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Trial registered on ANZCTR
Registration number
ACTRN12616001486415
Ethics application status
Approved
Date submitted
28/09/2016
Date registered
25/10/2016
Date last updated
25/10/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effectiveness of group cognitive behavioural therapy on pain, functional disability and psychological outcomes among knee osteoarthritis patients seen at Malaysian government hospital
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Scientific title
Effectiveness of group cognitive behavioural therapy on pain, functional disability and psychological outcomes among knee osteoarthritis patients seen at Malaysian government hospital
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Secondary ID [1]
290233
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NMRR Clinical Trial Registry: NMRR-15-73-24008
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Universal Trial Number (UTN)
U1111-1188-1579
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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:
knee osteoarthritis
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Condition category
Condition code
Musculoskeletal
300282
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Osteoarthritis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The current study will be conducted at Orthopedics Clinic in Malaysian public hospitals, namely Hospital Putrajaya and Hospital Serdang, which are located in the greater Klang Valley area of Selangor, Malaysia. This study consists of a two arm randomised clinical trial involving diagnosed knee OA patients who are eligible to the study. Both the experimental and control group will receive standard routine care throughout the study. Respondents have to attend clinic and physiotherapy session as usual on their fixed appointment date. However, respondents in the control group will be given The Knee Book and not receive further intervention. Respondents in the experimental group will be given The Knee Book and received a three sessions of group CBT (each session will be last for two and a half hours) every two weeks. The sessions will be held in a group of eight to ten respondents under the supervision of an experienced senior clinical psychologist and a physiotherapist. The intervention will be delivered by physiotherapists, nurses and graduate researcher who will undergo at least one day of training, specifically tailored for the trial which will be conducted by an experienced senior clinical psychologist with CBT experience. Each session will be audio- recorded with a written consent from the respondents. Fidelity of the CBT session will be assessed with a random sample of recordings by the experienced psychologist with the Cognitive Therapy Rating Scale (CTS-R).
The Knee Book was adapted with permission from the Ministry of Health, Singapore (Ministry of Health Singapore, 2007). This booklet was based on the Ministry of Health Clinical Practice Guidelines for OA of the Knee and has been written for patients with the aforementioned condition, their family members and caregivers.
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Intervention code [1]
296011
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Behaviour
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Intervention code [2]
296110
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Treatment: Other
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Comparator / control treatment
There is no active treatment for control arm group. Participants in control group received standard routine care. Participants need to attend their clinic and physiotherapy session as usual based on their fixed appointment date
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Control group
Active
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Outcomes
Primary outcome [1]
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knee pain intensity
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Assessment method [1]
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Timepoint [1]
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mean change in Knee injury and Osteoarthritis Outcome Score (KOOS) knee pain against baseline and six months post treatment completion
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Secondary outcome [1]
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functional disability
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Assessment method [1]
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Timepoint [1]
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mean change in Knee injury and Osteoarthritis Outcome Score (KOOS) functional disability against baseline and six months post treatment completion
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Secondary outcome [2]
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depression
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Assessment method [2]
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Timepoint [2]
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mean change in Depression Anxiety and Stress Scale (DASS) depression score against baseline and six months post treatment completion
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Secondary outcome [3]
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Anxiety
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Assessment method [3]
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Timepoint [3]
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mean change in Depression Anxiety and Stress Scale (DASS) anxiety score against baseline and six months post treatment completion
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Secondary outcome [4]
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Stress
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Assessment method [4]
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Timepoint [4]
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mean change in Depression Anxiety and Stress Scale (DASS) stress score against baseline and six months post treatment completion
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Secondary outcome [5]
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Fear- avoidance beliefs
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Assessment method [5]
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Timepoint [5]
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mean change in fear- avoidance beliefs score against baseline and six months post treatment completion
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Secondary outcome [6]
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Pain self- efficacy
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Assessment method [6]
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Timepoint [6]
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mean change in pain self- efficacy score against baseline and six months post treatment completion
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Secondary outcome [7]
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Pain catastrophising
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Assessment method [7]
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Timepoint [7]
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mean change in pain catastrophising score against baseline and six months post treatment completion
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Eligibility
Key inclusion criteria
1. Patients with OA of the knee who are aged 35 to 75 years;
2. Patients diagnosed with primary knee OA on the basis of medical evaluation (knee pain for most days of previous month and bony enlargement of the knee) and radiographic examination (Kellgren- Lawrence) of grade 2 or more; and
3. Patients with an average pain intensity of 40 or more on a 100mm visual analogue scale in the 7 days before baseline assessment.
