Bronchiectasis Adult Clinical Trial
Official title:
Feasibility of Implementing SIMEOX® Using Tele-physiotherapy and Evaluation of Compliance With SIMEOX® at Home for Bronchial Drainage in Patients With Bronchiectasis Other Than Cystic Fibrosis and Who Have Difficulties in Accessing Regular Respiratory Physiotherapy Sessions.
NCT number | NCT04742270 |
Other study ID # | 2020-03 |
Secondary ID | |
Status | Completed |
Phase | N/A |
First received | |
Last updated | |
Start date | March 4, 2021 |
Est. completion date | December 31, 2021 |
Verified date | January 2022 |
Source | Physio-Assist |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Bronchiectasis is a chronic multiple etiologies pulmonary disease characterized by permanent dilatation of the caliber of the bronchial tree territory with an alteration of mucociliary clearance. This alteration causes mucus retention and leads to infections and chronic bronchial inflammation. Respiratory physiotherapy is one of the cornerstones of the management of these patients, particularly to facilitate bronchial drainage. In patients with abundant bronchial secretions, it is recommended to carry out airway clearance sessions daily or several times a day, which represents a very significant burden of care. Moreover, access to respiratory physiotherapy care isn't always easy for patients due to geographical, time, or professional availability limitations. In addition, few professionals are trained in France for this specific care dedicated to chronic lung disease. Finally with this kind of remote formation and follow up, it may be more suitable for this at-risk patient population in the context of the COVID-19 pandemic situation (limitation of physical contact). SIMEOX® (Physio-Assist, Aix en Provence, France) is an innovative medical device (CE medical mark) for bronchial tree drainage. The use of this device in autonomy by the patient requires however a specific initial training of a few sessions (3-5 sessions). Tele-physiotherapy could allow remote training of patients in the use of SIMEOX®. This SIMEOX® device used autonomously at home, could provide patients with a practical and efficient bronchial clearance technique. The overall objective of this pilot study is to evaluate the use of SIMEOX® at home after education in its use by telecare for bronchial drainage in patients with bronchiectasis (non-cystic Fibrosis Bronchiectasis) and who have difficulty accessing usual respiratory physiotherapy sessions.
Status | Completed |
Enrollment | 22 |
Est. completion date | December 31, 2021 |
Est. primary completion date | December 31, 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Patient with a diagnosis of bronchiectasis confirmed by HR CT scan, regardless of etiology except cystic fibrosis and with estimated bronchorrhea >10mL/d. - Disease stability, defined as a delay of at least 4 weeks since the end of an exacerbation (end of antibiotic therapy or judged as resolved by the investigator). - Age > 18 years old - Patient does not have access to a physiotherapist or does not usually go to a physiotherapy office (<1/week on average) Exclusion Criteria: - Pneumothorax or severe hemoptysis (more than 30 ml per 24 hours) within 6 weeks before inclusion, - Patient on transplant list - Any contraindication to an instrumental bronchial clearance technique (at the discretion of the investigator) - Patient not available or wishing to change of region within 3 months of inclusion - Patient is currently participating or has participated within one month prior to inclusion in another clinical intervention research study that may impact the study, the impact of which is at the discretion of the investigator. - Persons referred to in articles L1121-5 to L1121-8 of the CSP (corresponds to all protected persons: pregnant woman (verified by the dosage of ß-HCG for any woman wishing to participate in the protocol and of childbearing age < 60 years), parturient, breastfeeding mother, person deprived of liberty by judicial or administrative decision, person subject to a legal protection measure) |
Country | Name | City | State |
---|---|---|---|
France | Grenoble University-Affiliated Hospital : Pneumology department | Grenoble | |
France | Nice university-affiliated hospital : pneumonoly department | Nice | |
France | Toulouse University-Affiliated Hospital : Pneumology department | Toulouse |
Lead Sponsor | Collaborator |
---|---|
Physio-Assist | Icadom |
France,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Compliance | The compliance with the SIMEOX® device at home is assessed by the change in the percentage of patient with an average of at least 3 sessions/week between D15 and 3 months (self-reported compliance by the patient on a diary) | 3 months after inclusion | |
Secondary | Compliance reliability | Comparison of self-reported patient compliance to compliance reported on the "Simeox web application" web platform is assessed by the variation between the total number of sessions self-reported by the patient via a diary and the number of sessions found on the secure web platform "Simeox web application" between D15 and 3 months | 3 months after inclusion | |
Secondary | Device use | The evolution of the use of the device (number of sessions self-reported by the patient) between D15 and 3 months will be described per week for all patients | 3 months after inclusion | |
Secondary | Device satisfaction | Patient satisfaction with the SIMEOX device will be estimated using a visual analog scale from 0 for the worst satisfaction to 10 for the best satisfaction. | 3 months after inclusion | |
Secondary | General compliance | Overall therapeutic adherence will be estimated by the BMQ questionnaire (Beliefs about Medecines Questionnaire) from 5 for the worst general compliance to 25 for the best general compliance. | At inclusion | |
Secondary | Link between compliance to treatment and Physical activity | The link between treatment compliance and physical activity will be assessed by the IPAQ questionnaire (International Physical Activity Questionnaire). This questionnaire provides separate scores on sedentary, walking, moderate-intensity, and vigorous-intensity activity. | At inclusion and 3 months after | |
Secondary | Poor compliance factors | To determine the factors associated with poor (self-reported) compliance with the SIMEOX® device.
