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针对新冠病毒后综合征(PACS)的筛查和评估,由个人飞行员提供指导,并在跨部门护理中提供个性化数字培训:一项随机对照试验的研究方案。

Screening and assessment for post-acute COVID-19 syndrome (PACS), guidance by personal pilots and support with individual digital trainings within intersectoral care: a study protocol of a randomized controlled trial.

机构信息

Klinikum Wolfsburg, Sauerbruchstraße 7, 38440, Wolfsburg, Germany.

Jacobs University Bremen gGmbH, Campus Ring 1, 28759, Bremen, Germany.

出版信息

BMC Infect Dis. 2022 Aug 15;22(1):693. doi: 10.1186/s12879-022-07584-z.

DOI:10.1186/s12879-022-07584-z
PMID:35971066
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9377288/
Abstract

BACKGROUND

Because the clinical patterns and symptoms that persist after a COVID-19 infection are diverse, a diagnosis of post-acute COVID-19 syndrome (PACS) is difficult to implement. The current research project therefore aims to evaluate the feasibility and the practicability of a comprehensive, interdisciplinary, and cross-sectoral treatment program consisting of a low-threshold online screening and holistic assessment for PACS. Furthermore, it aims to evaluate digital interventions and the use of so-called personal guides that may help to facilitate the recovery of PACS.

METHODS

This German study consists of a low-threshold online screening for PACS where positively screened participants will be supported throughout by personal pilots. The personal pilots are aimed at empowering patients and helping them to navigate through the study and different treatment options. Patients will then be randomly assigned either to an intervention group (IG) or an active control group (ACG). The IG will receive a comprehensive assessment of physiological and psychological functioning to inform future treatment. The ACG does not receive the assessment but both groups will receive a treatment consisting of an individual digital treatment program (digital intervention platform and an intervention via a chatbot). This digital intervention is based on the needs identified during the assessment for participants in the IG. Compared to that, the ACG will receive a more common digital treatment program aiming to reduce PACS symptoms. Importantly, a third comparison group (CompG) will be recruited that does not receive any treatment. A propensity score matching will take place, ensuring comparability between the participants. Primary endpoints of the study are symptom reduction and return to work. Secondary outcomes comprise, for example, social participation and activities in daily life. Furthermore, the feasibility and applicability of the online screening tool, the holistic assessment, digital trainings, and personal pilots will be evaluated.

DISCUSSION

This is one of the first large-scale studies to improve the diagnosis and the care of patients with PACS by means of empowerment. It is to be evaluated whether the methods utilized can be used for the German and international population. Trial registration ClinicalTrials.gov Identifier: NCT05238415; date of registration: February 14, 2022.

摘要

背景

由于 COVID-19 感染后持续存在的临床模式和症状多种多样,因此难以实施新冠后综合征(PACS)的诊断。因此,目前的研究项目旨在评估由低门槛在线筛查和整体评估组成的综合、跨学科和跨部门治疗方案的可行性和实用性,该方案用于治疗 PACS。此外,它旨在评估数字干预措施和使用所谓的个人指南,这些可能有助于促进 PACS 的康复。

方法

这项德国研究包括对 PACS 进行低门槛在线筛查,对筛查呈阳性的参与者将由个人飞行员全程支持。个人飞行员旨在赋予患者权力并帮助他们在研究和不同治疗方案中进行导航。随后,患者将被随机分配到干预组(IG)或积极对照组(ACG)。IG 将接受生理和心理功能的全面评估,以告知未来的治疗。ACG 不会接受评估,但两组都将接受包括个人数字治疗方案(数字干预平台和通过聊天机器人进行干预)的治疗。该数字干预措施基于 IG 参与者评估中确定的需求。相比之下,ACG 将接受更常见的数字治疗方案,旨在减轻 PACS 症状。重要的是,将招募第三个不接受任何治疗的比较组(CompG)。将进行倾向评分匹配,以确保参与者之间的可比性。该研究的主要终点是症状减轻和重返工作岗位。次要结果包括社会参与和日常生活活动等。此外,还将评估在线筛查工具、整体评估、数字培训和个人飞行员的可行性和适用性。

讨论

这是通过赋权来改善 PACS 患者诊断和护理的首批大规模研究之一之一。将评估所使用的方法是否可用于德国和国际人群。

试验注册

ClinicalTrials.gov 标识符:NCT05238415;注册日期:2022 年 2 月 14 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a2a/9380372/7fe30f0bf0e6/12879_2022_7584_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a2a/9380372/db4d44de14e5/12879_2022_7584_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a2a/9380372/1c6427d27b1f/12879_2022_7584_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a2a/9380372/ef69c884aec5/12879_2022_7584_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a2a/9380372/7fe30f0bf0e6/12879_2022_7584_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a2a/9380372/db4d44de14e5/12879_2022_7584_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a2a/9380372/1c6427d27b1f/12879_2022_7584_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a2a/9380372/ef69c884aec5/12879_2022_7584_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a2a/9380372/7fe30f0bf0e6/12879_2022_7584_Fig4_HTML.jpg

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