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DeliriumNCT01700816

Prevention of Delirium After Bone Marrow Transplantation

A study testing Bright light therapy in people with Delirium, run by Massachusetts General Hospital at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this study is to find out if using bright light sessions during bone marrow transplant can prevent people from developing confusion also known as delirium. Read more about this study

Who is it for?
Ages 18 to 90 years
Conditions the study is for
Delirium
What is being tested?
Bright light therapy
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
40 participants
Where
1 siteUnited States
Study dates
Oct 2012to Oct 2013
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 90 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18 or older
  • Male or female
  • Patients scheduled to undergo HSCT
  • English speaking

Who cannot join

  • Previous history of bipolar affective disorder
  • On-going delirium
  • History of substance abuse/dependence within 6 months prior to HSCT
  • History of invasive melanoma. Patients with a history of basal cell carcinoma, melanoma in situ, or squamous cell carcinoma are permitted to enroll if the lesion(s) have been excised with negative margins
  • History of medical/dermatological conditions that make skin especially sensitive to light,such as systemic lupus erythematosus (SLE) and/or porphyria
  • Eye condition that makes eyes vulnerable to light damage
  • Concomitant use of medications that increase sensitivity to sunlight, such as the herbal supplement St. John's Wort
  • Established primary insomnia

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

Other trials in United States

About this study

Official title: Usefulness of Bright Light Therapy in the Prevention of Delirium in Patients Undergoing Hematopoietic Stem Cell Transplant (HSCT)

The purpose of this study is to find out if using bright light sessions during bone marrow transplant can prevent people from developing confusion also known as delirium.

Read the detailed description

This is a pilot, double blind randomized study conducted in patients scheduled to undergo bone marrow transplant at the Massachusetts General Hospital. The goal of this study is to look at the usefulness of bright light therapy in the prevention of delirium in a population at high risk for developing this condition.

Delirium can develop in up to half of the people that undergo bone marrow transplant. Symptoms include changes in level of alertness, confusion, and temporary problems with memory and attention. In severe cases, it can be accompanied by agitation, paranoia(overly suspicious), and hallucinations(seeing or hearing things that are not really there).

Bright light uses no medication and is often used to treat seasonal affective depression and multiple sleep disorders. The light boxes are portable and are placed in front of individuals for about 30 minutes every day.

Conditions
Delirium
Being tested
Bright light therapy, Sham light
Keywords
Delirium, Hematopoietic stem cell transplantation, Bone marrow transplantation, Bright Light Therapy
Medical subject headings
Delirium

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Bright light therapyDevice

    Also called DL930 Day-Light Classic by Uplift Technologies Inc.

    The light box will be placed vertically on a patient table or bed side 2.5 feet away from the user's eyes daily from 8 am to 8:30 am.

  • Sham lightDevice

    Also called DL930 Day-Light Classic Uplift Tecnologies placebo box

    The light box will be placed vertically on a patient table or bed side 2.5 feet away from the user's eyes daily from 8 am to 8:30 am.

Study groups in NCT01700816
Study groupRoleWhat they receive
Bright light therapyExperimental2500 Lux gaze directed every morning from 8 am until 8:30 am
Receives: Device: Bright light therapy
Sham lightPlacebo comparator<1000 Lux gaze directed every morning from 8 am until 8:30 am
Receives: Device: Sham light

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants Who Developed Delirium Based on Meeting Criteria on the Delirium Rating Scale and/or Memorial Delirium Assessment Scale

    Monday, Wednesday, and Friday assessments will begin after beginning light therapy and include the Delirium Rating Scale-Revised-98 (DRS-98)and Memorial Delirium Assessment Scale (MDAS)

    Measured: From hospital admission until the date of first documented delirium, assessed up to 28 days post-transplant

Secondary outcomes (10)
  1. Severity of Delirium Episodes: Memorial Delirium Assessment Scale (MDAS)

    Monday, Wednesday, and Friday assessments of the Memorial Delirium Assessment Scale (MDAS); Patients will receive assessments after beginning light therapy until day 28 post-transplant or discharge, whichever comes first.

