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Tele-Coaching Intervention to Improve Treatment Adherence in Cystic Fibrosis

Primary Purpose

Cystic Fibrosis

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Tele-coaching
Sponsored by
Boston Children's Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Cystic Fibrosis focused on measuring Patient Care, Tele-health, Behavioral intervention

Eligibility Criteria

14 Years - 25 Years (Child, Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

COACH Participants:

1. Be a CF-focused clinician employed by one of the study sites, including: social workers; respiratory therapists, pharmacists, nurse practitioners, nurses, mental health coordinators, dieticians, and psychologists.

PATIENT Participants:

  1. Male or female ≥ 14 and ≤ 25 years of age;
  2. Documentation of a CF diagnosis as evidenced by one or more clinical features consistent with the CF phenotype and one or more of the following criteria: (a) sweat chloride > 60 mEq/L by quantitative pilocarpine iontophoresis test (QPIT), and/or (b) two well-characterized mutations in the CFTR (cystic fibrosis transmembrane conductance regulator) gene;
  3. Has been prescribed one or more respiratory nebulized medications, such as: (a) dornase alfa, (b) hypertonic saline, (c) inhaled tobramycin, (d) inhaled aztreonam, (e) inhaled colistimethate *and/or* uses a vest device for airway clearance;
  4. If taking, or anticipating to start on, Trikafta, has been taking the modulator for 6 weeks prior to enrolling in the study;
  5. Has access to necessary resources for participating in a technology-based intervention: (a) mobile phone, tablet, computer, or digital camera capable of capturing and sending a digital image, and access to Internet; (b) an email account;
  6. Is English-speaking;
  7. Endorsed score of ≥3 on any treatment component on the CF-CBS at Enrollment Visit.

CAREGIVER Participants:

  1. Is a caregiver of and resides with a Patient Participant in this study;
  2. Has received permission from the Patient Participant, if aged 18 years of age or older, to be in the study; and
  3. Is English-speaking.

Exclusion Criteria:

COACH Participants:

  1. Anticipated change in CF Center during study period;
  2. Physicians (MD, DO, or equivalent degree);
  3. Advanced practice providers (e.g., APRN, PA) who serve as the primary provider in the CF clinic setting; and
  4. Site research coordinator designated for this study.

PATIENT Participants:

  1. Participation in the previous Tele-coaching study;
  2. Anticipated transition to another CF care center within study period;
  3. Planned or scheduled hospitalization between consent and start of intervention;
  4. Self-reported current or planned pregnancy;
  5. Having a person in the same household who is also enrolled in the study;
  6. Presence of a condition, abnormality, or other factor that, in the opinion of the Investigator, would compromise the safety of the patient or the quality of the data including, but not limited to: (a) diagnosis of intellectual or developmental disability that would preclude safe or adequate completion of measures; (b) history of, or planned, lung transplant;
  7. Participation in concurrent studies targeting improvement in treatment adherence.

CAREGIVER Participants:

  1. Participation in the previous Tele-coaching study;
  2. Only one caregiver per Patient Participant can be enrolled in the Caregiver Cohort.

Sites / Locations

  • Stanford University
  • National Jewish Health
  • Northwestern University
  • University of Kansas Medical Center
  • University of Texas Southwestern Medical Center
  • West Virginia University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Intervention

Arm Description

6-months of 11 web-based intervention (tele-coaching) sessions (9 biweekly sessions and 2 monthly sessions) of approximately 30 minutes each; continued use of eTrack nebulizer and vest monitor photo capture as measures of adherence.

Outcomes

Primary Outcome Measures

Patient attrition
Patient attrition will be measured as the percentage of participants who do not receive a sufficient dose of the intervention.
Intervention acceptability for patients assessed by Likert scale
This measure was developed for this specific study to evaluate feasibility and acceptability of the intervention through aspects of usability, quality, and satisfaction. Assessed by 5 point Likert Scale: Strongly disagree, Disagree, Neither Agree or Disagree, Agree, Strongly Agree.
Intervention acceptability for coaches assessed by Likert scale
This measure was developed for this specific study to evaluate feasibility and acceptability of the intervention through aspects of usability, quality, and satisfaction. Assessed by 5 point Likert Scale: Strongly disagree, Disagree, Neither Agree or Disagree, Agree, Strongly Agree.
Recruitment and feasibility
Recruitment and feasibility will be evaluated using the percentage of screen failures which are the number of eligible participants who do not score at least a three on any given treatment component for the CF-CBS amongst all eligible participants.

