A multi-centre, randomized, controlled trial on coaching and telemonitoring in patients with cystic fibrosis: conneCT CF

Thee, Stephanie; Stahl, Mirjam; Fischer, Rainald; Sutharsan, Sivagurunathan; Ballmann, Manfred; Müller, A.; Lorenz, Daniel; Urbanski-Rini, Dominika; Püschner, Franziska; Amelung, Volker Eric; Fuchs, Carola; Mall, Marcus

doi:10.1186/s12890-021-01500-y

Cited by 17 publications

(8 citation statements)

References 44 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To maximize scalability of the e-visits, we opted to minimize the amount of training provided to participants. However, prior home spirometry trials have had success with incorporating synchronous coaching via video calls [ 29 ]. This approach may help improve the validity of home spirometry among adult smokers at risk for COPD, though it would limit scalability.…”

Section: Discussionmentioning

confidence: 99%

Proactive Electronic Visits for Smoking Cessation and Chronic Obstructive Pulmonary Disease Screening in Primary Care: Randomized Controlled Trial of Feasibility, Acceptability, and Efficacy

Dahne¹,

Player²,

Strange³

et al. 2022

J Med Internet Res

View full text Add to dashboard Cite

Background Most smokers with chronic obstructive pulmonary disease (COPD) have not yet been diagnosed, a statistic that has remained unchanged for over two decades. A dual-focused telehealth intervention that promotes smoking cessation, while also facilitating COPD screening, could help address national priorities to improve the diagnosis, prevention, treatment, and management of COPD. The purpose of this study was to preliminarily evaluate an integrated asynchronous smoking cessation and COPD screening e-visit (electronic visit) that could be delivered proactively to adult smokers at risk for COPD, who are treated within primary care. Objective The aims of this study were (1) to examine e-visit feasibility and acceptability, particularly as compared to in-lab diagnostic pulmonary function testing (PFT), and (2) to examine the efficacy of smoking cessation e-visits relative to treatment as usual (TAU), all within primary care. Methods In a randomized clinical trial, 125 primary care patients who smoke were randomized 2:1 to receive either proactive e-visits or TAU. Participants randomized to the e-visit condition were screened for COPD symptoms via the COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE). Those with scores ≥2 were invited to complete both home spirometry and in-lab PFTs, in addition to two smoking cessation e-visits. Smoking cessation e-visits assessed smoking history and motivation to quit and included completion of an algorithm to determine the best Food and Drug Administration–approved cessation medication to prescribe. Primary outcomes included measures related to (1) e-visit acceptability, feasibility, and treatment metrics; (2) smoking cessation outcomes (cessation medication use, 24-hour quit attempts, smoking reduction ≥50%, self-reported abstinence, and biochemically confirmed abstinence); and (3) COPD screening outcomes. Results Of 85 participants assigned to the e-visits, 64 (75.3%) were invited to complete home spirometry and in-lab PFTs based on CAPTURE. Among those eligible for spirometry, 76.6% (49/64) completed home spirometry, and 35.9% (23/64) completed in-lab PFTs. At 1 month, all cessation outcomes favored the e-visit, with a significant effect for cessation medication use (odds ratio [OR]=3.22). At 3 months, all cessation outcomes except for 24-hour quit attempts favored the e-visit, with significant effects for cessation medication use (OR=3.96) and smoking reduction (OR=3.09). Conclusions A proactive, asynchronous e-visit for smoking cessation and COPD screening may offer a feasible, efficacious approach for broad interventions within primary care. Trial Registration ClinicalTrials.gov NCT04155073; https://clinicaltrials.gov/ct2/show/NCT04155073

show abstract

Section: Discussionmentioning

confidence: 99%

Proactive Electronic Visits for Smoking Cessation and Chronic Obstructive Pulmonary Disease Screening in Primary Care: Randomized Controlled Trial of Feasibility, Acceptability, and Efficacy

Dahne¹,

Player²,

Strange³

et al. 2022

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Patients have not favored particularly innovative or technological tools or interventions previously tested in published studies such as feedback by connected objects 14,49,50 or building a web or mobile application. 11,51 On the contrary, they invested more in relational spaces mobilizing the lay expertise of patients and the transmission of this experiential knowledge. This is the case of the COMUCOs, this network of expert patients who can be mobilized by other users regarding sensitive issues related to their experience of daily life with the disease.…”

