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结缔组织病相关性间质性肺疾病试验(TEL-CTD-ILD)研究方案:一种基于家庭的治疗效果远程监测的随机对照试验。

Study protocol for connective tissue disease-associated interstitial lung disease trial (TEL-CTD-ILD): A randomized controlled trial of a home-based telemonitoring of treatment effects.

机构信息

Department of Pneumology, I Chair of Internal Medicine, Medical University of Lodz, Lodz, Poland.

Department of Pathobiology of Respiratory Diseases, II Chair of Internal Medicine, Medical University of Lodz, Lodz, Poland.

出版信息

PLoS One. 2022 Dec 27;17(12):e0278601. doi: 10.1371/journal.pone.0278601. eCollection 2022.

Abstract

INTRODUCTION

Interstitial lung disease is one of the most severe pulmonary complications related to connective tissue diseases, resulting in substantial morbidity and mortality. Telepneumology has the potential to improve the long-term management of patients with CTD-ILD. We propose a randomized controlled trial to evaluate the efficacy of home-based telemonitoring of patients with CTD-ILD, in whom treatment was initiated.

MATERIALS AND METHODS

We will conduct a randomized controlled trial comparing the standard of care with a telemonitoring program. Telemonitoring will start 10 to 14 days before treatment and will be carried out for three months of therapy. After initial training, patients from the intervention group will perform daily spirometry (FVC), transdermal pulse oximetry, pulse and blood pressure measurements, activity measurement (accelerometry), and assessment of the severity of cough and dyspnea. The results will be reported using a telemetric system designed by Mediguard® for this study. The primary outcome measure will be the health-related quality of life change using EQ-5D-5L questionnaire and St. George's Respiratory Questionnaire, as measured at stationary visits in both study groups. Secondary outcomes will include assessment of lung function, costs of health service utilization, satisfaction from being telemonitored, dyspnea by mMRC, fatigue by FAS, patients' adherence to recommended medications using the ASCD, anxiety and depression symptoms as measured by HADS, PHQ-9, and side effects of treatment.

DISCUSSION

This is the first clinical trial protocol to evaluate home-based telemonitoring to optimize connective tissue disease-associated interstitial lung management. The study aims to provide data on the impact of telemonitoring on quality of life, evaluation of health status of patients with CTD-ILD using telemonitoring versus standard care. Additionally, we will evaluate the cost-effectiveness of telemonitoring solutions in patients with CTD-ILD.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04428957; Registered June 11, 2020; https://clinicaltrials.gov/ct2/show/NCT04428957.

摘要

简介

间质性肺病是与结缔组织疾病相关的最严重肺部并发症之一,导致发病率和死亡率较高。远程医疗有潜力改善结缔组织疾病-间质性肺病患者的长期管理。我们提出了一项随机对照试验,以评估在开始治疗后对结缔组织疾病-间质性肺病患者进行家庭远程监测的疗效。

材料和方法

我们将进行一项随机对照试验,比较标准护理与远程监测方案。远程监测将在治疗前 10 至 14 天开始,并持续进行三个月的治疗。在初始培训后,干预组的患者将每天进行肺活量(FVC)、经皮脉搏血氧饱和度、脉搏和血压测量、活动测量(加速度计)以及咳嗽和呼吸困难严重程度评估。结果将使用 Mediguard®为这项研究设计的遥测系统报告。主要结局测量将是使用 EQ-5D-5L 问卷和圣乔治呼吸问卷评估健康相关生活质量的变化,这是在两组研究中进行固定访视时测量的。次要结局将包括肺功能评估、卫生服务利用成本、远程监测满意度、mMRC 呼吸困难评估、FAS 疲劳评估、ASCD 评估建议药物的患者依从性、HADS、PHQ-9 评估焦虑和抑郁症状以及治疗的副作用。

讨论

这是第一项评估家庭远程监测以优化结缔组织疾病相关间质性肺管理的临床试验方案。该研究旨在提供有关远程监测对生活质量的影响的数据,以及使用远程监测与标准护理评估结缔组织疾病-间质性肺病患者健康状况的数据。此外,我们将评估结缔组织疾病-间质性肺病患者远程监测解决方案的成本效益。

试验注册

ClinicalTrials.gov 标识符:NCT04428957;注册日期:2020 年 6 月 11 日;https://clinicaltrials.gov/ct2/show/NCT04428957。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ae6/9794074/7e0e3e204942/pone.0278601.g001.jpg

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