Correlations between insufficient adherence (self-reported; <3 sessions/weeks between D15-D+3 months) to the SIMEOX® device and the following six factors will be sought (age, gender, marital status, socio-professional category, (8 INSEE posts https://www.insee.fr/fr/information/2400059), smoking status, number of drug treatments, severity of bronchiectasis (BSI Score -Bronchiectasia Severity Index), co-morbidities. |
At inclusion | |
Secondary | Sputum collection feasability | To evaluate the feasibility of a weekly collection by the patient of the quantity of bronchial secretions after a bronchial clearance session with SIMEOX®.
The feasibility of a weekly collection by the patient will be estimated by the frequency and weight of secretions reported on the patient's diary. |
3 months after inclusion | |
Secondary | Quality of session | To assess the link between the quality of the session found on the web platform and the efficiency of bronchial clearance estimated by the frequency and weight of secretions reported on the patient's diary. | 3 months after inclusion | |
Secondary | Tele-physiotherapy feasability | To evaluate the feasibility of one call every 10 days (reported by the patient in his or her diary) for therapeutic motivational reinforcement. | 3 months after inclusion | |
Secondary | Specific quality of life | To evaluate the effect of SIMEOX®+ tele-physiotherapy on the specific quality of life of bronchiectasis after 3 months of home treatment.
The variation in quality of life will be measured by the change of the Qol-B questionnaire's score (total score and respiratory sub-scores, activity, social functioning, vitality, emotional function, constraints related to treatment) between inclusion and 3 months after inclusion. Score range from 0 to 100, with higher score representing fewer symptoms or better functioning. |
At inclusion and 3 months after | |
Secondary | Global quality of life | Evaluate the effect of SIMEOX®+ tele-physiotherapy on the overall quality of life of respiratory diseases after 3 months of home treatment; The change in overall quality of life for respiratory diseases will be measured before and after 3 months of treatment using the Saint Georges Questionnaire (SGQOL).
Each response to the questionnaire is assigned a unique " value " derived from anterior data. The minimum weight is 0 and the highest is 100. For each component, sum the values assigned to each response. The score is calculated by dividing this sum of the values by the maximum possible score for each component and expressing the result as a percentage. |
At inclusion and 3 months after | |
Secondary | Cough perception | Evaluate the effect of SIMEOX®+ tele-physiotherapy on the perception of cough after 3 months of home treatment;The change in cough perception will be measured before and after 3 months of treatment with the Leicester questionnaire.
It consists of 19 items with a 7 point likert response scale (range from 1 to 7). Each item is developed to assess symptoms during cough and impact of cough on three main domains: physical, psychological and social. Scores are calculated as a mean of each domain and the total score is calculated by adding every domain score. |
At inclusion and 3 months after | |
Secondary | Bronchial clearance perception | Evaluate the effect of SIMEOX®+ tele-physiotherapy on the perception of bronchial congestion after 3 months of home treatment;The change in perception of bronchial congestion will be measured before and after 3 months of treatment by the Chronic Airways Assessment Test (CAT) questionnaire.
Score range from 0 to 40, with higher score representing better health. |
At inclusion and 3 months after | |
Secondary | Respiratory function :Variation of forced expiratory volume in 1 second (FEV1) | Evaluate the effect of SIMEOX®+ tele-physiotherapy on respiratory function after 3 months of home treatment on the forced expiratory volume in 1 second (FEV1) | At inclusion and 3 months after | |
Secondary | Respiratory function :Pulmonary forced vital capacity (FVC) | Evaluate the effect of SIMEOX®+ tele-physiotherapy on respiratory function after 3 months of home treatment on relative variation of forced vital capacity in liter | At inclusion and 3 months after | |
Secondary | Respiratory function :FEV1/ FVC ratio | Evaluate the effect of SIMEOX®+ tele-physiotherapy on respiratory function after 3 months of home treatment on relative variation of FEV1/ FVC ratio in % | At inclusion and 3 months after | |
Secondary | Respiratory function : Forced Expiratory Flow (FEF) | Evaluate the effect of SIMEOX®+ tele-physiotherapy on respiratory function after 3 months of home treatment on relative variation of FEF in % | At inclusion and 3 months after | |
Secondary | Exacerbation | Evaluate the effect of SIMEOX®+ tele-physiotherapy on the number of respiratory exacerbations; Respiratory exacerbations will be documented by the investigating physicians according to the EMBARC consensus definition. | 3 months after inclusion | |
Secondary | First exacerbation onset | Evaluate the effect of SIMEOX®+ tele-physiotherapy on the time to onset of the first respiratory exacerbation.The date of consultation and/or hospitalization attesting to the exacerbation will be documented in the e-CRF to estimate the time to first exacerbation. | 3 months after inclusion | |
Secondary | Adverse events | Adverse events and device causality will be monitored through a questionnaire of 4 items (hemoptysis, chest pain, gastro-esophageal reflux, other) during tele-physiotherapie sessions and eventual event will be collected in the eCRF | 3 months after inclusion |
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