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Virtual Peer-to-peer Support Programme for Carers of MND

Primary Purpose

Motor Neuron Disease, Amyotrophic Lateral Sclerosis

Status
Recruiting
Phase
Not Applicable
Locations
United Kingdom
Study Type
Interventional
Intervention
Virtual peer-to-peer support
Sponsored by
King's College London
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Motor Neuron Disease focused on measuring caregiver

Eligibility Criteria

18 Years - 100 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. age ≥ 18 years;
  2. family/informal caregiver of an individual with MND living at home who is referred for consideration or receiving any of the following i.e., entering King's clinical staging Stage 4A: nutritional support; or Stage 4B: respiratory support [51]:

    1. assisted ventilation
    2. cough assist
    3. gastroscopy and enteral feeding
  3. able to speak/read English;
  4. has access to a computer, tablet, or smartphone and the internet (we have the ability to provide loan 4G enabled tablets if required); and
  5. consents to participation

Exclusion Criteria:

1. Actively receiving psychiatric/psychologist care identified through self-report.

Sites / Locations

  • Bedfordshire Hospitals NHS Foundation TrustRecruiting
  • Airedale NHS Foundation TrustRecruiting
  • University Hospitals Sussex NHS Foundation TrustRecruiting
  • Pilgrims HospiceRecruiting
  • Coventry Community Specialist Palliative Care TeamRecruiting
  • University Hospitals Coventry and Warwickshire NHS TrustRecruiting
  • Ninewells HospitalRecruiting
  • Royal Devon University Healthcare NHS Foundation TrustRecruiting
  • Phyllis Tuckwell HospiceRecruiting
  • Medway Community HealthcareRecruiting
  • Kingston Hospital NHS FoundationRecruiting
  • The Leicestershire & Rutland Organisation for the Relief of Suffering - LOROSRecruiting
  • The Walton Centre NHS Foundation TrustRecruiting
  • Guy's and St Thomas' NHS Foundation TrustRecruiting
  • Lancashire Teaching Hospitals NHS Foundation TrustRecruiting
  • Marie Curie HospiceRecruiting
  • Nottinghamshire Healthcare NHS Foundation TrustRecruiting
  • Royal Stoke University Hospital/University Hospitals NorthRecruiting
  • Swansea Bay University Health BoardRecruiting
  • University Hospitals Plymouth NHS trustRecruiting
  • Sheffield Teaching Hospitals NHS Foundation TrustRecruiting
  • Severn HospiceRecruiting
  • St Margaret's HospiceRecruiting
  • Hounslow and Richmond Community HealthcareRecruiting
  • Compton CareRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Virtual Peer-to-Peer Support

Control

Arm Description

Those participants randomised to the intervention arm will have access to a 12-week virtual peer-to-peer support programme which entails: weekly audio, video, or text private messaging with a peer supporter; synchronous weekly discussion forum attended by peer supporters and family caregiver participants moderated by the research team. These forums will discuss specific topics (e.g. caregiver self-care, the emotional impact of caregiving). Ask the expert forums will be moderated by clinical experts every 6 weeks (meaning all participants will have access to 2 ask the expert sessions); asynchronous discussion forums in which participants can post questions; and access to informational resources.

Those participants randomised to the control arm will receive usual care which comprises self-directed access to the MND Association Visitors programme and MND Association educational resources via their website.

Outcomes

Primary Outcome Measures

Hospital Anxiety and Depression Score (HADS)
Change in Hospital Anxiety and Depression Score from baseline to programme completion. The Hospital Anxiety and Depression Score Overall score ranges from 0 [best] to 21 [worst] with cutoff points of >7 (possible) and >10 (probable) indicating cases of anxiety or depression.

