A pilot randomized controlled trial of a telemedicine psychosocial intervention to improve symptom management in adults with long COVID: the COPE study protocol.

IF 1.5 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Lindsey M Knowles, Mehr Grewal, Sydney A Drever, Jeanne M Hoffman, Janna L Friedly, Tracy E Herring
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引用次数: 0

Abstract

Background: Long COVID is a serious public health concern due to its high prevalence and potentially debilitating symptoms. Symptoms may include fatigue, dyspnea, cognitive problems, insomnia, anxiety, and depression. There is currently no cure for long COVID, and the average length of recovery and proportion of patients who fully recover are still unknown. Subsequently, there is a critical need to improve function. Research in other chronic conditions suggests that psychosocial self-management interventions reduce symptom severity and interference with functioning. We describe the design of our study to examine the feasibility, acceptability, appropriateness, and preliminary efficacy of an intervention designed to improve symptom management and coping in adults with long COVID.

Methods: This pilot trial (N = 50) uses a pragmatic, randomized two-group parallel design set within the University of Washington Post-COVID Rehabilitation and Recovery Clinic. The self-management intervention is a 6-week, group-based telemedicine intervention that teaches evidence-based strategies to manage common symptoms and improve stress management as well as communication and self-advocacy. The comparator is a wait-list control. Participants complete self-report measures of the primary and secondary outcomes at baseline and post-treatment/wait-list. Primary outcomes include intervention feasibility, acceptability, and appropriateness. Secondary outcomes include Patient-Reported Outcomes Measurement Information System measures of fatigue, sleep disturbance, cognitive difficulties, self-efficacy, pain interference, depression and anxiety symptoms, and a measure of long COVID symptoms and impression of change. At post-intervention, intervention participants also complete a qualitative interview to inform intervention refinement. Quantitative data will be examined using descriptive and statistical analysis including t-tests and chi-square tests to compare the intervention and wait-list groups on secondary outcomes. Qualitative data will be analyzed using the rigorous and accelerated data reduction technique (RADaR).

Discussion: Results of this pilot randomized controlled trial will characterize the feasibility, acceptability, and appropriateness of the self-management intervention and inform intervention refinement necessary prior to further testing. Long COVID is a public health concern, and rehabilitation approaches that equip patients to manage symptoms may improve patient function and quality of life and reduce burden on the health care system.

Trial registration: NCT05658536. December 16, 2022.

通过远程医疗心理干预改善长期 COVID 成人症状管理的试点随机对照试验:COPE 研究方案。
背景:长期慢性阻塞性肺气肿是一个严重的公共卫生问题,因为它发病率高,并可能出现使人衰弱的症状。症状可能包括疲劳、呼吸困难、认知问题、失眠、焦虑和抑郁。长程 COVID 目前尚无根治方法,其平均康复时间和完全康复的患者比例仍是未知数。因此,迫切需要改善患者的功能。对其他慢性疾病的研究表明,社会心理自我管理干预可以减轻症状的严重程度和对功能的干扰。我们介绍了自己的研究设计,旨在研究一种干预措施的可行性、可接受性、适宜性和初步疗效,该干预措施旨在改善长期慢性阻塞性肺病成人患者的症状管理和应对能力:这项试点试验(N = 50)采用了务实、随机的两组平行设计,在华盛顿大学 COVID 后康复诊所内进行。自我管理干预是一项为期 6 周、以小组为基础的远程医疗干预,教授以证据为基础的策略,以管理常见症状、改善压力管理以及沟通和自我主张。对照组为等待对照组。参与者在基线和治疗后/等待名单上完成主要和次要结果的自我报告测量。主要结果包括干预的可行性、可接受性和适当性。次要结果包括患者报告结果测量信息系统对疲劳、睡眠障碍、认知困难、自我效能、疼痛干扰、抑郁和焦虑症状的测量,以及对长期 COVID 症状和变化印象的测量。干预结束后,干预参与者还将完成一次定性访谈,为改进干预提供信息。定量数据将采用描述性和统计分析方法进行检验,包括 t 检验和卡方检验,以比较干预组和等待组的次要结果。定性数据将采用严格的加速数据还原技术(RADaR)进行分析:讨论:这一试点随机对照试验的结果将说明自我管理干预的可行性、可接受性和适宜性,并为进一步测试前所需的干预改进提供信息。长期慢性阻塞性肺气肿是一个公共卫生问题,让患者有能力控制症状的康复方法可以改善患者的功能和生活质量,减轻医疗系统的负担:试验注册:NCT05658536。2022年12月16日
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来源期刊
Pilot and Feasibility Studies
Pilot and Feasibility Studies Medicine-Medicine (miscellaneous)
CiteScore
2.70
自引率
5.90%
发文量
241
审稿时长
9 weeks
期刊介绍: Pilot and Feasibility Studies encompasses all aspects of the design, conduct and reporting of pilot and feasibility studies in biomedicine. The journal publishes research articles that are intended to directly influence future clinical trials or large scale observational studies, as well as protocols, commentaries and methodology articles. The journal also ensures that the results of all well-conducted, peer-reviewed, pilot and feasibility studies are published, regardless of outcome or significance of findings. Pilot and feasibility studies are increasingly conducted prior to a full randomized controlled trial. However, these studies often lack clear objectives, many remain unpublished, and there is confusion over the meanings of the words “pilot” and “feasibility”. Pilot and Feasibility Studies provides a forum for discussion around this key aspect of the scientific process, and seeks to ensure that these studies are published, so as to complete the publication thread for clinical research.
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