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Trial registered on ANZCTR
Registration number
ACTRN12605000703606
Ethics application status
Approved
Date submitted
1/11/2005
Date registered
2/11/2005
Date last updated
10/11/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Understanding the role of self-management education in the rehabilitation of patients with chronic obstructive pulmonary disease.
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Scientific title
A randomised clinical trial examining the enhanced benefits in health outcomes with the addition of self-management education to exercise training in patients with chronic obstructive pulmonary disease (COPD).
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Secondary ID [1]
287856
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Nil known
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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.
852
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Condition category
Condition code
Respiratory
919
919
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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
Participants will be randomized to receive either exercise training or exercise training and disease specific group self-management education. All participants will under go twice weekly exercise training sessions consisting of aerobic and strength training programs (duration of one hour of exercise) for eight weeks (total of 16 sessions). Those randomized to the self-management education group will also receive twice weekly education sessions conducted by a multidisciplinary team for eight weeks. Each session will be an hour in duration, and topics covered will include how to self-manage, the lungs and COPD management, airway clearance, managing breathlessness, stress, anxiety and depression, sexuality issues, continence, exercise and physical activity, nutrition and healthy eating, medications, community resources, energy conservation techniques and swallowing. To complement the group sessions, participants will also receive a booklet on the above topics and an action plan diary. The focus of the sessions is on facilitating behaviour change rather than delivery of information.
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Intervention code [1]
745
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Rehabilitation
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Comparator / control treatment
The comparator group receives exercise training alone, with no education sessions as described above.
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Control group
Active
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Outcomes
Primary outcome [1]
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Healthcare utilization: general practitioner and physician visits.
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Assessment method [1]
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Timepoint [1]
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Examined for the 12 months following completion of the intervention.
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Primary outcome [2]
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Healthcare utilization: hospital admissions and length of stay.
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Assessment method [2]
1202
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Timepoint [2]
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Examined for the 12 months following completion of the intervention.
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Primary outcome [3]
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Healthcare utilization: pharmaceutical usage.
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Assessment method [3]
1203
0
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Timepoint [3]
1203
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Examined for the 12 months following completion of the intervention.
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Primary outcome [4]
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Healthcare utilization: allied health professional attendances.
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Assessment method [4]
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Timepoint [4]
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Examined for the 12 months following completion of the intervention.
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Secondary outcome [1]
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Quality of Life (Chronic Respiratory Questionnaire: CRQ and the Assessment of Quality of Life: AQoL)
- Health Behaviour (The Health Education Impact Questionnaire: HEI-Q)
- Self-efficacy (General Self-Efficacy Scale - 12) - Exercise Tolerance (6 Minute Walk Test)
- Dyspnea (BORG Scale during exercise, and the Medical Research Council Dyspnea Scale).
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Assessment method [1]
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Timepoint [1]
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Each of the outcomes will be measured prior to intervention, within two weeks post and at 3, 6 and 12 month time points following the intervention.
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Eligibility
Key inclusion criteria
Primary diagnosis of COPD as classified by NHLBI/WHO Global Initiative for COPD: FEV1 of <80% predicted and a FEV1/FVC ratio of < 70% (as measured with a vitalograph) - Participant reported symptomatic dyspnea (shortness of breath) interfering with their ability to perform normal activities of daily living.
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Minimum age
Not stated
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Maximum age
Not stated
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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
Attendance at pulmonary rehabilitation program in the preceding two years- Non-English speaking- A primary diagnosis of another chronic respiratory conditions (for example bronchiectasis, cystic fibrosis, pulmonary fibrosis, or lung carcinoma) - Another condition which would limit their ability to exercise (e.g. arthritis, cardiac conditions, lower back pain, Parkinson's disease)- A medically documented cognitive condition which would limit their ability to learn (e.g. Alzheimer's, dementia, short term memory loss following stroke or head injury).
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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)
Recruitment occurs before any assessment, and a second physiotherapists (not involved in recruitment or assessment) allocates participant to group.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
By computer generated random number table.
