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Trial registered on ANZCTR
Registration number
ACTRN12612000898853
Ethics application status
Approved
Date submitted
15/08/2012
Date registered
23/08/2012
Date last updated
10/11/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Increasing adherence to Obstructive Sleep Apnea treatment with a coaching intervention.
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Scientific title
Increasing adherence to Obstructive Sleep Apnea treatment with a coaching intervention.
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Secondary ID [1]
281034
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Nil
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Universal Trial Number (UTN)
U1111-1133-2492
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Low self-efficacy in patients with Obstructive Sleep Apnea (OSA)
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Condition category
Condition code
Respiratory
287409
287409
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0
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Sleep apnoea
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Mental Health
287410
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0
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Studies of normal psychology, cognitive function and behaviour
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will be randomised to either the current Treatment As Usual group (TAU) or a Coaching Group (C). Both TAU and C groups will undergo a psycho-education and mask fitting session (1.5 - 2 hours), a CPAP Titration study night, a 1 hour CPAP set-up session, and 4 CPAP data usage download sessions (each 1 hour in length). In addition, the C group will also receive four, one hour one-to-one coaching sessions – three face-to-face and one by phone.
The psycho-education is a group session of a standardised slide presentation containing information about normal sleep, daytime and night-time health consequences of untreated OSA , and the effectiveness of CPAP treatment. Side-effects encountered when using CPAP will be highlighted and discussed. All participants will have a trial of CPAP at a pressure of 4cm H20 in a supine position and will be encouraged to handle the equipment. Participants will also be encouraged to seek help and support for any mechanical difficulties throughout the study period.
During the CPAP titration night, subjects will undergo an in-laboratory manual titration of their CPAP pressure with polysomnography (PSG). CPAP-therapy pressure will be titrated to treat apnea, hypopnea, and flow limitation, with a therapy target of AHI<5 per hour of sleep. A prescription for an appropriate CPAP pressure and well sealing mask will be provided for participants.
The coaching sessions involve: Coaching Session 1 (immediately after the psycho-education and mask fitting session): to develop a collaborative relationship between coach and participant, help the participant develop personally meaningful coaching goals and explore how CPAP treatment can be incorporated into their lifestyle. Coaching Session 2 (immediately after the CPAP set-up session): This session will review and evaluate actions and progress to date. Participant generated goals will be set and action plans developed. The key focus will be on identifying areas of success thus far and coaching the participant to capitalise on these, although barriers to change will also be explored where relevant. Coaching Sessions 3 & 4: to help the participant prepare for longer-term use of the CPAP equipment, exploring ways to consolidate change and building self-efficacy, confidence and motivation levels. Session 3 will be between the 1st and 2nd download sessions and Session 4 will be immediately after the 3rd download session.
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Intervention code [1]
285363
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Behaviour
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Comparator / control treatment
Treatment as Usual - psycho-education session and mask fitting
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Control group
Active
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Outcomes
Primary outcome [1]
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Adherence as measured by CPAP download (mean hours per night)
All participants will be provided with a CPAP device (provided by Air Liquide) with data-storage which allows for usage data to be directly downloaded from the machine or via a memory key. The data card/key records run time while the mask is on the patient's face and includes information about air leaks and apneas/hypopneas (complete or partial airway closures). The returned data will be downloaded by a CPAP therapist from Air Liquide and automatically analyzed using software provided by the device manufacturers.