Secondary Outcome Measures

Positive and Negative Affect Schedule
10-item Positive Affect Scale of the Positive and Negative Affect Schedule from baseline to programme completion. Scores range from 10 to 50; higher scores indicate more psychological well-being.
Zarit Burden Interview (ZBI)
Change in ZBI score from baseline to programme completion. The sum of scores ranges between 0 to 88. Higher scores indicate greater burden. Caregivers can be categorised as 'highly burdened' (score of ≥ 24) and low burdened groups (score <24)
Pearlin Mastery Scale
Change in Pearlin Mastery Scale from baseline to programme completion. The Pearlin Mastery Scale is a 7 item scale with scores from 7 to 28. Higher scores indicate a greater sense of control over life.
Brief-COPE (note COPE is not an abbreviation)
Change in Brief COPE from baseline to programme completion. 14 scales with 2 items (28 items in total. Scores on each scale range from 2 (minimum) to 8 (maximum). Higher scores indicate increased utilisation of that specific coping strategy.

Full Information

First Posted
December 19, 2020
Last Updated
April 26, 2023
Sponsor
King's College London
Collaborators
MND Association, Marie Curie Charity, Guy's and St Thomas' NHS Foundation Trust
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1. Study Identification

Unique Protocol Identification Number
NCT04695210
Brief Title
Virtual Peer-to-peer Support Programme for Carers of MND
Official Title
A Virtual Peer-to-peer Support Programme for Family Caregivers of Individuals With Motor Neurone Disease at Risk of Becoming or Currently Technology-dependent: Randomised Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 15, 2022 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
King's College London
Collaborators
MND Association, Marie Curie Charity, Guy's and St Thomas' NHS Foundation Trust

4. Oversight

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

5. Study Description

Brief Summary
Background/scope There is growing recognition that family caregiving is a serious public health issue requiring supportive interventions. Family caregivers play an essential role in sustaining a stable environment enabling individuals with motor neurone disease (MND) that are technology dependent to live at home. The family caregivers can experi¬ence exceptional burden and significant decline in psychological wellbeing due to MND's rapid and pro¬gressive nature with profoundly debilitating effects and intensive support needs. Dependence on assistive technology adds an additional level of complexity to family caregiving due to the need to learn how to operate and troubleshoot medical devices, train other caregivers, and negotiate appointments with new specialties within the healthcare system. Despite the recognized impact of caregiving for individuals with MND, data are scarce as to effective interventions that provide direct practical and psychosocial supports. Difficulty accessing support may increase psychological distress. As the burden of caring increases due to disease progression and increasing technology dependence, access to existing informal support networks may diminish. Online peer support using virtual modalities is a flexible and low cost form of support. Peers, people who have experienced the same health problem and have similar characteristics as support recipients, can be a key source of emotional, informational, and affirmational support. Peer support improves psychological well-being of caregivers of people with conditions such as dementia, cancer, and brain injury. Although peer support programmes for family caregivers of people with MND exist, data as to their efficacy are limited. Therefore, we have developed an online peer support programme, completed beta and usability testing and now propose to test the effect on caregiver psychological wellbeing and caregiver burden. Aim/research question(s) Overall aim: to determine the efficacy of a 12-week online peer support programme on family caregiver psychological health and caregiver burden. Primary research question: What is the effect of the online peer support programme on psychological distress measured using the Hospital Anxiety and Depression Scale (HADS)? Secondary research questions: What is the effect on positive affect, caregiver burden, caregiving mastery, caregiving personal gain, and coping? How do participants use the programme (fidelity and reach)? What is the perceived usability and acceptability? Methods The investigators will conduct a parallel group randomised controlled trial with participants allocated to 12-week access to the online peer support programme or a usual care control group. The investigators will enrol family caregivers of an individual with MND who is referred for consideration or receiving any of the following assisted ventilation cough assist gastroscopy and enteral feeding i.e., entering King's clinical staging Stage 4A: nutritional support; or Stage 4B: respiratory support [51]: The 12-week peer-to-peer support programme entails: audio, video, or text private messaging; synchronous weekly chat; asynchronous discussion forum; and informational resources. The investigators will collect demographic and caregiving data including the Caregiver Assistance Scale and Caregiving Impact Scale, and caregiver measures (HADS, Positive and Negative Affect Schedule, Zarit Burden Interview, Pearlin Mastery Scale, Personal Gain Scale, Brief COPE) at baseline and programme completion. The investigators will download use of online peer support programme features, assess usability, and conduct semi-structured interviews to explore acceptability using the Theoretical Framework of Acceptability. To test for a medium size effect (d=0.5), at 5% level of significance (2-sided) with power 80%, 64 participants are required in each arm (128 total). Adjusting for 20% attrition requires 154 participants. Proposed findings The proposed study will demonstrate the effect of a online peer support programme on psychological distress, positive affect, caregiving burden, mastery, personal gain and coping. Data on programme fidelity will enable the investigators to objectively assess acceptability and interpret study results. Data on usability and acceptability will inform future scalability of the online peer support programme outside of the trial both nationally and internationally, and to other family caregiver populations.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Motor Neuron Disease, Amyotrophic Lateral Sclerosis
Keywords
caregiver