4. Written informed consent will be obtained from each patient.
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Minimum age
35
Years
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Maximum age
75
Years
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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
1. Patients with knee pain caused by conditions other than knee OA;
2. Patients who had knee replacement surgery of the affected knee in the past year;
3. Patients who had undergone psychological treatment or any other clinical study during the past 12 months; and
4. Patients diagnosed with mental disorder, pregnancy or breastfeeding.
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Study design
Purpose of the study
Treatment
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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)
Randomisation using the block randomisation method will be implemented by an individual who is not involved in the recruitment process. The randomised names will be divided into 15 smaller subgroups in each experimental and control group. The subgroup lists will be given to the hospital staffs. All the names in the subgroups will be contacted personally before every assignment by different hospital staffs, who will not have visibility on the group allocation. Therefore, the allocation will be concealed in advance from the patients, researchers involved in recruitment, hospital staffs and therapists.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Those patients who are eligible and willing to participate in this study will be randomly assigned to either of the experimental or control group based on block randomisation method by using random allocation software (http://random-allocation-software.software.informer.com/2.0/) after the written consent is obtained.
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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
Mixed design repeated measure ANOVA
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
10/08/2015
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Date of last participant enrolment
Anticipated
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Actual
9/10/2015
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Date of last data collection
Anticipated
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Actual
5/08/2016
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Sample size
Target
262
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Accrual to date
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Final
300
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Recruitment outside Australia
Country [1]
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Malaysia
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State/province [1]
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Selangor Darul Ehsan
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Putra Malaysia
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Address [1]
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Jalan UPM, 43400 Serdang, Selangor Darul Ehsan
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Country [1]
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Malaysia
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Primary sponsor type
University
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Name
Research University Grants (RUGS), University of Putra Malaysia
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Address
University of Putra Malaysia, Jalan UPM, 43400 Serdang, Selangor Darul Ehsan
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Country
Malaysia
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
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None
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296043
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National Medical Research Registry (NMRR)
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Ethics committee address [1]
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Medical Research & Ethics Committee Ministry of Health Malaysia Jalan Rumah Sakit, Bangsar 59000 Kuala Lumpur
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Ethics committee country [1]
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Malaysia
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Date submitted for ethics approval [1]
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20/01/2015
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Approval date [1]
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27/07/2015
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Ethics approval number [1]
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NMRR-15-73-24008
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Summary
Brief summary
This study aimed to develop, implement and perform an evaluation on the efficacy of a cognitive behavioural therapy module among knee OA patients that would reduce knee pain intensity, functional disability, psychological distress (depression, anxiety and stress), pain catastrophising, fear- avoidance beliefs, and improve pain self- efficacy level.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
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/AnzctrAttachments/371567-RESEARCH PROPOSAL_141215.pdf
(Protocol)
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Attachments [2]
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/AnzctrAttachments/371567-Foo Chai Nien - ApprovalLetter_MREC_1_260715.pdf
(Ethics approval)
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Attachments [3]
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/AnzctrAttachments/371567(v28-09-2016-15-13-28)-Foo Chai Nien - PIS-Eng.pdf
(Participant information/consent)
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Contacts
Principal investigator
Name
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Miss Foo Chai Nien
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Address
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No. 33, Jalan Indah 1/11 B Taman University Indah 43300 Seri Kembangan Selangor Darul Ehsan
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Country
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Malaysia
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Phone
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+60123167252
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Fax
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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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Foo Chai Nien
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Address
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No. 33, Jalan Indah 1/11 B Taman University Indah 43300 Seri Kembangan Selangor Darul Ehsan
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Country
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Malaysia
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Phone
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+60123167252
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Fax
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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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Foo Chai Nien
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Address
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No. 33, Jalan Indah 1/11 B Taman University Indah 43300 Seri Kembangan Selangor Darul Ehsan
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Country
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Malaysia
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Phone
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+60123167252
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Fax
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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.
Download to PDF