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Trial registered on ANZCTR
Registration number
ACTRN12608000112369
Ethics application status
Approved
Date submitted
26/02/2008
Date registered
28/02/2008
Date last updated
5/08/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
Pathways to Lung Health:a comprehensive
Self-Management Programme for Chronic
Obstructive Pulmonary Disease in the community
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Scientific title
The effect of telphone delivered health-mentoring by community and practice nurses on quality of life in Chronic Obstructive Pulmonary Disease compared to usual care in the community.
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Secondary ID [1]
259652
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not required
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Secondary ID [2]
259653
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not required
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Universal Trial Number (UTN)
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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:
Chronic Obstructive Pulmonary Disease
2869
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Condition category
Condition code
Respiratory
3005
3005
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0
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Chronic obstructive pulmonary disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patient participants recruited in practices in the active arm will have an individual management plan developed by the research team in consultation with their general practitioner. Community and practice nurses, trained in a model of behaviour change based on motivational interviewing to improve self-efficacy, will work in partnership with participants to achieve behavioural change through a cycle of goal setting and action planning during regular telephone contacts over 12 months. Goals will focus on health behaviours identified in the management plan to support patients to develop capacity to self-manage their chronic illness.
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Intervention code [1]
2599
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Behaviour
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Intervention code [2]
2600
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Treatment: Other
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Intervention code [3]
2601
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Lifestyle
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Comparator / control treatment
Patient participants recruited in practices in the the usual care arm will have an individual management plan developed by the research team in consultation with their general practitioner.
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Control group
Active
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Outcomes
Primary outcome [1]
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Medical Outcomes Study SF-36 v2 quality of life (generic health related)
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Assessment method [1]
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Timepoint [1]
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Baseline, 6 months and 12 months after intervention commencement, at 6 months and 12 months following intervention cessation
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Primary outcome [2]
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St George's Respiratory Questionnaire quality of life (respiratory related)
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Assessment method [2]
290170
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Timepoint [2]
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Baseline, 6 months and 12 months after intervention commencement.
6 months and 12 months following intervention cessation.
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Secondary outcome [1]
6530
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Center for Epidemiologic Studies Depression Scale
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Assessment method [1]
6530
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Timepoint [1]
6530
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Baseline, 6 months and 12 months after intervention commencement, at 6 months and 12 months following intervention cessation
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Secondary outcome [2]
6531
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PTSD Checklist-Civilian Version (PCL-C) anxiety measure
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Assessment method [2]
6531
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Timepoint [2]
6531
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Baseline, 6 months and 12 months after intervention commencement, at 6 months and 12 months following intervention cessation
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Secondary outcome [3]
6532
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Hospital Anxiety and Depression scale
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Assessment method [3]
6532
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Timepoint [3]
6532
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Baseline, 6 months and 12 months after intervention commencement, at 6 months and 12 months following intervention cessation.
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Secondary outcome [4]
6533
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Satisfaction With Life Survey
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Assessment method [4]
6533
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Timepoint [4]
6533
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Baseline, 6 months and 12 months after intervention commencement, at 6 months and 12 months following intervention cessation
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Secondary outcome [5]
6534
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Client Satisfaction Questionnaire (mentoring process)
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Assessment method [5]
6534
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Timepoint [5]
6534
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Baseline and 6 months after intervention commencement
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Secondary outcome [6]
6535
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Lung function measured by spirometry (FEV1, FVC, FEF 25-75%)
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Assessment method [6]
6535
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Timepoint [6]
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Baseline, 6 months and 12 months after intervention commencement, at 6 months and 12 months following intervention cessation
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Secondary outcome [7]
6536
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Health care utilization measured by general practitioner routine and urgent attendances, public hospital admissions and emergency visits for Chronic Obstructive Pulmonary Disease
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Assessment method [7]
6536
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Timepoint [7]
6536
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12 months prior to intervention commencement , during 12 months intervention, 12 months post intervention completion
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Secondary outcome [8]
6537
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Prescriptions for oral steroids and antibiotics for exacerbations of Chronic Obstructive Pulmonary Disease recorded in general practitioner records
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Assessment method [8]
6537
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Timepoint [8]
6537
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12 months prior to intervention commencement , during 12 months intervention, 12 months post intervention completion
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Secondary outcome [9]
6556
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Physical activity (steps/day) measured with accelerometer
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Assessment method [9]
6556
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Timepoint [9]
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7day periods at baseline, 6 months and 12 months after intervention commencement, at 6 months and 12 months following intervention cessation