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Assessment method [1]
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Timepoint [1]
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After the following number of weeks of CPAP usage: 2 weeks, 5 weeks, 8 weeks, 12 weeks
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Secondary outcome [1]
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Sleepiness and sleep related quality of life. Measured by: Epworth Sleepiness Scale (ESS)
Functional Outcomes Sleep Questionnaire (FOSQ)
Pittsburgh Sleep Quality Index (PSQI)]
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Assessment method [1]
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Timepoint [1]
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Baseline, 3 months, 6 months
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Secondary outcome [2]
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Mood and Wellbeing. Measured by:
Depression, Anxiety and Stress Scale 21 items (DASS-21)
Newark Cognitive Hardness Scale
Multidimensional Quality of Life Inventory
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Assessment method [2]
298616
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Timepoint [2]
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Baseline, 3 months, 6 months
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Secondary outcome [3]
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Self-efficacy & related Variables. Measured by:
Social Cognitive Theory Questionnaire
SEMSA
Newark Cognitive Hardness Scale (resilience)
Solution-focussed thinking inventory
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Assessment method [3]
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Timepoint [3]
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Baseline, 1 week, 1 month, 3 months, 6 months
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Eligibility
Key inclusion criteria
Any patient (over 18 years) with untreated OSA and a low self-efficacy score (4 or lower)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Previous use of CPAP
Individuals not fluent in written and oral English
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants will have undergone a Sleep Study and diagnosed with Obstructive Sleep Apnea. At the follow-up visit with their Sleep physician they will be asked to complete a Self-efficacy questionnaire. Any patient with a self-efficacy score of 4 or less will be contacted for participation in this study. Once recruited participants will be randomised to a 1:1 ratio (treatment as usual or health coaching). The randomisation sequence will be prepared by a party independent of the trial, with randomly permuted block sizes. Allocation concealment will be ensured by use of sequentially numbered, opaque, sealed envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The randomisation sequence will be prepared by a party independent of the trial, with randomly permuted block sizes.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
1/10/2012
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Actual
27/08/2013
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Date of last participant enrolment
Anticipated
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Actual
7/06/2016
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Date of last data collection
Anticipated
21/12/2016
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Actual
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Sample size
Target
60
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Accrual to date
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Final
55
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Royal Prince Alfred Hospital - Camperdown
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Recruitment postcode(s) [1]
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2037 - Glebe
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Recruitment postcode(s) [2]
7576
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2050 - Missenden Road
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Air Liquide Healthcare
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Address [1]
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Unit 5, 476 Gardeners Road, Alexandria, NSW, 2015
(Locked Bag 1008, Rosebery NSW, 1445)
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Country [1]
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Australia
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Primary sponsor type
Commercial sector/Industry
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Name
Air Liquide Healthcare
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Address
Unit 5, 476 Gardeners Road, Alexandria, NSW, 2015
(Locked Bag 1008, Rosebery NSW, 1445)
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Sydney Local Health District Ethics Review Committee (RPAH Zone)
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Ethics committee address [1]
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c/- Research Development Office Royal Prince Alfred Hospital Missenden Road CAMPERDOWN NSW 2050
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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29/08/2012
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Approval date [1]
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27/09/2012
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Ethics approval number [1]
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HREC/12/RPAH/442
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Summary
Brief summary
This project aims to (1) assess the effectiveness of a coaching intervention (C) in increasing adherence to CPAP compared with an enhanced education or treatment as usual (TAU) intervention; (2) to identify individuals with low self-efficacy scores who are at risk of stopping treatment and (3) to examine the role of mood, quality of life and well-being in the treatment response. The hypothesis is that the C intervention will increase uptake and adherence to CPAP and will improve low baseline self-efficacy scores as individuals feel they can perceive themselves using CPAP effectively. By using CPAP on a nightly basis for most of the night, mood and well-being, sleepiness and sleep related quality of life and self-efficacy will also be improved. A total of 60 individuals diagnosed with OSA will be recruited into the study on the basis of being naive to CPAP treatment and having low self-efficacy scores (<4). Participants will be randomised to either the current treatment as usual group (TAU) which consists of psycho-education and mask fitting (1.5 - 2 hours) before the CPAP titration night or a coaching group (C). The C group will undergo the psycho-education and mask fitting but will also undertake 4 individual coaching sessions at baseline (3 face-to-face session and 1 by telephone). All participants will be asked attend 4 CPAP data usage download sessions and to complete questionnaires at baseline, 1 week after starting CPAP, 1 month after starting CPAP, 12 weeks after starting CPAP and 3 months after study end. All participants will receive a CPAP machine and tubing free of charge for the duration of the study. Past CPAP research has found that self-efficacy predicts CPAP adherence, and as SF/CBC has been found to enhance self-efficacy and goal attainment and adherence, thus advancing knowledge and practice in CPAP and contributing to the broader emerging area of health coaching.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Delwyn Bartlett
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Address
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Woolcock Institute of Medical Research 431 Glebe Point Road Glebe NSW 2037
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Country
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Australia
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Phone
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+61 2 9114 0460
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Fax
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+ 61 2 9114 0014
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Email
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[email protected]
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Contact person for public queries
Name
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Associate Professor Delwyn Bartlett
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Address
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Woolcock Institute of Medical Research
431 Glebe Point Road
Glebe
NSW
2037
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Country
17746
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Australia
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Phone
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+61 2 9114 0460
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Fax
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+ 61 2 9114 0014
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Email
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[email protected]
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Contact person for scientific queries
Name
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Associate Professor Delwyn Bartlett
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Address
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Woolcock Institute of Medical Research
431 Glebe Point Road
Glebe
NSW
2037
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Country
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Australia
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Phone
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+61 2 9114 0460
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Fax
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+ 61 2 9114 0014
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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