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Trial registered on ANZCTR
Registration number
ACTRN12620000031965
Ethics application status
Approved
Date submitted
18/12/2019
Date registered
20/01/2020
Date last updated
16/11/2023
Date data sharing statement initially provided
20/01/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
A study to investigate if melatonin can improve sleep in hospital after abdominal surgery.
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Scientific title
Melatonin to Improve Sleep in Patients Undergoing Major Abdominal Surgery:
A Double-blind, Randomised Placebo-controlled Trial
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Secondary ID [1]
300066
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None
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Universal Trial Number (UTN)
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Trial acronym
Melrose
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Abdominal surgery
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Sleep disturbance
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Condition category
Condition code
Surgery
313871
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0
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Other surgery
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Alternative and Complementary Medicine
314059
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0
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Other alternative and complementary medicine
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Melatonin 5mg wafer once daily sublingual whilst in hospital from day 1 post surgery up to 7 days or until discharge if prior to 7 days. The doses will be prescribed via the electronic medication chart and this will be reviewed to confirm compliance to administration.
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Intervention code [1]
316333
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Treatment: Drugs
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Comparator / control treatment
Placebo 1 wafer once daily sublingual whilst in hospital up to 7 days or until discharge if prior to 7 days. The placebo will consist of a starch.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The primary efficacy outcome is a difference in Patient-Reported Outcome Measurement Information System (PROMIS) Sleep Disturbance 8a score between the 2 arms of the study.
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Assessment method [1]
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Timepoint [1]
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At day 3 post surgery.
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Secondary outcome [1]
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Mean difference between groups for serum cortisol levels
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Assessment method [1]
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Timepoint [1]
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Levels measured at baseline, day of surgery and day 1, 2, 3 post-operatively as recorded from the medial record.
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Secondary outcome [2]
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Incidence of post-operative surgical complications graded by the Clavien-Dindo Classification of Surgical Complications.
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Assessment method [2]
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Timepoint [2]
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Up to day 30 post-op as recorded in medical record.
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Secondary outcome [3]
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Difference between groups for mean length of hospital stay (days)
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Assessment method [3]
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Timepoint [3]
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As recorded in medical record for index admission, up to the time of suitability for surgical discharge to home or rehabilitation.
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Secondary outcome [4]
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All-cause mortality
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Assessment method [4]
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Timepoint [4]
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By day 30 as recorded in medical record or reported by treating surgeon.
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Secondary outcome [5]
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Incidence of delirium as defined by a clinical diagnosis of same by treating team.
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Assessment method [5]
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Timepoint [5]
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Assessed from the medical record up to the time of hospital discharge or discharge from surgical service.
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Secondary outcome [6]
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Patient reported quality of life scores
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Assessment method [6]
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Timepoint [6]
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Measured pre-operatively and at day 30 post-op using the EQ-5D-5L.
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Eligibility
Key inclusion criteria
All English-speaking patients 18 years and over undergoing elective/semi-elective major abdominal surgery with an anticipated length of stay greater than 48 hours.
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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
Patients from the above group will be excluded if they:
• Are unable to give written informed consent to take part in the study,
• Patients who require the use of a trained healthcare interpreter to be able to understand study information.
• Lack decision-making capacity,
• Expected stay less than 48 hours,
• Concurrent use of benzodiazepine, non-benzodiazepine (Z-drugs) or melatonin,
• Alcohol consumption > 13 units/week for women and >20 units/week for men.
• Currently taking melatonin
• Drug interaction with melatonin.
• Allergy to melatonin or its excipients (may contain lactose)
• Decreased renal function as defined by an eGFR of <30 mL/min/1.73m2
• Decreased liver function defined as an AST > 500 U/L or ALT >500 U/L
• Pregnant or breastfeeding females
• Enrolment in other clinical trials involving an investigational agent
• Taking quinolones, carbamazepine and rifampicin, fluvoxamine, 5- or 8- methoxypsoralen, cimetidine, oestrogens.
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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)
Central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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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
17/08/2020
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Actual
17/08/2020
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Date of last participant enrolment
Anticipated
17/08/2023
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Actual
1/03/2023
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Date of last data collection
Anticipated
29/11/2024
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Actual
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Sample size
Target
340
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Accrual to date
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Final
152
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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John Hunter Hospital - New Lambton
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Recruitment hospital [2]
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Calvary Mater Newcastle - Waratah
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Recruitment postcode(s) [1]
28899
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2305 - New Lambton
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Recruitment postcode(s) [2]
38665
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2298 - Waratah
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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John Hunter Hospital
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Address [1]
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Lookout Road
New Lambton Heights NSW 2305
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
Hunter New England Local Health District.
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Address
Lookout Road
New Lambton Heights NSW 2305
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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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Hunter New England Human Research Ethics Committee
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Ethics committee address [1]
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Locked Bag 1 New Lambton NSW 2305
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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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29/11/2019
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Approval date [1]
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18/12/2019
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Ethics approval number [1]
304946
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Summary
Brief summary
The primary purpose of this project is to determine whether the use of melatonin improves the quality of sleep in patients undergoing major abdominal surgery. Melatonin is a natural hormone secreted by the pineal gland. Melatonin when given at night works to promote sleep by helping to regulate the body's bio clock and sleep-wake cycles. It is well known that sleep quality in hospital is poor and can cause insufficient sleep which reduces natural immune function. Major abdominal surgery leads to the release of both pro-inflammatory and anti-inflammatory chemical in the blood.. Melatonin could be an effective adjunct medication not only to assist in improving sleep but to dampen the inflammatory response after surgery.
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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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Dr Eduard Martinez
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Address
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Intensive Care Unit
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
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Australia
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Phone
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+61 0249236397
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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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Rosemary Carroll
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Address
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Surgical Services
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
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Australia
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Phone
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+61 2 4923 6397
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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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Eduard Martinez
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Address
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Intensive Care Unit
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
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Australia
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Phone
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+61 0249236397
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Undecided as yet.
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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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