    10 item scale Items are rated on a four-point scale from 0 (none) to 3 (severe) depending on the level of impairment, rendering a maximum possible score of 30.

    A score of 13 has been recommended as a cut-off for establishing the diagnosis of delirium

    Measured: From first documented episode of delirium until discharge from the hospital, assessed up to 28 days post-transplant

  2. Average Dose of Antipsychotic Medications Required to Manage Delirium

    Measured: From admission to hospital to discharge, an expected average of 28 days post-transplant

  3. Hospital Length of Stay

    Measured: From admission to hospital to discharge, an expected average of 28 days post-transplant

  4. Sodium (Na), Potassium (K), Chloride (Cl), and Carbon Dioxide (CO2)

    Lab values at latest available follow-up date per participant. These tests are performed as part of routine clinical care on patients undergoing HSCT (Hematopoietic Stem Cell Transplantation).

    Measured: From admission to hospital to discharge, an expected average of 28 days post-transplant

  5. Serum Creatinine and Blood Urea Nitrogen (BUN)

    Lab values at latest available follow-up date per participant. These tests are performed as part of routine clinical care on patients undergoing HSCT.

    Measured: From admission to hospital to discharge, an expected average of 28 days post-transplant

  6. Red Blood Cells (RBC)

    Lab values at latest available follow-up date per participant. These tests are performed as part of routine clinical care on patients undergoing HSCT.

    Measured: From admission to hospital to discharge, an expected average of 28 days post-transplant

  7. White Blood Cells (WBC)

    Lab values at latest available follow-up date per participant. These tests are performed as part of routine clinical care on patients undergoing HSCT.

    Measured: From admission to hospital to discharge, an expected average of 28 days post-transplant

  8. Hemoglobin (HGB)

    Lab values at latest available follow-up date per participant. These tests are performed as part of routine clinical care on patients undergoing HSCT.

    Measured: From admission to hospital to discharge, an expected average of 28 days post-transplant

  9. Hematocrit (HCT)

    Lab values at latest available follow-up date per participant. These tests are performed as part of routine clinical care on patients undergoing HSCT.

    Measured: From admission to hospital to discharge, an expected average of 28 days post-transplant

  10. Platelet Count

    Lab values at latest available follow-up date per participant. These tests are performed as part of routine clinical care on patients undergoing HSCT.

    Measured: From admission to hospital to discharge, an expected average of 28 days post-transplant

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Oct 2012 (estimated)
  2. Study startOct 2012
  3. Primary completionSep 2013
  4. Study completionOct 2013

Why it stopped: Low incidence of delirium.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
40 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01700816
Sponsor's protocol ID
2010P002801
Status last verified
May 2017
First submitted
1 Oct 2012
Last updated
28 Jun 2017
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Kirshner HS. Delirium: a focused review. Curr Neurol Neurosci Rep. 2007 Nov;7(6):479-82. doi: 10.1007/s11910-007-0074-7.

    PubMed 17999893
  • Minden SL, Carbone LA, Barsky A, Borus JF, Fife A, Fricchione GL, Orav EJ. Predictors and outcomes of delirium. Gen Hosp Psychiatry. 2005 May-Jun;27(3):209-14. doi: 10.1016/j.genhosppsych.2004.12.004.

    PubMed 15882768
  • Inouye SK, Schlesinger MJ, Lydon TJ. Delirium: a symptom of how hospital care is failing older persons and a window to improve quality of hospital care. Am J Med. 1999 May;106(5):565-73. doi: 10.1016/s0002-9343(99)00070-4.

    PubMed 10335730
  • Fricchione GL, Nejad SH, Esses JA, Cummings TJ Jr, Querques J, Cassem NH, Murray GB. Postoperative delirium. Am J Psychiatry. 2008 Jul;165(7):803-12. doi: 10.1176/appi.ajp.2008.08020181. No abstract available.