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Secondary outcome [10]
273274
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Fidelity of delivery of intervention assessed from sample of recorded mentoring phone calls
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Assessment method [10]
273274
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Timepoint [10]
273274
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At completion of mentoring and control phone calls
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Secondary outcome [11]
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Qualitative assessment of health-mentoring using semi-structured interviews with representative sample of 35-45 participants in intervention arm
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Assessment method [11]
273279
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Timepoint [11]
273279
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Completion of/ or withdrawal from intervention
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Secondary outcome [12]
304043
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Partners in Health Scale
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Assessment method [12]
304043
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Timepoint [12]
304043
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Baseline, 6 months, 12 months
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Secondary outcome [13]
304044
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Self-efficacy for managing chronic disease (SE MCD) 6-item questionnaire
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Assessment method [13]
304044
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Timepoint [13]
304044
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Baseline, 6 months, 12 months
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Eligibility
Key inclusion criteria
1. Chronic obstructive pulmonary disease FEV1/FVC < 0.7 post-bronchodilator
2. Severity FEV1 30-80% predicted
3. > 10 pack year smoking history
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Minimum age
45
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
No expectation of terminal lung disease or another terminal disease within 2 years
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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)
Patients will be allocated to intervention or control arms according to their practice randomisation. The study design is cluster randomised by general practice, with 10 patients with Chronic Obstructive Pulmonary Disease recruited per practice and outcome data analysed at individual patient level using mixed models to compare mean change in the outcome factors between each arm of the study, with the practice declared a random factor to account for clustering of patients within practices.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The unit of randomisation is the general practice to avoid contamination between groups. They will be randomised to active or control intervention using computer generated random numbers with stratification for rurality and socio-economic demographics from the Australian Bureau of Statistics.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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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
The study was powered on a sample size of 200 participants to detect differences in mean QOL scores in SF36 in COPD for physical functioning (PF) of 8.1 and for general health (GH) of 6.3, with 80% power at level of significance alpha 0.05, assuming an intra class correlation coefficient of 0.05 and cluster size of 10.
Proportion participants with hospital admission analysed by chi-square tests.
Effects of the intervention on outcome measures over 12-months were estimated using multilevel mixed-effects linear models.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
10/03/2008
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Actual
14/05/2008
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Date of last participant enrolment
Anticipated
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Actual
3/08/2009
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
250
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
TAS
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
3122
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National Health and Medical Research Council (NHMRC)
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Address [1]
3122
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National Health and Medical Research Council (NHMRC),
20 Allara Street,
Level 5,
GPO Box 1421,
Canberra City ACT 2601
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Country [1]
3122
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Australia
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Funding source category [2]
3123
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University
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Name [2]
3123
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University of Tasmania
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Address [2]
3123
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1 Churchill Avenue,
Research House,
Private Bag 1,
Hobart TAS 7001
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Country [2]
3123
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Australia
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Primary sponsor type
University
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Name
Menzies Research Institute Tasmania
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Address
MS1 17 Liverpool Street,
PB23
Hobart 7001
Tasmania
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Country
Australia
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Secondary sponsor category [1]
2810
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Government body
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Name [1]
2810
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Department 0f Health & Human Services, Tasmania
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Address [1]
2810
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34 Davey Street, Hobart TAS 7000
Postal
GPO Box 125, Hobart TAS 7001
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Country [1]
2810
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
5099
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Tasmanian Human Research Ethics Committee (HREC) Tasmania
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Ethics committee address [1]
5099
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38 French Street, Tasmanian Human Research Ethics Committee (HREC) Tasmania, Research House, University of Tasmania Private Bag 01 Hobart Tasmania 7001
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Ethics committee country [1]
5099
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Australia
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Date submitted for ethics approval [1]
5099
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Approval date [1]
5099
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29/11/2007
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Ethics approval number [1]
5099
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H0009777
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Summary
Brief summary
Chronic Obstructive Pulmonary Disease (COPD) is a major contributor to the burden of disease in Australia. Increasing prevalence of chronic diseases has seen a shift in patient care paradigms towards disease specific programmes that focus on self-management. This new model for COPD care involving mentoring by trained nurses to increase self-efficacy aims to improve the health-related quality of life of people with COPD, while reducing associated healthcare costs through the early identification and treatment of acute exacerbations. Research Plan: A randomised study of participants with COPD recruited from general practices compares the model with usual care. Participants recruited to the active arm will have an individual management plan developed by the research team in consultation with their general practitioner. Nurses, trained in methods to improve self-efficacy, will work in partnership with participants to achieve behavioural change through a cycle of goal setting and action planning, focussing on health behaviours identified in the management plan. Outcomes will include health-related quality of life, self-efficacy, healthcare utilisation, lung function and physical activity.
