:

COPD: The diagnosis of COPD is made according to GOLD criteria Chronic respiratory failure: PaO2>60mmHg at room air and/or PaCO2> 45

Eligibility for LTOT:

  1. PaO2 ≤ 55 mmHg or SaO2 ≤ 88% under room air
  2. PaO2 value of 55-59 mmHg or SaO2 ≤ 89% and cor pulmonale with hematocrit >55 or p pulmonale in ECG or congestive heart failure.

Eligibility for NIV:

  1. PaCO2≥55 mmHg or
  2. PaCO2 50 to 54 mmHg and nocturnal desaturation ≤ %88 for 5 minutes under 2lt/min nasal O2 therapy 3. PaCO2 50 to 54 mmHg and >2 exacerbations within the last year

Exclusion criteria

Exclusion Criteria:

  1. Patients receiving LTOT or NIV for a different cause 2. Patients who do not give consent 3. Patients who are unable to be followed up regularly due to reasons such as living far from study center, lack of family support, unwillingness or inability to contact regularly.

-

04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
160 participants (actual)

Study arms

  • Active comparator
    Intervention

    The intervention mainly consists of a developed protocol for education about the disease and medications AND an education of the equipment and how to use it to have the best benefit. Actions in structured discharge and follow up protocol: 1. Patient education for disease severity and medications 2. Education of family/relatives about medications and types of equipment 3. Detailed education for LTOT and/or NIV (how to use, duration of use, solutions for possible common problems) 4. Preparation of home environment for patients needs 5. Regular telephone visits on day 7 and day 14 after discharge and telephone visits in emergency situations and early referral to the hospital when needed 6. Outpatient control for the first month

    Other: Protocol for structured discharge and follow-up

  • No intervention
    Control

    Control patients will receive usual care

Interventions

  • OtherProtocol for structured discharge and follow-up
05

What researchers measure

Primary outcomes

  1. Readmission rate

    The rate of unplanned, COPD-related hospital readmissions over 90 days after discharge

    Time frame: 90days

Secondary outcomes

  1. Time to first exacerbation

    Time to first exacerbation after discharge

    Time frame: 90 days

  2. Rate of exacerbation

    Total COPD exacerbation rate within 90 days after discharge

    Time frame: 90 days

  3. Rate of hospitalization

    Total hospitalization number due to COPD within 90 days after discharge

    Time frame: 90 days

  4. Compliance to treatment

    Compliance to LTOT and NIV therapies will be assessed by duration of use (number of hours per day and number of nights per week) within 90 days after discharge.

    Time frame: 90 days

  5. Long term survival

    One year survival after discharge

    Time frame: One year

06

Study locations

10 sites
  • Dokuz Eylul University
    Izmir, Narlıdere 35340, Turkey
  • Cukurova University
    Adana, Turkey
  • Gazi University
    Ankara, Turkey
  • Health Sciences University Ataturk Chest Diseases and Chest Surgery Hospital
    Ankara, Turkey
  • Uludag University
    Bursa, Turkey
  • Duzce University
    Düzce, Turkey
  • Ataturk University
    Erzurum, Turkey
  • Health Sciences University Sureyyapasa Chest Diseases and Chest Surgery Hospital
    Istanbul, Turkey
  • Ege University
    Izmir, Turkey
  • Celal Bayar University
    Manisa, Turkey
07

Registry details

Key details

Study ID
NCT03499470
Lead sponsor
Dokuz Eylul University
Collaborators
Celal Bayar University, Ege University, Gazi University, Duzce University, Cukurova University, Ataturk University, Uludag University, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul Sureyyapasa Chest Diseases and Chest Surgery Training and Research Hospital, T.C. ORDU ÜNİVERSİTESİ, Hacettepe University, Turkish Directorate General of Public Health, Istanbul University - Cerrahpasa, Diskapi Yildirim Beyazit Education and Research Hospital
Responsible party
Begum Ergan (Instructor, Dokuz Eylul University) — Principal investigator
First posted
Apr 17, 2018
Start date
Nov 7, 2016
Primary completion
Aug 31, 2019 (estimated)
Completion
Aug 31, 2019 (estimated)
Last update
Jul 18, 2019

Study contacts

BEGUM ERGAN, MD
study director · Dokuz Eylul University
TUGBA GOKTALAY, MD
study director · Celal Bayar University
PINAR ERGUN, MD
principal investigator · Health Sciences University Ataturk Chest Diseases and Chest Surgery Hospital
ALEV GURGUN, MD
principal investigator · Ege University
METIN AKGUN, MD
principal investigator · Ataturk University
NURDAN KOKTURK, MD
principal investigator · Gazi University
EZGI OZYILMAZ, MD
principal investigator · Cukurova University
ASLI DILEKTASLI, MD
principal investigator · Uludag University
BIRSEN OCAKLI, MD
principal investigator · Health Sciences University Sureyyapasa Chest Diseases and Chest Surgery Hospital
ONER BALBAY, MD
principal investigator · Duzce University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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