Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Trial Review
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Download to PDF
Trial registered on ANZCTR
Registration number
ACTRN12624000996561
Ethics application status
Approved
Date submitted
26/07/2024
Date registered
14/08/2024
Date last updated
14/10/2024
Date data sharing statement initially provided
14/08/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparison of Osteoarthritis Management Programs: remote versus face-to-face care (COASTAL)
Query!
Scientific title
Comparison of Osteoarthritis Management Programs: remote versus face-to-face care on knee pain and functional outcomes (COASTAL)
Query!
Secondary ID [1]
312256
0
None
Query!
Universal Trial Number (UTN)
Query!
Trial acronym
COASTAL
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Knee osteoarthritis
333963
0
Query!
Knee pain
333964
0
Query!
Condition category
Condition code
Musculoskeletal
330633
330633
0
0
Query!
Osteoarthritis
Query!
Public Health
330634
330634
0
0
Query!
Health service research
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
We will compare three services delivery approaches to osteoarthritis (OA) care. The three interventional approaches are the Osteoarthritis Chronic Care Program (OACCP) face-to-face hospital clinical approach, a telehealth approach, and an app (OA Coach). Participants randomised to the treatment arms will receive the interventions over 6-months. Appropriate to the mode of delivery, the interventions will deliver a standardised participant needs assessment; OA education; develop a collaborative management plan for each individual that selects appropriate self-management behaviours for therapeutic exercise, physical activity, pain management, and/or weight management. A report to each participant's referring health professional using a standardised template will be prepared after randomisation, and at trial conclusion. Each intervention arm will receive:
• OACCP arm: participants will receive the OACCP model of care, as currently delivered through hospitals in NSW Australia. The delivery of the model will vary depending on the host hospital’s capacity/services, but will typically comprise of participant visits with a multidisciplinary team (e.g. physiotherapists, occupational therapists, dietitians), with care overseen by an OACCP Musculoskeletal Coordinator (usually a physiotherapist). There will be 3 sessions (~1-2 hrs each) over the 6 months approximately every 2 months during months 1, 3/4 and 6. Adherence will be monitored by participant self-reported monthly surveys and session attendance checklists.
• Telehealth arm: participants will receive a remotely delivered telehealth service delivered by Ramsay Connect. This model is based upon the Optimising primary care management of knee osteoarthritis (PARTNER) PARTNER model of service delivery, tested previously. The Care Support Team (CST) will be an allied health team with members from a range of professions (e.g. Physiotherapists, Dietitians), trained in behaviour change techniques and OA management and will provide participants tailored OA educational materials, exercise programs, or weight-loss programs, as appropriate. There will be ~6-10 sessions (approx. one hour for the first session, and then subsequent sessions approx. 10-15 minutes each) delivered to participants by phone call over 6-months, ideally at least one phone session per month. Adherence will be monitored by participant self-reported monthly surveys and session attendance checklists.
• OA Coach arm: participants will be guided in their care through a smartphone app. Interaction with the app will be at the participants' discretion, but they will be encouraged to login at least daily. Participants will complete assessments involving the input of anthropometric measurements and completion of pain scales, be able to set their own goals, be provided a display of their progress including steps (participants will be provided a Fitbit activity tracker to wear during the trial alongside the app), weight loss and pain levels. The learning page will cover core components of OA management, including physical activity, exercise, weight management, sleep hygiene, mood, and flare management. The duration off each app interaction is expected to take approx. 10-15 minutes each. Adherence will be monitored by participant self-reported monthly surveys and back-end monitoring progress (e.g. steps being uploaded).
Query!
Intervention code [1]
328705
0
Treatment: Other
Query!
Intervention code [2]
328818
0
Lifestyle
Query!
Intervention code [3]
328819
0
Behaviour
Query!
Comparator / control treatment
The control group are participants with knee osteoarthritis referred to OACCP who do not wish to be randomised to any of the three treatment arms, but are happy to still participate in the study. They will continue with their usual care and complete self-report questionnaires at baseline, 6 months and 12 months. For the purposes of this study, “usual care” is defined as however the participant has been controlling and managing their knee OA pain in their day-to-day life, whether that may include no additional care, or care from their GP or other health practitioners.
Query!
Control group
Active
Query!
Outcomes
Primary outcome [1]
338379
0
Between group change in average knee pain during walking
Query!
Assessment method [1]
338379
0
11 point, numerical rating scale (NRS), adjusted for baseline score.
Query!
Timepoint [1]
338379
0
At Baseline and 6 months post-Baseline
Query!
Secondary outcome [1]
435685
0
Between group changes in knee pain on walking
Query!
Assessment method [1]
435685
0
11 point, NRS
Query!
Timepoint [1]
435685
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [2]
435686
0
Between group changes in knee specific pain
Query!
Assessment method [2]
435686
0
Knee injury and Osteoarthritis Outcome Score (KOOS) (Pain subscale)
Query!
Timepoint [2]
435686
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [3]
435687
0
Between group changes at 6- and 12-months in weight/BMI
Query!
