Hepatitis C Clinical Trial
Official title:
A Pilot Feasibility Study of a Cognitive Behavioral Coping Skills (CBCS) Group Intervention for Patients Undergoing Antiviral Therapy for Chronic Hepatitis C
This is a pilot feasibility study of a small randomized controlled trial (RCT)design to evaluate participation in a Cognitive Behavioral Coping Skills (CBCS) group intervention versus standard of care in patients with hepatitis C undergoing antiviral treatment. The primary objectives are to (1) examine effect size (ES) estimates of key outcomes to provide essential data to inform a larger efficacy trial, (2) determine whether clinically significant improvements occurred in any key outcomes, and (3) evaluate study feasibility and patient acceptability. Study findings will inform a larger efficacy study of the CBCS-HCV.
This is a pilot feasibility study of a Cognitive Behavioral Coping Skills (CBCS) Group
Intervention with a representative sample of patients with Hepatitis C viral (HCV)undergoing
standard antiviral treatment in a small RCT to examine (1) study feasibility, (2) effect
size estimates, and (3) whether clinically significant improvements occurred in key
outcomes. This pilot study will allow the investigators to test the hypotheses that the
study procedures are feasible and that participation in the CBCS-HCV group is acceptable and
useful to participants. Furthermore, effect size estimates of key outcome variables will
determine which outcomes appear to improve as a result of the intervention and should
potentially be evaluated in a future efficacy study. Several patient-reported outcomes
(PROs) are evaluated: health-related quality of life (HrQOL), perceived stress, depression,
anxiety, anger, fatigue, sleep, pain and medication adherence. The investigators will also
determine if group participation affects viral cure rate. Change scores that have an effect
size d> .35 are considered potentially clinically significant and reasonable to evaluate in
a larger efficacy study. Study feasibility elements evaluated included: feasibility of a RCT
study design, intervention delivery, patient acceptability, therapist protocol fidelity,
recruitment, enrollment, attendance, retention and data collection.
The investigators planned to enroll and evaluate the intervention in two waves of study
participants (Wave 2, Wave 3). When a block of 12 patients is consented for Wave 2,
participants will be randomized to standard of care (SC; n=6) or the CBCS-HCV group
intervention (n=6). The same procedure will be used to consent and randomize 12 patients in
Wave 3 to SC vs CBCS-HCV. Patients randomized to CBCS will participate in 4 weekly CBCS
sessions prior to starting HCV treatment, and 5 more sessions during HCV treatment, on the
same day they attend follow-up treatment visits at weeks 2, 4, 6, 8, and 12. Outcome data
will be collected at baseline (T1), just prior to HCV treatment starting (T2); at week 8 of
HCV treatment (T3), at end of CBCS intervention/ HCV treatment at week 12 (T4), and 1-month
post-CBCS intervention/ HCV treatment (T5). The primary outcome is change in total HrQOL
score. Secondary outcomes are change in other PROs noted above. Additional secondary
outcomes are group differences in medication adherence and viral cure rate. Elements of
study feasibility are also evaluated.
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