Idiopathic Pulmonary Fibrosis Clinical Trial
Official title:
Does Cognitive Behavioural Therapy (CBT) Delivered by a Respiratory Nurse Reduce Anxiety and the Impact of Cough and Breathlessness on Quality of Life in Patients With Idiopathic Pulmonary Fibrosis (IPF)?
Idiopathic Pulmonary Fibrosis (IPF) is a chronic progressive lung disease of unknown cause for which there is no effective medical treatment. The main symptoms are increasing breathlessness and cough which can significantly impact on quality of life (QOL) often leading to anxiety and depression. The focus of disease management is shifting from pharmacological attempts to reduce disease progression to managing symptoms and a more holistic approach. Cognitive behavioural therapy (CBT) is increasingly used to treat anxiety and depression in chronic disease. Our investigators aim to determine whether CBT can reduce anxiety and depression related to symptoms and improve QOL in patients with IPF. This study will compare CBT intervention (Group 1) against standard treatment (Group 2). Patients will be recruited from a specialist IPF clinic - all patients attending with IPF who suffer from anxiety will be eligible to participate in the study. The study aims to recruit 30 patients (15 in each group). Patients will be randomly allocated into each group using an envelope concealment system. At entry a baseline visit will be conducted with information gathered regarding disease severity, hospital admissions, medication, symptoms (subjective and objective), quality of life and anxiety and depression using questionnaires and routine clinical tests. Patients will then receive CBT intervention (Group 1) or no intervention (Group 2). Patients receiving CBT will undergo a maximum of 6 (minimum of 2) individual therapy sessions. Follow up visits for both groups will be conducted at 3, 6, 9 and 12 months with the same information gathered as at the baseline visit.
Status | Not yet recruiting |
Enrollment | 30 |
Est. completion date | February 2014 |
Est. primary completion date | February 2014 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: diagnosis of IPF confirmed by a specialist IPF MDT according to ATS/ERS criteria, agreement to participate and provide written, informed consent, agreement to attend a minimum of 2 and maximum of 6 CBT sessions. Exclusion Criteria: HADS-A equal or more than eight, Known psychiatric disorders, psychosis or personality disorders, currently receiving psychological therapy including counselling and/or cognitive behavioural therapy (CBT), cognitive impairment e.g. dementia preventing engagement with CBT, unwilling to engage in CBT, verbal and/or written communication problems limiting ability to engage with CBT or provide written consent (all attempts made to include patients in whom English is not their first language by using an interpreter). |
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
Country | Name | City | State |
---|---|---|---|
United Kingdom | Royal Victoria Infirmary | Newcastle upon Tyne | |
United Kingdom | Royal Victoria Infirmary | Newcastle upon Tyne |
Lead Sponsor | Collaborator |
---|---|
Royal Victoria Infirmary | University Hospital of South Manchester NHS Foundation Trust |
United Kingdom,
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Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | validity of tools used | to determine validity of tools used in pilot study to inform a future, multicentre RCT. | baseline and 12 months | Yes |
Primary | estimation of recruitment rate | to determine estimation of recruitment rate to inform a future RCT | baseline to 12 months | No |
Primary | number of patients needed | estimation of parameters such as variance of outcome variables to enable calculation of sample size in a future RCT. | baseline to 12 months | No |
Secondary | change in Hospital Anxiety and Depression Scale-Anxiety subset | to assess change in anxiety scores using the Hospital Anxiety and Depression Scale (anxiety subset) at 3 months. | baseline and 3 months | No |
Secondary | change in Hospital Anxiety and Depression Scale-Depression subset | to assess change in depression using the Hospital Anxiety and Depression Scale (depression subset) at 3 months. | baseline and 3 months | No |
Secondary | change in cough frequency | to assess change in cough frequency using a 24 hour cough monitor | baseline and 3 months | No |
Secondary | change in Medical Research Council (MRC) dyspnoea scale | to assess the impact on breathlessness using change in MRC dyspnoea scale at 3 months | baseline and 3 months | No |
Secondary | change in pulmonary function tests (FVC, TLCO) | to assess impact on disease severity using pulmonary function tests at 3 months | baseline and 3 months | No |
Secondary | change in leicester cough questionnaire | to assess the change in quality of life using the Leicester cough questionnaire at 3 months | baseline and 3 months | No |
Secondary | change in Hospital Anxiety and Depression Scale-Anxiety subset | change in anxiety score using Hospital Anxiety and Depression Scale (anxiety subset) at 6 months | baseline and 6 months | No |
Secondary | change in Hospital Anxiety and Depression Scale-Anxiety subset | change in anxiety score using the Hospital Anxiety and Depression Scale (anxiety subset) at 9 months | baseline and 9 months | No |
Secondary | change in Hospital Anxiety and Depression Scale-Anxiety subset | change in anxiety score using the Hospital Anxiety and Depression Scale (anxiety subset) at 12 months | baseline and 12 months | No |
