The CAPTURE Study: Validating a Unique COPD Case Finding Tool in Primary Care (Aim 3) (CAPTURE)

• ClinicalTrials.gov Identifier: NCT03583099
• Recruitment Status: Recruiting
• First Posted: July 11, 2018
• Last Update Posted: January 24, 2022
• Sponsor: Weill Medical College of Cornell University
• Collaborators: National Heart, Lung, and Blood Institute (NHLBI); University of Michigan; National Jewish Health; Wake Forest University Health Sciences; Duke University; High Plains Research Network; L.A. Net Community Health Resource Network; Oregon Health and Science University; University of Kentucky; University of Minnesota; COPD Foundation
• Information provided by (Responsible Party): Weill Medical College of Cornell University

Study Description

Brief Summary:

A prospective, multicenter study including a cross-section validation to define sensitivity and specificity of CAPTURE to identify previously undiagnosed patients with clinically significant Chronic Obstructive Pulmonary Disease (COPD), and its impact on clinical care across a broad range of primary care settings in a cluster randomized controlled clinical trial.

Condition or disease	Intervention/treatment	Phase
Chronic Obstructive Pulmonary Disease (COPD)	Other: COPD plus CAPTURE education and patient-level information; Other: COPD Education Only	Not Applicable

Detailed Description:

This is a large prospective, multi-center study explore the impact of the CAPTURE tool on clinical care and patient outcomes across a broad range of primary care settings in a cluster randomized controlled clinical trial.

The CAPTURE tool consists of a 5-item self-administered questionnaire and selected use of peak expiratory flow (PEF) measurement, designed to identify clinically significant COPD.

The study will enroll approximately 5,000 patients across 100 participating primary care clinics associated with practice-based research networks (PBRNs). Participants will be assessed with the CAPTURE Tool and have research spirometry testing.

Participating primary care practices will be randomized in a 1:1 fashion to one of the following interventions:

• Arm 1: Practice clinicians will receive basic COPD education, and patient-level CAPTURE information with CAPTURE interpretation education (CAPTURE+ COPD education).
• Arm 2: Practice clinicians will receive basic COPD education only (COPD education) and will be blinded to patient-level CAPTURE information.

A predefined subgroup of participants will undergo longitudinal follow-up at 12 months to determine the impact of the CAPTURE Tool on clinical care and patient outcomes. Participant reported data will be collected through in-person visits, telephone and mail-based methodologies, depending upon practice site preferences and feasibility. Clinic site data will also be collected from the medical record to assess for changes in practice-level care.

Study Design

• Study Type: Interventional (Clinical Trial)
• Estimated Enrollment: 5000 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment

Intervention Model Description

Participating primary practices will be randomized to one of 2 arms.

• Arm 1: Practice clinicians will receive basic COPD education, and patient-level CAPTURE information with CAPTURE interpretation education (CAPTURE+ COPD education).
• Arm 2: Practice clinicians will receive basic COPD education only (COPD education).

• Masking: Double (Participant, Care Provider)

Masking Description

Practitioners at sites randomized to the COPD education only intervention will be blinded to CAPTURE scores.

Practitioners in both intervention arms will be blinded to research spirometry results.

Participants will be blinded to spirometry results.

• Primary Purpose: Other
• Official Title: The CAPTURE Study: Validating a Unique Chronic Obstructive Pulmonary Disease (COPD) Case Finding Tool in Primary Care
• Actual Study Start Date: September 17, 2018
• Estimated Primary Completion Date: February 28, 2023
• Estimated Study Completion Date: February 28, 2023

Arms and Interventions

Arm	Intervention/treatment
Experimental: CAPTURE + COPD Education; Practice clinicians will receive basic COPD education, and patient-level CAPTURE information with CAPTURE interpretation education. As the second aim address the optimal format for delivering practice CAPTURE education this will be incorporated at the sites randomized to this arm.	Other: COPD plus CAPTURE education and patient-level information; Basic COPD Education plus CAPTURE education and patient-level CAPTURE information will be provided to all practice personnel randomized to the 'CAPTURE + COPD Education' arm.
Active Comparator: COPD Education; Practice clinicians will receive basic COPD education only.	Other: COPD Education Only; Practice clinicians will receive basic COPD education only. Patient-level CAPTURE information will not be provided.