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Masking / blinding
Blinded (masking 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
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/03/2006
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Actual
6/11/2006
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Date of last participant enrolment
Anticipated
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Actual
19/10/2010
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
300
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Accrual to date
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Final
276
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Austin Health - Austin Hospital - Heidelberg
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Primary sponsor type
Individual
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Name
Felicity Blackstock
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Address
School of Physiotherapy, La Trobe University, Victoria, Australia 3086
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Country
Australia
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Secondary sponsor category [1]
877
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None
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Name [1]
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Nil
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Address [1]
877
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Country [1]
877
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
2322
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La Trobe University
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Ethics committee address [1]
2322
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Ethics committee country [1]
2322
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Australia
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Date submitted for ethics approval [1]
2322
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Approval date [1]
2322
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21/09/2005
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Ethics approval number [1]
2322
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Ethics committee name [2]
2323
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Department of Veterans Affairs
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Ethics committee address [2]
2323
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Ethics committee country [2]
2323
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Australia
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Date submitted for ethics approval [2]
2323
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Approval date [2]
2323
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10/06/2005
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Ethics approval number [2]
2323
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Ethics committee name [3]
2324
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Austin Health
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Ethics committee address [3]
2324
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Ethics committee country [3]
2324
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Australia
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Date submitted for ethics approval [3]
2324
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Approval date [3]
2324
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17/02/2006
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Ethics approval number [3]
2324
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Summary
Brief summary
Method: A randomised trial with allocation concealment, assessor blinded to group allocation and intention-to-treat analysis was conducted. Two hundred and sixty-seven people with COPD [mean age 72(9) years, FEV1 59(23)% predicted] were allocated to receive either eight weeks of twice-weekly group exercise training plus education or exercise training alone. Education was disease specific with a self-management focus. Primary outcome measures included six-minute walk distance and Chronic Respiratory Questionnaire. Secondary outcomes included dyspnoea, health behaviours, generic health related quality of life, self-efficacy, and healthcare usage with measurements taken immediately following completion and at six and 12 months. Results: There were no significant differences that indicated greater improvement in any health outcome with the addition of education. The two intervention groups had similar significant improvements immediately following intervention, and these were maintained comparably in the subsequent 12 months. Conclusions: The results of this investigation suggest that disease-specific group education is not an essential component of pulmonary rehabilitation. Pulmonary rehabilitation based on exercise training is an effective option in the management of patients with COPD if multidisciplinary education cannot be offered.
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Trial website
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Trial related presentations / publications
Blackstock, F.C., Webster, K.E., McDonald, C.F. & Hill, C.J. (2014). Comparable improvements achieved in chronic obstructive pulmonary disease through pulmonary rehabilitation with and without a structured educational intervention: a randomized controlled trial. Respirology, 19(2), 193-202. Blackstock, F., Webster, K.E., McDonald, C.F. & Hill, C.J. (2013) Pulmonary rehabilitation: can we predict who responds if the program includes an education component? Australian Physiotherapy Association Conference, October (Melbourne). Blackstock F., Hill, C.J., Webster, K.E. & McDonald, C. (2011) The addition of education to exercise in pulmonary rehabilitation for patients with COPD does not result in greater improvements in outcomes. Australian Physiotherapy Association Conference, October (Brisbane). Blackstock F, Hill, C.J., Webster, K.E. & McDonald, C. (2011) Exercise training alone achieves improvements comparable to pulmonary rehabilitation in COPD. TSANZ Annual Scientific Meeting, April (Perth).
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Public notes
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Contacts
Principal investigator
Name
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Dr Felicity Blackstock
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Address
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School of Physiotherapy Faculty of Health Sciences La Trobe University Melbourne VIC 3086
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Country
35905
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Australia
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Phone
35905
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+61 9478 626 203
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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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Felicity Blackstock
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Address
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Physiotherapy,
Building 24.2.115 Campbelltown Campus
Western Sydney University
Locked Bag 1797,
Penrith, NSW 2751, Australia
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Country
9934
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Australia
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Phone
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+61 0478 626 203
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Fax
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Nil 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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Felicity Blackstock
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Address
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Physiotherapy,
Building 24.2.115 Campbelltown Campus
Western Sydney University
Locked Bag 1797,
Penrith, NSW 2751, Australia
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Country
862
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Australia
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Phone
862
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+61 0478 626 203
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Fax
862
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Email
862
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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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