Assessment method [3]
435687
0
Self-reported weight/height, calculated BMI
Query!
Timepoint [3]
435687
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [4]
435688
0
Between group changes in ability to participate in life
Query!
Assessment method [4]
435688
0
8-question, PROMIS ability to participate in social roles and activities – knee OA instrument
Query!
Timepoint [4]
435688
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [5]
435689
0
Between group changes in physical activity
Query!
Assessment method [5]
435689
0
International Physical Activity Questionnaire (IPAQ-LF)
Query!
Timepoint [5]
435689
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [6]
435690
0
Between group changes in health related quality of life
Query!
Assessment method [6]
435690
0
Quality of Life EQoL- 5D-5L
Query!
Timepoint [6]
435690
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [7]
435691
0
Between group changes in global rating of knee change
Query!
Assessment method [7]
435691
0
NRS
Query!
Timepoint [7]
435691
0
At 6 and 12 months post-Baseline only
Query!
Secondary outcome [8]
435692
0
Between group changes in depressive symptoms
Query!
Assessment method [8]
435692
0
Depression and Anxiety scale 21 (DASS-21)
Query!
Timepoint [8]
435692
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [9]
435693
0
Between group changes in sleep quality
Query!
Assessment method [9]
435693
0
Pittsburgh Sleep Quality Index (PSQI)
Query!
Timepoint [9]
435693
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [10]
435695
0
Between group changes in willingness for joint replacement surgery
Query!
Assessment method [10]
435695
0
NRS
Query!
Timepoint [10]
435695
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [11]
438352
0
Between group changes in knee function
Query!
Assessment method [11]
438352
0
Knee injury and Osteoarthritis Outcome Score (KOOS) (Function and daily living subscale)
Query!
Timepoint [11]
438352
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [12]
438353
0
Between group changes in symptoms
Query!
Assessment method [12]
438353
0
Knee injury and Osteoarthritis Outcome Score (KOOS) (Other Symptoms subscale)
Query!
Timepoint [12]
438353
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [13]
438354
0
Between group changes in quality of life (QoL)
Query!
Assessment method [13]
438354
0
Knee injury and Osteoarthritis Outcome Score (KOOS) (QoL subscale)
Query!
Timepoint [13]
438354
0
At Baseline and at 6 and 12 months post-Baseline
Query!
Secondary outcome [14]
438356
0
Between group changes in satisfaction with knee symptoms
Query!
Assessment method [14]
438356
0
NRS
Query!
Timepoint [14]
438356
0
At 6 and 12 months post-Baseline only
Query!
Secondary outcome [15]
438357
0
Between group changes in satisfaction with treatment
Query!
Assessment method [15]
438357
0
NRS
Query!
Timepoint [15]
438357
0
At 6 and 12 months post-Baseline only
Query!
Eligibility
Key inclusion criteria
• Referred to participating OACCP clinic by primary care (e.g. GP, physiotherapist, allied health professional) or other non-surgical wait list pathway
• triaged by the OACCP as category 2 or 3 (as applicable to OACCP site)
• activity related knee pain related to OA for at least 3 months
• knee pain on walking between 4 and 8 inclusive on an 11-point numerical rating scale (NRS) the week prior to screening and confirmed prior to enrolment,
• prepared to complete the suite of online surveys at 3 timepoints over 1 year
• has a smart phone or device, and internet access
Query!
Minimum age
45
Years
Query!
Query!
Maximum age
No limit
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
• non-English speaker who requires a translator
• unable to give informed consent (including people in high level care, or with any medical condition which precludes giving informed consent, e.g. dementia, intellectual disability, mental health issues)
• non-ambulatory or very limited mobility
• terminally ill, has rheumatoid arthritis, gout or any other severe inflammatory condition, or is undergoing active treatment for serious medical conditions which would preclude participation in this study (e.g. cancer treatment).
Query!
Study design
Purpose of the study
Treatment
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer - REDCap randomisation module
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Prior to study activation, the study statistician will prepare a computer-generated randomisation schedule considering the sample size, and allocation rate of 1:1:1, and random permuted block sizes.
Query!
Masking / blinding
Blinded (masking used)
Query!
Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
Query!
Query!
Query!
Query!
Intervention assignment
Parallel
Query!
Other design features
Query!
Phase
Not Applicable
Query!
Type of endpoint/s
Efficacy
Query!
Statistical methods / analysis
Data analysis will be blinded, based on the intention to treat principles, and guided by a detailed statistical analysis plan. The mean difference in pain on walking between the groups at six months (primary outcome) will be compared using the ANCOVA model and adjusting for baseline pain scores. Baseline descriptive statistics of the participant will be presented to allow comparison of treatment groups.
For continuous outcome measures, differences in mean change (baseline minus follow-up) will be compared between groups using generalised estimating equations to account for within-practice correlation with exchangeable correlation, robust standard errors, and adjusting for the baseline value of the outcome variable. For binary outcomes, GEEs will be fitted using a logit link function assuming an exchangeable correlation structure and robust variance estimation, adjusting for stratification variables, with results presented as odds ratios. To aid interpretation, risk differences will also be calculated using marginal probabilities.