Section: Dovepressmentioning

confidence: 99%

A Participatory Approach Involving Patients with Cystic Fibrosis and Healthcare Professionals for the Co-Design of an Adherence-Enhancing Intervention Toolkit

Viprey¹,

Mougeot²,

Dima³

et al. 2023

PPA

View full text Add to dashboard Cite

Cystic fibrosis (CF) is an inherited life-shortening disease involving a significant treatment burden. Few interventions have been proven effective in improving adherence, and of these fewer have been adopted for implementation. Patient participation in research is increasingly desired in developing relevant health care services. A participatory approach was implemented in an adult CF center to co-design an adherence-enhancing intervention toolkit. We aimed to report on the participatory process and the results regarding the co-designed intervention. Patients and Methods: Two focus group sessions and four working sessions were conducted at 4-week intervals with three healthcare professionals (HCP; physician, nurse, physiotherapist), eight patients, and two researchers (sociologist, public health pharmacist). The two initial focus group sessions were dedicated to the collection of narratives about CF treatment experiences to identify drivers of adherence. The next four working sessions were dedicated to the reflection on solutions that could alleviate the difficulties identified and be used in current clinical practice. The researchers observed during all sessions the interactions between participants, group dynamics, and process of implementation of the collective reflection. Results: The process facilitated an active participation of patients and HCP, who contributed equally to the intervention development. The co-design adherence-enhancing intervention toolkit consisted in a self-questionnaire to be completed by patients before the medical consultation and used as a communication support during the consultation, plus a toolkit of solutions to be proposed by the HCP for each barrier identified by patients, and to be followed up during the next consultation. Conclusion:This study demonstrated that a participatory approach involving CF patients and HCP lead to the development of an adherence-enhancing intervention toolkit, using a 6-session format; the benefits of the co-designed intervention on the medication adherence have yet to be tested in a multicenter, open-label study in 3 centers in France.

show abstract

“…Similar applications have been applied to nebulized aerosol delivery systems in adult CF patient cohorts with overall higher adherence during study enrollment but unknown long-term sustained effects [47]. Recently, a multi-centre trial, conneCT CF, aiming to evaluate use of a self-management app, videoconferencing and telephone coaching on adherence to treatment, lung function, and PEx in CF has been proposed with results currently pending, but may translate to applicability in NCFB patients [48].…”

Section: Digital Technology and Electronic Monitoring Devices (Emds)mentioning

confidence: 99%

Assessment of factors and interventions towards therapeutic adherence among persons with non-cystic fibrosis bronchiectasis

Thornton

Somayaji²,

Lim³

2022

ERJ Open Res

View full text Add to dashboard Cite

Non-cystic fibrosis bronchiectasis (NCFB) is a highly prevalent chronic respiratory disease with substantial burden to both patients and health care systems. Persons with NCFB (pwNCFB) are often given complex acute and chronic treatment regimens consisting of medications, airway clearance techniques and exercise. Accordingly, the high burden in NCFB has contributed to lower therapy adherence with estimates of 53% to medications, 41% to airway clearance and only 16% to all prescribed therapy. Consequent clinical outcomes from lower adherence include reduced quality of life, accelerated lung function decline and recurrent pulmonary exacerbations. In this narrative review, we explore the impact of multifactorial mechanisms underpinning adherence in NCFB and evaluate the available evidence towards interventions to improve uptake of therapy as demonstrated in other chronic respiratory diseases. A holistic approach, starting with a careful review of patient adherence at regular intervals, may increase the success of multidimensional therapeutic interventions in pwNCFB, but robust ongoing studies are an area of need in this population.

show abstract

A multi-centre, randomized, controlled trial on coaching and telemonitoring in patients with cystic fibrosis: conneCT CF

Cited by 17 publications

References 44 publications

Proactive Electronic Visits for Smoking Cessation and Chronic Obstructive Pulmonary Disease Screening in Primary Care: Randomized Controlled Trial of Feasibility, Acceptability, and Efficacy

Proactive Electronic Visits for Smoking Cessation and Chronic Obstructive Pulmonary Disease Screening in Primary Care: Randomized Controlled Trial of Feasibility, Acceptability, and Efficacy

A Participatory Approach Involving Patients with Cystic Fibrosis and Healthcare Professionals for the Co-Design of an Adherence-Enhancing Intervention Toolkit

Assessment of factors and interventions towards therapeutic adherence among persons with non-cystic fibrosis bronchiectasis

Contact Info

Product

Resources

About