Secondary | change in Hospital Anxiety and Depression Scale-Depression subset | to assess change in depression using the Hospital Anxiety and Depression Scale (depression subset) at 6 months. | baseline and 6 months | No |
Secondary | change in Hospital Anxiety and Depression Scale-Depression subset | to assess change in depression using the Hospital Anxiety and Depression Scale (depression subset) at 9 months. | baseline and 9 months | No |
Secondary | change in Hospital Anxiety and Depression Scale-Depression subset | to assess change in depression using the Hospital Anxiety and Depression Scale (depression subset) at 12 months. | baseline and 12 months | No |
Secondary | change in MRC dyspnoea scale | to assess the impact on breathlessness using change in MRC dyspnoea scale at 6 months | baseline and 6 months | No |
Secondary | change in MRC dyspnoea scale | to assess the impact on breathlessness using change in MRC dyspnoea scale at 9 months | baseline and 9 months | No |
Secondary | change in MRC dyspnoea scale | to assess the impact on breathlessness using change in MRC dyspnoea scale at 12 months | baseline and 12 months | No |
Secondary | change in pulmonary function tests (FVC, TLCO) | to assess impact on disease severity using pulmonary function tests at 6 months | baseline and 6 months | No |
Secondary | change in pulmonary function tests (FVC, TLCO) | to assess impact on disease severity using pulmonary function tests at 9 months | baseline and 9 months | No |
Secondary | change in pulmonary function tests (FVC, TLCO) | to assess impact on disease severity using pulmonary function tests at 12 months | baseline and 12 months | No |
Secondary | change in 6 minute walk distance | to assess impact on disease severity using six minute walk distance and desaturation index at 3 months | baseline and 3 months | No |
Secondary | change in six minute walk distance | to assess impact on disease severity using six minute walk distance and desaturation index at 6 months | baseline and 6 months | No |
Secondary | change in six minute walk distance | to assess impact on disease severity using six minute walk distance and desaturation index at 9 months | baseline and 9 months | No |
Secondary | change in six minute walk distance | to assess impact on disease severity using six minute walk distance and desaturation index at 12 months | baseline and 12 months | No |
Secondary | change in leicester cough questionnaire | to assess the change in quality of life using the Leicester cough questionnaire at 6 months | baseline and 6 months | No |
Secondary | change in leicester cough questionnaire | to assess the change in quality of life using the Leicester cough questionnaire at 9 months | baseline and 9 months | No |
Secondary | change in leicester cough questionnaire | to assess the change in quality of life using the Leicester cough questionnaire at 12 months | baseline and 12 months | No |
Secondary | change in King's brief interstitial lung disease questionnaire | to assess the change in quality of life using the King's brief Interstitial Lung Disease questionnaire at 3 months | baseline and 3 months | No |
Secondary | change in King's brief interstitial lung disease questionnaire | to assess the change in quality of life using the King's brief Interstitial Lung Disease questionnaire at 6 months | baseline and 6 months | No |
Secondary | change in King's brief interstitial lung disease questionnaire | to assess the change in quality of life using the King's brief Interstitial Lung Disease questionnaire at 9 months | baseline and 9 months | No |
Secondary | change in King's brief interstitial lung disease questionnaire | to assess the change in quality of life using the King's brief Interstitial Lung Disease questionnaire at 12 months | baseline and 12 months | No |
Secondary | change in generalised anxiety disorder questionnaire | to assess the change in quality of life using the Generalised anxiety disorder questionnaire at 3 months | baseline and 3 months | No |
Secondary | change in generalised anxiety disorder questionnaire | to assess the change in quality of life using the Generalised anxiety disorder questionnaire at 6 months | baseline and 6 months | No |
Secondary | change in generalised anxiety disorder questionnaire | to assess the change in quality of life using the Generalised anxiety disorder questionnaire at 9 months | baseline and 9 months | No |
Secondary | change in generalised anxiety disorder questionnaire | to assess the change in quality of life using the Generalised anxiety disorder questionnaire at 12 months | baseline and 12 months | No |
Secondary | change in EuroQol5 Dimension questionnaire | to assess the change in quality of life using the EuroQol5 Dimension questionnaire at 3 months | baseline and 3 months | No |
Secondary | change in EuroQol5 Dimension questionnaire | to assess the change in quality of life using the EuroQol5 Dimension questionnaire at 6 months | baseline and 6 months | No |
Secondary | change in EuroQol5 Dimension questionnaire | to assess the change in quality of life using the EuroQol5 Dimension questionnaire at 9 months | baseline and 9 months | No |
Secondary | change in EuroQol5 Dimension questionnaire | to assess the change in quality of life using the EuroQol5 Dimension questionnaire at 12 months | baseline and 12 months | No |
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