Outcome Measures

Primary Outcome Measures :

1. Proportion of CAPTURE+ participants who meet a composite endpoint for diagnosis and management of COPD [ Time Frame: Baseline to 12 months ]
   Proportion of CAPTURE+ participants who meet one of the following (composite endpoint): 1) referral for clinical spirometry testing, 2) new diagnosis of COPD, 3) newly prescribed respiratory medication (long acting bronchodilator or anti-inflammatory for respiratory condition), or 4) referral to a specialist for respiratory evaluation/treatment CAPTURE+ is defined as Participants with: CAPTURE score > 5, or CAPTURE score of 2, 3, or 4 with a low PEF, defined as <350 L/min for males and <250 L/min for females

Secondary Outcome Measures :

1. Proportion of CAPTURE+ participants who are referred for or completion of clinical spirometry testing [ Time Frame: Baseline to 12 months ]
   Proportion of CAPTURE+ participants who are referred for or completion of clinical spirometry testing
2. Proportion of CAPTURE+ participants who are newly diagnosed with COPD [ Time Frame: Baseline to 12 months ]
   Proportion of CAPTURE+ participants who are newly diagnosed with COPD
3. Proportion of CAPTURE+ participants with newly prescribed respiratory medication [ Time Frame: Baseline to 12 months ]
   Proportion of CAPTURE+ participants with newly prescribed respiratory medication (long acting bronchodilator or anti-inflammatory for respiratory condition)
4. Proportion of CAPTURE+ participants referred to a specialist for respiratory evaluation/treatment [ Time Frame: Baseline to 12 months ]
   Proportion of CAPTURE+ participants referred to a specialist for respiratory evaluation/treatment.
5. Incidence of physician referral to a formal smoking cessation program in subjects with clinically significant COPD and are current smokers [ Time Frame: Baseline to 12 months ]
   Incidence of physician referral to a formal smoking cessation program in subjects with clinically significant COPD, defined as post-bronchodilator forced expiratory volume at 1 second/forced vital capacity (FEV1/FVC) < 0.7, plus one of the following: FEV1 < 60% predicted, or > 1 exacerbation-like event within the past 12 months, and are current smokers.
6. Incidence of physician referral to pulmonary rehabilitation program in subjects with clinically significant COPD and are current smokers [ Time Frame: Baseline to 12 months ]
   Incidence of physician referral to pulmonary rehabilitation program in subjects with clinically significant COPD and are current smokers, defined as post-bronchodilator FEV1/FVC < 0.7, plus one of the following: FEV1 < 60% predicted, or > 1 exacerbation-like event within the past 12 months, and are current smokers
7. Incidence of physician prescribed smoking cessation medication in subjects with clinically significant COPD and are current smokers [ Time Frame: Baseline to 12 months ]
   Incidence of physician prescribed smoking cessation medication in subjects with clinically significant COPD, defined as post-bronchodilator FEV1/FVC < 0.7, plus one of the following: FEV1 < 60% predicted, or > 1 exacerbation-like event within the past 12 months, and are current smokers
8. Incidence of physician referral to a formal smoking cessation program in subjects with spirometrcially defined COPD and are current smokers [ Time Frame: Baseline to 12 months ]
   Incidence of physician referral to a formal smoking cessation program in subjects with spirometrcially defined COPD (post-bronchodilator FEV1/FVC < 0.70)
9. Incidence of physician prescribed smoking cessation medication in subjects with spirometrcially defined COPD and are current smokers [ Time Frame: Baseline to 12 months ]
   Incidence of physician prescribed smoking cessation medication in subjects with spirometrcially defined COPD (post-bronchodilator FEV1/FVC < 0.70) and are current smokers
10. Incidence of physician referral to pulmonary rehabilitation program in subjects with spirometrcially defined COPD and are current smokers [ Time Frame: Baseline to 12 months ]
    Incidence of physician referral to pulmonary rehabilitation program in subjects with spirometrcially defined COPD (post-bronchodilator FEV1/FVC < 0.70) and are current smokers
11. Change in COPD Assessment Test (CAT) score in participants with clinically significant COPD [ Time Frame: Baseline to 12 months ]
    Change in CAT score in participants with clinically significant COPD
12. Change in COPD Assessment Test (CAT) score in participants with spirometrically defined COPD [ Time Frame: Baseline to 12 months ]
    Change in COPD Assessment Test (CAT) score in participants with spirometrically defined COPD (post-bronchodilator FEV1/FVC < 0.70)
13. Proportion of participants with clinically significant COPD who experience exacerbations, hospitalizations, or mortality [ Time Frame: Baseline to 12 months ]
    Proportion of participants with clinically significant COPD who experience exacerbations, hospitalizations, or mortality
14. Proportion of participants with spirometrically defined COPD who experience exacerbations, hospitalizations, or mortality [ Time Frame: Baseline to 12 months ]
    Proportion of participants with spirometrically defined COPD, (post-bronchodilator FEV1/FVC < 0.70) who experience exacerbations, hospitalizations, or mortality
15. Proportion of participants with spirometrically defined COPD who meet a composite endpoint for diagnosis and management of COPD [ Time Frame: Baseline to 12 months ]
    Proportion of participants with spirometrically defined COPD who meet one of the following (composite endpoint): 1) referral for clinical spirometry testing, 2) new diagnosis of COPD, 3) newly prescribed respiratory medication (long acting bronchodilator or anti-inflammatory for respiratory condition), or 4) referral to a specialist for respiratory evaluation/treatment CAPTURE+ is defined as Participants with: CAPTURE score > 5, or CAPTURE score of 2, 3, or 4 with a low PEF, defined as <350 L/min for males and <250 L/min for females