Secondary Outcome Measures

Mean change in global adherence
Assess the preliminary effect of intervention on treatment adherence from data collected from vest photo capture and eTrack nebulizers. Vest photo capture will be scored as a ratio of total minutes used to total minutes prescribed in the study period. Medication adherence will be scored as a 'per drug analysis' of adherence with a ratio of competed to total prescribed doses in the study period. A composite score will be determined based on prescribed medications and medication/doses taken.
Change in treatment barriers
The CF-CBS (Cystic Fibrosis Care Behaviors Survey) will be used to analyze barriers to treatment. Measure will be based on an overall decrease (difference in means) in barrier specific frequency, specific treatment total barriers and the composite score for barriers from pre-intervention to post-intervention.

Full Information

First Posted
April 4, 2019
Last Updated
March 8, 2023
Sponsor
Boston Children's Hospital
Collaborators
Cystic Fibrosis Foundation, Johns Hopkins University, University of Kansas Medical Center, West Virginia University
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1. Study Identification

Unique Protocol Identification Number
NCT03921229
Brief Title
Tele-Coaching Intervention to Improve Treatment Adherence in Cystic Fibrosis
Official Title
Feasibility, Acceptability, and Pilot Randomized Controlled Trial of a Tele-Coaching Intervention to Improve Treatment Adherence in Cystic Fibrosis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Completed
Study Start Date
January 13, 2020 (Actual)
Primary Completion Date
January 31, 2023 (Actual)
Study Completion Date
February 1, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Boston Children's Hospital
Collaborators
Cystic Fibrosis Foundation, Johns Hopkins University, University of Kansas Medical Center, West Virginia University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a prospective, multicenter pilot study to investigate the feasibility and preliminary effectiveness of a tailored tele-coaching intervention to enhance medical adherence in patients with CF.
Detailed Description
This is a prospective, multicenter pilot study to test the feasibility and acceptability of a tele-coaching intervention and its implementation in patients with CF (ages 14-25 years), and to obtain estimates of treatment effects across a range of key outcome measures (e.g., global adherence, change in treatment barriers, specific improvement in adherence, etc.)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cystic Fibrosis
Keywords
Patient Care, Tele-health, Behavioral intervention

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
31 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Intervention
Arm Type
Experimental
Arm Description
6-months of 11 web-based intervention (tele-coaching) sessions (9 biweekly sessions and 2 monthly sessions) of approximately 30 minutes each; continued use of eTrack nebulizer and vest monitor photo capture as measures of adherence.
Intervention Type
Behavioral
Intervention Name(s)
Tele-coaching
Intervention Description
Patients will meet with a "tele-coach," who is a care team member, via video-calling, on a regular basis for six months to identify and address treatment adherence concern(s).
Primary Outcome Measure Information:
Title
Patient attrition
Description
Patient attrition will be measured as the percentage of participants who do not receive a sufficient dose of the intervention.
Time Frame
up to 30 months
Title
Intervention acceptability for patients assessed by Likert scale
Description
This measure was developed for this specific study to evaluate feasibility and acceptability of the intervention through aspects of usability, quality, and satisfaction. Assessed by 5 point Likert Scale: Strongly disagree, Disagree, Neither Agree or Disagree, Agree, Strongly Agree.
Time Frame
up to 30 months
Title
Intervention acceptability for coaches assessed by Likert scale
Description
This measure was developed for this specific study to evaluate feasibility and acceptability of the intervention through aspects of usability, quality, and satisfaction. Assessed by 5 point Likert Scale: Strongly disagree, Disagree, Neither Agree or Disagree, Agree, Strongly Agree.
Time Frame
up to 30 months
Title
Recruitment and feasibility
Description
Recruitment and feasibility will be evaluated using the percentage of screen failures which are the number of eligible participants who do not score at least a three on any given treatment component for the CF-CBS amongst all eligible participants.
Time Frame
up to 30 months
Secondary Outcome Measure Information:
Title
Mean change in global adherence
Description
Assess the preliminary effect of intervention on treatment adherence from data collected from vest photo capture and eTrack nebulizers. Vest photo capture will be scored as a ratio of total minutes used to total minutes prescribed in the study period. Medication adherence will be scored as a 'per drug analysis' of adherence with a ratio of competed to total prescribed doses in the study period. A composite score will be determined based on prescribed medications and medication/doses taken.
Time Frame
Day 1 to approximately week 51
Title
Change in treatment barriers
Description
The CF-CBS (Cystic Fibrosis Care Behaviors Survey) will be used to analyze barriers to treatment. Measure will be based on an overall decrease (difference in means) in barrier specific frequency, specific treatment total barriers and the composite score for barriers from pre-intervention to post-intervention.
Time Frame
Day 1 to approximately week 51
Other Pre-specified Outcome Measures:
Title
Exploratory outcome: self-reported adherence
Description
We will compare the Self-Reported Adherence measure and the CF-CBS Self-Reported Adherence using Pearson Correlations.
Time Frame
Day 1 to approximately week 51