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Trial website
http://www.pathways.utas.edu.au/
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Trial related presentations / publications
Presentations: 1. Walters JAE, Wills K, Cameron-Tucker H, Courtney-Pratt H, Nelson M, Robinson A, et al. Telephone Health Mentoring Improves Self-Management Capacity In Community-Recruited COPD [Abstract]. Respirology. 2013;18(Suppl 2):50. 2. Walters JAE, Wills K, Robinson A, Nelson M, Turner P, Scott J, et al. Effect of health-mentoring to increase daily physical activity in chronic obstructive pulmonary disease (COPD) [Conference abstract]. Respirology. 2012;17(Suppl 1):61. 3. Walters JAE, Wills K, Robinson A, Nelson M, Scott J, Turner P, et al. Health-mentoring in chronic obstructive pulmonary disease (COPD) to reduce psychological morbidity [Conference abstract]. Respirology. 2012;17(suppl 1):15. 4. Walters JA, Cameron-Tucker H, Courtney-Pratt H, Wood-Baker R, Robinson A, Scott J, et al., editors. Telephone delivered health mentoring for people with Chronic Obstructive Pulmonary Disease (COPD) in Tasmania is feasible and effective in supporting adoption of positive health behaviour changes [Conference abstract]. Primary Health Care Research Conference Proceedings; 2011 13-15 July 2011.; Brisbane. 5. Walters J, Wills K, Nelson M, Robinson A, Turner P, Scott J, et al. Free living physical activity in community-based patients with moderate or severe COPD assessed by accelerometer [Conference abstract]. Respirology. 2011;16(supplement 1):23. 6. Walters JAE. Patients misclassified with Chronic Obstructive Pulmonary Disease (COPD) have significant morbidity. Australia & New Zealand Society of Respiratory Science Annual Scientific Meeting; Darwin, Australia2009. Publications: 1. Walters JAE, Courtney-Pratt H, Cameron-Tucker H, Nelson M, Robinson A, Scott J, et al. Engaging general practice nurses in chronic disease self-management support in Australia: insights from a controlled trial in chronic obstructive pulmonary disease. Aust J Prim Health. 2012;18(1):74-9. 2. Walters JAE, Cameron-Tucker H, Courtney-Pratt H, Nelson M, Robinson A, Scott J, et al. Supporting health behaviour change in chronic obstructive pulmonary disease with telephone health-mentoring: insights from a qualitative study. BMC Family Practice. 2012;13(1):55. 3. Walters J, Walters E, Nelson M, Robinson A, Scott J, Turner P, et al. Factors associated with misdiagnosis of chronic obstructive pulmonary disease in primary care. Primary Care Respiratory Journal 2011;20(4):396-402.
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Public notes
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Contacts
Principal investigator
Name
28401
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A/Prof R. Wood-Baker
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Address
28401
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MS1 UTAS
PB 34
University of Tasmania
Hobart
TAS 7001
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Country
28401
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Australia
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Phone
28401
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+61 3 6226 4798
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Fax
28401
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Email
28401
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[email protected]
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Contact person for public queries
Name
11558
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Dr Julia Walters
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Address
11558
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MS1 UTAS
PB 34
University of Tasmania
Hobart
TAS 7001
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Country
11558
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Australia
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Phone
11558
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03 6226 4798
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Fax
11558
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03 6226 7704
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Email
11558
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[email protected]
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Contact person for scientific queries
Name
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A/Prof Richard Wood-Baker
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Address
2486
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MS1 UTAS
PB 34
University of Tasmania
Hobart
TAS 7001
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Country
2486
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Australia
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Phone
2486
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03-6222-7353
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Fax
2486
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Email
2486
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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
Source
Title
Year of Publication
DOI
Embase
Patient Anxiety and Depression Moderate the Effects of Increased Self-management Knowledge on Physical Activity: A Secondary Analysis of a Randomised Controlled Trial on Health-Mentoring in COPD.
2015
https://dx.doi.org/10.3109/15412555.2014.995289
N.B. These documents automatically identified may not have been verified by the study sponsor.
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