Eligibility Criteria

• Ages Eligible for Study: 45 Years to 80 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

• 1. Provision of signed and dated informed consent form
• 2. Stated willingness to comply with all study procedures and availability for the duration of the study
• 3. Male or female, aged 45 - 80 years

Exclusion Criteria:

• 1. Previous clinician provided diagnosis of COPD
• 2. Treated respiratory infection (with antibiotics and/or systemic steroids) in the past 30 days

• 3. Participants unable to perform spirometry due to any of the following conditions within the past 30 days

  1. Chest surgery
  2. Abdominal surgery
  3. Eye surgery
  4. Heart attack
  5. Stroke

Contacts and Locations

Contacts

Contact: Fernando J Martinez, MD, MS; 646-962-2748; fjm2003@med.cornell.edu

Contact: Elizabeth Peters, BSN, RN; 646-962-2742; elp2018@med.cornell.edu

Locations

United States, California

LANet; Active, not recruiting

Los Angeles, California, United States, 90802

United States, Colorado

High Plains Research Network; Recruiting

Aurora, Colorado, United States, 80054

Contact: Linda Zittleman, MSPH 303-724-9716 linda.zittleman@ucdenver.edu

United States, Florida

COPD Foundation; Not yet recruiting

Miami, Florida, United States, 33134

Contact: Barbara Yawn, MD Byawn@copdfoundation.org

United States, Illinois

Cook County Hospital; Recruiting

Chicago, Illinois, United States, 60612

Contact: Min Joo, MD, MPH 312-996-8039 joo@uic.edu

Contact: Esther Pacheco 312-413-3438 estherp@uic.edu

University of Illinois at Chicago; Recruiting

Chicago, Illinois, United States, 60612

Contact: Min Joo, MD, MPH 312-996-8039 joo@uic.edu

Contact: Esther Pacheco 312-413-3438 estherp@uic.edu

United States, New York

Circuit Clinical; Recruiting

Buffalo, New York, United States, 14203

Contact: Irfan Khan, MD 216-409-8980 ikhan@circuitclinical.com

United States, North Carolina

Atrium Healthcare; Recruiting

Charlotte, North Carolina, United States, 28207

Contact: Hazel Tapp, PhD 704-304-7120 Hazel.Tapp@atriumhealth.org

Duke University; Recruiting

Durham, North Carolina, United States, 27701

Contact: Rowena Dolor, MD 919-668-8627 rowena.dolor@duke.edu

United States, Oregon

Oregon Rural Practice-based Research Network (ORPRN); Active, not recruiting

Portland, Oregon, United States, 97239

Sponsors and Collaborators

Weill Medical College of Cornell University

National Heart, Lung, and Blood Institute (NHLBI)

University of Michigan

National Jewish Health

Wake Forest University Health Sciences

Duke University

High Plains Research Network

L.A. Net Community Health Resource Network

Oregon Health and Science University

University of Kentucky

University of Minnesota

COPD Foundation

Investigators

• Principal Investigator: Fernando J Martinez, MD, MS; Weill Medical College of Cornell University
• Principal Investigator: MeiLan Han, MD, MS; University of Michigan

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Cross AJ, Thomas D, Liang J, Abramson MJ, George J, Zairina E. Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care. Cochrane Database Syst Rev. 2022 May 6;5:CD012652. doi: 10.1002/14651858.CD012652.pub2. Review.

• Responsible Party: Weill Medical College of Cornell University
• ClinicalTrials.gov Identifier: NCT03583099
• Other Study ID Numbers: 1803019032-3; R01HL136682-01 ( U.S. NIH Grant/Contract )
• First Posted: July 11, 2018
• Last Update Posted: January 24, 2022
• Last Verified: January 2022

• Studies a U.S. FDA-regulated Drug Product: No
• Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:

Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive; Respiratory Tract Diseases