Query!
Recruitment
Recruitment status
Not yet recruiting
Query!
Date of first participant enrolment
Anticipated
31/10/2024
Query!
Actual
Query!
Date of last participant enrolment
Anticipated
30/11/2026
Query!
Actual
Query!
Date of last data collection
Anticipated
30/11/2027
Query!
Actual
Query!
Sample size
Target
1348
Query!
Accrual to date
Query!
Final
Query!
Recruitment in Australia
Recruitment state(s)
NSW
Query!
Funding & Sponsors
Funding source category [1]
316634
0
Government body
Query!
Name [1]
316634
0
NHMRC
Query!
Address [1]
316634
0
Query!
Country [1]
316634
0
Australia
Query!
Funding source category [2]
316635
0
Charities/Societies/Foundations
Query!
Name [2]
316635
0
Ramsay Health Research Foundation
Query!
Address [2]
316635
0
Query!
Country [2]
316635
0
Australia
Query!
Funding source category [3]
316636
0
Other Collaborative groups
Query!
Name [3]
316636
0
Institute of Bone and Joint Research
Query!
Address [3]
316636
0
Query!
Country [3]
316636
0
Australia
Query!
Primary sponsor type
University
Query!
Name
The University of Sydney
Query!
Address
Query!
Country
Australia
Query!
Secondary sponsor category [1]
318820
0
None
Query!
Name [1]
318820
0
Query!
Address [1]
318820
0
Query!
Country [1]
318820
0
Query!
Ethics approval
Ethics application status
Approved
Query!
Ethics committee name [1]
315416
0
Northern Sydney Local Health District Human Research Ethics Committee
Query!
Ethics committee address [1]
315416
0
https://www.nslhd.health.nsw.gov.au/Research/ResearchOffice/Pages/HREC.aspx
Query!
Ethics committee country [1]
315416
0
Australia
Query!
Date submitted for ethics approval [1]
315416
0
26/07/2024
Query!
Approval date [1]
315416
0
03/09/2024
Query!
Ethics approval number [1]
315416
0
2024/ETH01461
Query!
Summary
Brief summary
OA is a condition that affects the joints and causes pain and stiffness. In Australia, around three million people have OA, but the way we currently treat OA isn't always based on the best evidence. Sometimes, the care is not well coordinated, not very helpful, or not suitable for the person's needs. The COASTAL study is a research study testing three different ways of providing this care: in-person (face-to-face), or through technology like telehealth (video or phone calls) or using an online app. This research study will compare how well these different programs work at improving pain for people with knee OA. We hope the results of this study will help policymakers and healthcare providers decide on the best way to organise services for people with knee OA. We hypothesise that the three methods of delivering knee OA management programs will be non-inferior to each other for reducing average knee pain on walking.
Query!
Trial website
Query!
Trial related presentations / publications
Query!
Public notes
Query!
Contacts
Principal investigator
Name
134642
0
Prof David Hunter
Query!
Address
134642
0
Kolling Institute, Royal North Shore Hospital, 10 Westbourne St, St Leonards NSW 2065
Query!
Country
134642
0
Australia
Query!
Phone
134642
0
+61 2 9463 1887
Query!
Fax
134642
0
Query!
Email
134642
0
[email protected]
Query!
Contact person for public queries
Name
134643
0
Scott Chery
Query!
Address
134643
0
Kolling Institute, Royal North Shore Hospital, 10 Westbourne St, St Leonards NSW 2065
Query!
Country
134643
0
Australia
Query!
Phone
134643
0
+61 2 9463 1898
Query!
Fax
134643
0
Query!
Email
134643
0
[email protected]
Query!
Contact person for scientific queries
Name
134644
0
Jocelyn Bowden
Query!
Address
134644
0
Kolling Institute, Royal North Shore Hospital, 10 Westbourne St, St Leonards NSW 2065
Query!
Country
134644
0
Australia
Query!
Phone
134644
0
+61 2 9463 1898
Query!
Fax
134644
0
Query!
Email
134644
0
[email protected]
Query!
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
Query!
What data in particular will be shared?
Initially, individual participant data underlying published results will be available (after de-identification). Prior to the other data may be available at the discretion of the CIs.
Query!
When will data be available (start and end dates)?
Immediately following publication or as agreed by the CIs, no end date has been determined.
Query!
Available to whom?
Initially, data will be available to researchers who provide a methodologically sound proposal. Data will become available through a public database once the major findings have been published.
Query!
Available for what types of analyses?
No restrictions
Query!
How or where can data be obtained?
Initially, access will be subject to approvals by the Principal Investigator, and may require a data access agreement. Data will eventually be submitted to a public database.
Principal Investigator: Prof David Hunter (
[email protected]
)
Query!
What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
24042
Study protocol
[email protected]
24043
Informed consent form
[email protected]
24044
Statistical analysis plan
[email protected]
24045
Ethical approval
[email protected]
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