10. Eligibility

Sex
All
Minimum Age & Unit of Time
14 Years
Maximum Age & Unit of Time
25 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: COACH Participants: 1. Be a CF-focused clinician employed by one of the study sites, including: social workers; respiratory therapists, pharmacists, nurse practitioners, nurses, mental health coordinators, dieticians, and psychologists. PATIENT Participants: Male or female ≥ 14 and ≤ 25 years of age; Documentation of a CF diagnosis as evidenced by one or more clinical features consistent with the CF phenotype and one or more of the following criteria: (a) sweat chloride > 60 mEq/L by quantitative pilocarpine iontophoresis test (QPIT), and/or (b) two well-characterized mutations in the CFTR (cystic fibrosis transmembrane conductance regulator) gene; Has been prescribed one or more respiratory nebulized medications, such as: (a) dornase alfa, (b) hypertonic saline, (c) inhaled tobramycin, (d) inhaled aztreonam, (e) inhaled colistimethate *and/or* uses a vest device for airway clearance; If taking, or anticipating to start on, Trikafta, has been taking the modulator for 6 weeks prior to enrolling in the study; Has access to necessary resources for participating in a technology-based intervention: (a) mobile phone, tablet, computer, or digital camera capable of capturing and sending a digital image, and access to Internet; (b) an email account; Is English-speaking; Endorsed score of ≥3 on any treatment component on the CF-CBS at Enrollment Visit. CAREGIVER Participants: Is a caregiver of and resides with a Patient Participant in this study; Has received permission from the Patient Participant, if aged 18 years of age or older, to be in the study; and Is English-speaking. Exclusion Criteria: COACH Participants: Anticipated change in CF Center during study period; Physicians (MD, DO, or equivalent degree); Advanced practice providers (e.g., APRN, PA) who serve as the primary provider in the CF clinic setting; and Site research coordinator designated for this study. PATIENT Participants: Participation in the previous Tele-coaching study; Anticipated transition to another CF care center within study period; Planned or scheduled hospitalization between consent and start of intervention; Self-reported current or planned pregnancy; Having a person in the same household who is also enrolled in the study; Presence of a condition, abnormality, or other factor that, in the opinion of the Investigator, would compromise the safety of the patient or the quality of the data including, but not limited to: (a) diagnosis of intellectual or developmental disability that would preclude safe or adequate completion of measures; (b) history of, or planned, lung transplant; Participation in concurrent studies targeting improvement in treatment adherence. CAREGIVER Participants: Participation in the previous Tele-coaching study; Only one caregiver per Patient Participant can be enrolled in the Caregiver Cohort.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Deepika Polineni, MD, MPH
Organizational Affiliation
University of Kansas Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Christina Duncan, PhD
Organizational Affiliation
West Virginia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stanford University
City
Palo Alto
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
National Jewish Health
City
Denver
State/Province
Colorado
ZIP/Postal Code
80206
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Facility Name
University of Texas Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Facility Name
West Virginia University
City
Morgantown
State/Province
West Virginia
ZIP/Postal Code
26506
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Tele-Coaching Intervention to Improve Treatment Adherence in Cystic Fibrosis

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