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Parallel group single blinded (outcome assessor) randomised controlled trial
Masking
InvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
154 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Virtual Peer-to-Peer Support
Arm Type
Experimental
Arm Description
Those participants randomised to the intervention arm will have access to a 12-week virtual peer-to-peer support programme which entails: weekly audio, video, or text private messaging with a peer supporter; synchronous weekly discussion forum attended by peer supporters and family caregiver participants moderated by the research team. These forums will discuss specific topics (e.g. caregiver self-care, the emotional impact of caregiving). Ask the expert forums will be moderated by clinical experts every 6 weeks (meaning all participants will have access to 2 ask the expert sessions); asynchronous discussion forums in which participants can post questions; and access to informational resources.
Arm Title
Control
Arm Type
No Intervention
Arm Description
Those participants randomised to the control arm will receive usual care which comprises self-directed access to the MND Association Visitors programme and MND Association educational resources via their website.
Intervention Type
Behavioral
Intervention Name(s)
Virtual peer-to-peer support
Intervention Description
See arm description
Primary Outcome Measure Information:
Title
Hospital Anxiety and Depression Score (HADS)
Description
Change in Hospital Anxiety and Depression Score from baseline to programme completion. The Hospital Anxiety and Depression Score Overall score ranges from 0 [best] to 21 [worst] with cutoff points of >7 (possible) and >10 (probable) indicating cases of anxiety or depression.
Time Frame
6 weeks & 12 weeks
Secondary Outcome Measure Information:
Title
Positive and Negative Affect Schedule
Description
10-item Positive Affect Scale of the Positive and Negative Affect Schedule from baseline to programme completion. Scores range from 10 to 50; higher scores indicate more psychological well-being.
Time Frame
12 weeks
Title
Zarit Burden Interview (ZBI)
Description
Change in ZBI score from baseline to programme completion. The sum of scores ranges between 0 to 88. Higher scores indicate greater burden. Caregivers can be categorised as 'highly burdened' (score of ≥ 24) and low burdened groups (score <24)
Time Frame
6 weeks & 12 weeks
Title
Pearlin Mastery Scale
Description
Change in Pearlin Mastery Scale from baseline to programme completion. The Pearlin Mastery Scale is a 7 item scale with scores from 7 to 28. Higher scores indicate a greater sense of control over life.
Time Frame
12 weeks
Title
Brief-COPE (note COPE is not an abbreviation)
Description
Change in Brief COPE from baseline to programme completion. 14 scales with 2 items (28 items in total. Scores on each scale range from 2 (minimum) to 8 (maximum). Higher scores indicate increased utilisation of that specific coping strategy.
Time Frame
12 weeks
Other Pre-specified Outcome Measures:
Title
Usability
Description
For those participants in the intervention arm, on programme completion we will also ask them to rate the usability of the virtual peer-to-peer support programme on a 9-point Likert scale ranging from difficult to easy.
Time Frame
At 12 weeks following programme completion
Title
Acceptability
Description
Semi-structured qualitative interviews exploring perceived acceptability of the virtual peer-to-peer support programme following programme completion
Time Frame
After 12 weeks following programme completion

