Long - Term Respiratory Rehabilitation Programs in Chronic Obstructive Pulmonary Disease (COPD) Patients: Study of Cost- Effectiveness
Recruitment status was Recruiting
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Purpose
OBJECTIVE: To determine whether a long-term maintenance program after respiratory rehabilitation, in contrast to the usual minimal maintenance therapy, improves the cost-effectiveness through: a.- maintaining long term effects in terms of effort capacity, HRQL, and reduced exacerbations b.- reducing the total cost of care to patients, largely through reduction of exacerbations.
MATERIAL AND METHODS: multi-center (4 hospitals) prospective randomized controlled study that will include 150 patients with moderate-severe COPD (age <75; BODE 4-10) with a 3 years follow-up. All patients will receive an initial in-hospital rehabilitation program which includes: Education, Physiotherapy, lower and upper extremities training and respiratory muscles training. Following completion of this program, patients will undergo concealed randomization to one of two maintenance strategies:1.-an intensive maintenance program (GR1) 2.- a standard, minimal monitoring program (GR2). On the intensive maintenance program (GR1) the physiotherapist will call once a week as a reminder and the patient will attend the hospital once a week . A physiotherapist will supervise the weekly in-hospital exercise and he/she will check if the patient is properly undergoing the rehabilitation treatment.
OUTCOMES: 1.- Clinical: dyspnea (area of CRQ questionnaire), HRQL (CRQ, SF 36); Effort capacity (6minute Walking Test), BODE index; 2.- Economical: direct costs (programs); indirect costs (exacerbations, admissions); comparison of GR1 and GR2 costs; EXPECTED OUTCOMES: reduction of dyspnea, improvement of HRQL, effort capacity and BODE index, and reduction of health expenditures in GR1 compared to GR2.
| Condition | Intervention |
|---|---|
|
Chronic Obstructive Pulmonary Disease |
Other: long-term maintenance respiratory rehabilitation program |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Long - Term Respiratory Rehabilitation Programs in Chronic Obstructive Pulmonary Disease (COPD) Patients: Study of Cost- Effectiveness. |
- 1.- Clinical: dyspnea (area of CRQ questionnaire), [ Time Frame: 1.5 YEARS ] [ Designated as safety issue: Yes ]
- Effort capacity (6minute Walking Test), [ Time Frame: 1.5 Years ] [ Designated as safety issue: Yes ]
- BODE index; [ Time Frame: 1.5 Years ] [ Designated as safety issue: Yes ]
- Economical: direct costs (programs); [ Time Frame: 1.5 Years ] [ Designated as safety issue: Yes ]
- indirect costs (exacerbations, admissions); [ Time Frame: 1.5 Years ] [ Designated as safety issue: Yes ]
- comparison of GR1 and GR2 costs; [ Time Frame: 1.5 Years ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 116 |
| Study Start Date: | October 2006 |
| Estimated Study Completion Date: | December 2012 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
No Intervention: 1
All patients will receive an initial in-hospital rehabilitation program which includes: Education, Physiotherapy, lower and upper extremities training and respiratory muscles training. Following completion of this program, patients will undergo concealed randomization to one of two maintenance strategies. The No Intervention group will undergo a standard, minimal monitoring program. |
Other: long-term maintenance respiratory rehabilitation program
To determine whether a long-term maintenance program after respiratory rehabilitation (group active comparator), in contrast to the usual minimal maintenance therapy (group no intervention), improves the cost-effectiveness through: a.- maintaining long term effects in terms of effort capacity, HRQL, and reduced exacerbations b.- reducing the total cost of care to patients, largely through reduction of exacerbations.
|
|
Active Comparator: 2
All patients will receive an initial in-hospital rehabilitation program which includes: Education, Physiotherapy, lower and upper extremities training and respiratory muscles training. Following completion of this program, patients will undergo concealed randomization to one of two maintenance strategies. The active comparator group will undergo an intensive maintenance program after the initial in-hospital rehabilitation program. |
Other: long-term maintenance respiratory rehabilitation program
To determine whether a long-term maintenance program after respiratory rehabilitation (group active comparator), in contrast to the usual minimal maintenance therapy (group no intervention), improves the cost-effectiveness through: a.- maintaining long term effects in terms of effort capacity, HRQL, and reduced exacerbations b.- reducing the total cost of care to patients, largely through reduction of exacerbations.
|
Eligibility| Ages Eligible for Study: | up to 77 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- COPD Patients
- Less than 77 years
- BODE index of 3-10 (BODE 3 when FEV1<50% v. Ref.).
- clinically stable (at least one month)
- Informed consent signed
Exclusion Criteria:
- Bone or muscle disease that limits the exercise training.
- Heart disease that disable physic exercise.
- Bronchiectasis or other Respiratory diseases different than COPD.
- Comorbidity that difficult o disable respiratory rehabilitation program carrying out.
- Life expectation less than 2 years.
Contacts and Locations| Contact: M Rosa Güell, Medical Doctor | +034935575972 ext - | MGuellR@santpau.cat |
| Contact: M Carme Puy, Physician | +034935575972 ext - | MPuyR@santpau.cat |
| Spain | |
| Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau | Recruiting |
| Barcelona, Spain, 08025 | |
| Contact: M Rosa Güell, Medical Doctor +034935575972 ext - MGuellR@santpau.cat | |
| Contact: M Carme Puy, Physician +034935575972 ext - MPuyR@santpau.cat | |
More Information
No publications provided
| Responsible Party: | Carme Puy Rion, Hospital del a Santa Creu i Sant Pau |
| ClinicalTrials.gov Identifier: | NCT01090999 History of Changes |
| Other Study ID Numbers: | PR04/04/2007 |
| Study First Received: | March 19, 2010 |
| Last Updated: | January 19, 2011 |
| Health Authority: | Spain: Ethics Committee |
Keywords provided by Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau:
|
COPD Pulmonary Rehabilitation |
Additional relevant MeSH terms:
|
Lung Diseases Respiration Disorders Pulmonary Disease, Chronic Obstructive Lung Diseases, Obstructive Respiratory Tract Diseases |
ClinicalTrials.gov processed this record on May 23, 2013