HOPE (Home-based Oxygen [Portable] and Exercise) for Patients on Long Term Oxygen Therapy (LTOT) (HOPE)
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|ClinicalTrials.gov Identifier: NCT03662438|
Recruitment Status : Recruiting
First Posted : September 7, 2018
Last Update Posted : June 24, 2019
Long term oxygen therapy (LTOT) is proven to increase the survival of patients with respiratory failure, most commonly from diseases such as Chronic Obstructive Pulmonary Disease (COPD). At least 15 hours' usage per day is needed to improve mortality. Most patients on LTOT utilise bulky oxygen concentrators (OC) which run on continuous Alternating Current (AC) power. This intervention, however, limits patient mobility and social engagement as patients are tethered to their device and confined to their homes.
Reduced physical activity levels have been shown in COPD patients to be associated with reduced quality of life (QoL), increased admission rates to hospital and survival even after adjustment for severity of COPD. Significant benefits stand to be made by improving physical activity levels in LTOT patients. Pulmonary Rehabilitation (PR), which is traditionally conducted in a healthcare setting, is an established intervention that addresses this by improving exercise tolerance but uptake and completion rates have been low due to reasons such as cost and difficulty with transport. LTOT usage is also cited as an independent barrier to PR.
The investigators propose the establishment of a 10-week home-based physiotherapy programme as a novel community-centric and resource-lean intervention that seeks to improve the physical activity level of LTOT patients. Patients will be prescribed an ambulatory oxygen device and receive education on its usage in conjunction with a home exercise regimen which includes a home visit and subsequent telephone support by a physiotherapist in partnership with a community-based healthcare provider.
A prospective pilot study of 30 patients is proposed. The outcome measures include mobility function, activity levels, generic and disease-specific QoL.
If successful, our programme may revolutionize the approach to LTOT patients in Singapore and improve their ability to function independently in the community greatly; in addition, the reduction in hospital-based healthcare utilisation is greatly advantageous.
|Condition or disease||Intervention/treatment||Phase|
|Exercise Therapy Physical Activity Respiratory Failure Oxygen Inhalation Therapy||Other: Home-based physiotherapy program Device: Prescription of a Portable Oxygen Concentrator (POC) device||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||30 participants|
|Intervention Model:||Single Group Assignment|
|Intervention Model Description:||This is a self-controlled study where participants will serve as their own controls. Physical activity levels and quality of life will be measured before and after a 10 week home-based exercise program.|
|Masking:||None (Open Label)|
|Official Title:||HOPE (Home-based Oxygen [Portable] and Exercise) - Improving Mobility in Patients on Long Term Oxygen Therapy: a Home-based Physiotherapy Programme With Novel Ambulatory Oxygen Device.|
|Actual Study Start Date :||September 9, 2018|
|Estimated Primary Completion Date :||March 20, 2020|
|Estimated Study Completion Date :||March 20, 2020|
This is a self-controlled study where participants will serve as their own controls. All participants will be enrolled into a 10 week home-based physiotherapy program which will include a total of 2 home visits by a physiotherapist at the start and midpoint of the program. Participants will also receive weekly telephone calls by a research coordinator to provide encouragement for patient on the programme and enquire about compliance to the home exercise regimen and safety (e.g. falls and healthcare utilisation).
Patients will also be prescribed a lightweight portable oxygen concentrator to facilitate exercise therapy and mobility in the community. They will receive familiarisation and training in its usage as part of the home-based physiotherapy program.
Other: Home-based physiotherapy program
The home-based physiotherapy program will consist of a total of 2 home visits by a physiotherapist which will be scheduled at the start and midpoint of the 10-week program. The visit will include activity education, goal setting and establishment of a home exercise regimen in patient's own home and community environment). Participants will be contacted weekly via telephone to provide encouragement for patient on the program, enquire about compliance to the exercise program and safety (e.g. falls and healthcare utilisation).
Device: Prescription of a Portable Oxygen Concentrator (POC) device
Participants will be prescribed a lightweight Portable Oxygen Concentrator (POC) device [Philips SimplyGo Mini] to be used during exercise and when going into the community setting. Familiarisation and training on the usage of the device will also be provided in conjunction with the home-based physiotherapy program.
- Change in daily physical activity, which will be measured via the daily step count. [ Time Frame: Baseline, 10 weeks ]Daily physical activity will be measured via the daily step count. This will be measured with the activPAL device, a validated tool to measure physical activity. Participants will have the activPAL device applied to their mid-thigh continuously with an adhesive patch for 1 week prior to the home physiotherapy program and for the 10th week of the home physiotherapy program.
- Change in respiratory disease specific quality of life questionnaire (St George's Respiratory Questionnaire (SGRQ)) [ Time Frame: Baseline, 10 weeks ]Participants will complete the respiratory disease specific quality of life questionnaire St George's Respiratory Questionnaire (SGRQ) at enrollment and after the 10 week home physiotherapy program.
- Change in The Hospital Anxiety and Depression Scale (HADS) [ Time Frame: Baseline, 10 weeks ]Participants will complete the Hospital Anxiety and Depression Scale (HADS) questionnaire at enrollment and after the 10 week home physiotherapy program to measure the levels of anxiety and depression.
- Change in Exercise capacity as measured by 6 minute walk test [ Time Frame: Baseline, 10 weeks ]Participants will undergo exercise capacity assessment with the 6-minute walk test .
- Change in Exercise capacity assessment with 1 minute Sit to Stand test [ Time Frame: Baseline, 10 weeks ]Participants will undergo exercise capacity assessment with the 1-minute Sit to Stand test.
- Change in Participants' daily sedentary time [ Time Frame: Baseline, 10 weeks ]Daily sedentary time will be measured via the time spent in sedentary body postures (e.g. supine and sitting) as opposed to time spent in active body postures (walking and standing). This will be measured with the activPAL device. Participants will have the activPAL device applied to their mid-thigh continuously for 1 week with an adhesive patch.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03662438
|Contact: Thun How Ong, Dr||+65 email@example.com|
|Contact: Mariko SY Koh, A/Prof||+65 firstname.lastname@example.org|
|Department of Respiratory and Critical Care Medicine, Singapore General Hospital||Recruiting|
|Singapore, Singapore, 169608|
|Contact: Si Yuan Chew, MBBS 6563214700 email@example.com|
|Contact: Thun How Ong, MBBS 6563214700 firstname.lastname@example.org|
|Principal Investigator:||Thun How Ong, Dr||Department of Respiratory and Critical Care Medicine, Singapore General Hospital|