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
100 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: age ≥ 18 years; family/informal caregiver of an individual with MND living at home who is referred for consideration or receiving any of the following i.e., entering King's clinical staging Stage 4A: nutritional support; or Stage 4B: respiratory support [51]: assisted ventilation cough assist gastroscopy and enteral feeding able to speak/read English; has access to a computer, tablet, or smartphone and the internet (we have the ability to provide loan 4G enabled tablets if required); and consents to participation Exclusion Criteria: 1. Actively receiving psychiatric/psychologist care identified through self-report.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Louise Rose, PhD
Phone
+44 2078383616
Email
louise.rose@kcl.ac.uk
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Louise Rose, PhD
Organizational Affiliation
King's College London
Official's Role
Principal Investigator
Facility Information:
Facility Name
Bedfordshire Hospitals NHS Foundation Trust
City
Bedford
ZIP/Postal Code
MK42 9DJ
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Airedale NHS Foundation Trust
City
Bradford
ZIP/Postal Code
BD20 6TD
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
University Hospitals Sussex NHS Foundation Trust
City
Brighton
ZIP/Postal Code
BN2 1DH
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Pilgrims Hospice
City
Canterbury
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Coventry Community Specialist Palliative Care Team
City
Coventry
ZIP/Postal Code
CV1 4NZ
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
University Hospitals Coventry and Warwickshire NHS Trust
City
Coventry
ZIP/Postal Code
CV2 2DX
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Ninewells Hospital
City
Dundee
ZIP/Postal Code
DD1 9SY
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Royal Devon University Healthcare NHS Foundation Trust
City
Exeter
ZIP/Postal Code
EX2 5DW
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Phyllis Tuckwell Hospice
City
Farnham
ZIP/Postal Code
GU9 8BL
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Medway Community Healthcare
City
Gillingham
ZIP/Postal Code
ME8 0PZ
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Kingston Hospital NHS Foundation
City
Kingston upon Thames
ZIP/Postal Code
KT2 7QB
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
The Leicestershire & Rutland Organisation for the Relief of Suffering - LOROS
City
Leicester
ZIP/Postal Code
LE3 9QE
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
The Walton Centre NHS Foundation Trust
City
Liverpool
ZIP/Postal Code
L9 7LJ
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Guy's and St Thomas' NHS Foundation Trust
City
London
ZIP/Postal Code
SE1 9RT
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rebecca Rogers
Email
peersupport@kcl.ac.uk
First Name & Middle Initial & Last Name & Degree
Thilipan Thaventhiran, PhD
Email
peersupport@kcl.ac.uk
Facility Name
Lancashire Teaching Hospitals NHS Foundation Trust
City
Multiple Locations
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Marie Curie Hospice
City
Multiple Locations
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Nottinghamshire Healthcare NHS Foundation Trust
City
Multiple Locations
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Royal Stoke University Hospital/University Hospitals North
City
Multiple Locations
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Swansea Bay University Health Board
City
Multiple Locations
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
University Hospitals Plymouth NHS trust
City
Plymouth
ZIP/Postal Code
PL6 8DH
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Sheffield Teaching Hospitals NHS Foundation Trust
City
Sheffield
ZIP/Postal Code
S10 2JF
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Severn Hospice
City
Shrewsbury
ZIP/Postal Code
SY3 8HS
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
St Margaret's Hospice
City
Taunton
ZIP/Postal Code
TA1 5HA
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Hounslow and Richmond Community Healthcare
City
Teddington
ZIP/Postal Code
TW11 8HU
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk
Facility Name
Compton Care
City
Wolverhampton
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
Email
peersupport@kcl.ac.uk

12. IPD Sharing Statement

Plan to Share IPD
No

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Virtual Peer-to-peer Support Programme for Carers of MND

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