    PubMed 18593786
  • Hshieh TT, Fong TG, Marcantonio ER, Inouye SK. Cholinergic deficiency hypothesis in delirium: a synthesis of current evidence. J Gerontol A Biol Sci Med Sci. 2008 Jul;63(7):764-72. doi: 10.1093/gerona/63.7.764.

    PubMed 18693233
  • Kalisvaart KJ, de Jonghe JF, Bogaards MJ, Vreeswijk R, Egberts TC, Burger BJ, Eikelenboom P, van Gool WA. Haloperidol prophylaxis for elderly hip-surgery patients at risk for delirium: a randomized placebo-controlled study. J Am Geriatr Soc. 2005 Oct;53(10):1658-66. doi: 10.1111/j.1532-5415.2005.53503.x.

    PubMed 16181163
  • Prakanrattana U, Prapaitrakool S. Efficacy of risperidone for prevention of postoperative delirium in cardiac surgery. Anaesth Intensive Care. 2007 Oct;35(5):714-9. doi: 10.1177/0310057X0703500509.

    PubMed 17933157
  • Liptzin B, Laki A, Garb JL, Fingeroth R, Krushell R. Donepezil in the prevention and treatment of post-surgical delirium. Am J Geriatr Psychiatry. 2005 Dec;13(12):1100-6. doi: 10.1176/appi.ajgp.13.12.1100.

    PubMed 16319303
  • Sampson EL, Raven PR, Ndhlovu PN, Vallance A, Garlick N, Watts J, Blanchard MR, Bruce A, Blizard R, Ritchie CW. A randomized, double-blind, placebo-controlled trial of donepezil hydrochloride (Aricept) for reducing the incidence of postoperative delirium after elective total hip replacement. Int J Geriatr Psychiatry. 2007 Apr;22(4):343-9. doi: 10.1002/gps.1679.

    PubMed 17006875
  • Leung JM, Sands LP, Rico M, Petersen KL, Rowbotham MC, Dahl JB, Ames C, Chou D, Weinstein P. Pilot clinical trial of gabapentin to decrease postoperative delirium in older patients. Neurology. 2006 Oct 10;67(7):1251-3. doi: 10.1212/01.wnl.0000233831.87781.a9. Epub 2006 Aug 16.

    PubMed 16914695
  • Tabet N, Howard R. Non-pharmacological interventions in the prevention of delirium. Age Ageing. 2009 Jul;38(4):374-9. doi: 10.1093/ageing/afp039. Epub 2009 May 21.

    PubMed 19460856
  • Inouye SK, Bogardus ST Jr, Charpentier PA, Leo-Summers L, Acampora D, Holford TR, Cooney LM Jr. A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med. 1999 Mar 4;340(9):669-76. doi: 10.1056/NEJM199903043400901.

    PubMed 10053175
  • Lipowski ZJ. Delirium (acute confusional states). JAMA. 1987 Oct 2;258(13):1789-92.

    PubMed 3625989
  • Shigeta H, Yasui A, Nimura Y, Machida N, Kageyama M, Miura M, Menjo M, Ikeda K. Postoperative delirium and melatonin levels in elderly patients. Am J Surg. 2001 Nov;182(5):449-54. doi: 10.1016/s0002-9610(01)00761-9.

    PubMed 11754849
  • McIntyre IM, Norman TR, Burrows GD, Armstrong SM. Human melatonin suppression by light is intensity dependent. J Pineal Res. 1989;6(2):149-56. doi: 10.1111/j.1600-079x.1989.tb00412.x.

    PubMed 2915324

Questions about this trial

What is this clinical trial studying?

A study testing Bright light therapy in people with Delirium, run by Massachusetts General Hospital at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 28 Jun 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Jun 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants Who Developed Delirium Based on Meeting Criteria on the Delirium Rating Scale and/or Memorial Delirium Assessment Scale (time frame: From hospital admission until the date of first documented delirium, assessed up to 28 days post-transplant). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01700816, which also lists 27 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jun 2017.

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