Wood Jamie, Jenkins Sue, Putrino David, Mulrennan Siobhain, Morey Sue, Cecins Nola, Hill Kylie
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
BMJ Open. 2018 Apr 21;8(4):e021136. doi: 10.1136/bmjopen-2017-021136.
In people with cystic fibrosis (CF), exacerbations have been shown to have profound and prolonged negative effects such as reducing physical activity and health-related quality of life, increasing the rate of decline of lung function and healthcare costs, and ultimately increasing the risk of mortality. Delayed initiation of treatment following the signs of an exacerbation has been shown to be associated with failure to recover to baseline. Therefore, the late identification and treatment of an exacerbation due to delayed presentation will potentially worsen short-term and long-term outcomes. We have developed a smartphone application, containing questions which require yes or no responses relating to symptoms suggestive of a respiratory exacerbation. Its use is intended to facilitate the early identification of symptoms suggestive of a respiratory exacerbation, and allow the CF team to initiate treatment sooner, thereby potentially reducing the risk of severe exacerbations which require intravenous antibiotics (IVAB) and often a hospital admission.
We will undertake a randomised controlled trial. 60 adults with CF will be recruited and randomised to either the intervention or control group. The intervention group will use the smartphone application weekly for 12 months, or earlier than the next weekly reporting time if they feel their symptoms have worsened. The control group will continue to receive usual care, involving regular (approximately 3 monthly) CF outpatient clinic appointments. The primary outcome measure will be courses and days of IVAB.
Approval was obtained from the Sir Charles Gairdner Group Human Research Ethics Committee for WA Health (2015-030) and Curtin University Human Research Ethics Committee (HR212/2015), and has been registered with the Australian and New Zealand Clinical Trials Registry. Results of this study will be presented at international conferences and published in peer-reviewed journals in accordance with the Consolidated Standards of Reporting Trials statement.
ACTRN12615000599572.
在囊性纤维化(CF)患者中,病情加重已被证明会产生深远且持久的负面影响,如降低体力活动和与健康相关的生活质量、加快肺功能下降速度并增加医疗成本,最终还会增加死亡风险。病情加重迹象出现后延迟开始治疗已被证明与无法恢复到基线水平有关。因此,由于就诊延迟导致病情加重的识别和治疗延迟可能会使短期和长期预后恶化。我们开发了一款智能手机应用程序,其中包含一些问题,这些问题需要对提示呼吸道病情加重的症状回答是或否。其用途旨在促进对提示呼吸道病情加重症状的早期识别,并使CF团队能够更快地开始治疗,从而有可能降低需要静脉使用抗生素(IVAB)且通常需要住院治疗的严重病情加重的风险。
我们将进行一项随机对照试验。将招募60名成年CF患者并随机分为干预组或对照组。干预组将每周使用该智能手机应用程序,持续12个月,或者如果他们感觉症状恶化,则在下次每周报告时间之前使用。对照组将继续接受常规护理,包括定期(约每3个月一次)的CF门诊预约。主要结局指标将是IVAB的疗程和天数。
已获得查尔斯·盖尔德纳爵士集团西澳大利亚卫生人类研究伦理委员会(2015 - 030)和科廷大学人类研究伦理委员会(HR212/2015)的批准,并已在澳大利亚和新西兰临床试验注册中心注册。本研究结果将在国际会议上展示,并根据《报告试验的统一标准》声明发表在同行评审期刊上。
ACTRN12615000599572。