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Multiple Chronic ConditionsNCT04566107

Self-Management Interventions Using Mobile Health for the Multimorbid

A study testing mHealth intervention and mHealth Plus in people with Multiple Chronic Conditions, run by University of Nebraska at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this pilot study is to evaluate the feasibility and impact of delivering mobile health self-management interventions to improve adherence to the prescribed treatment in a multimorbid population returning home after hospital discharge. Read more about this study

Who is it for?
Ages 19 years and older
Conditions the study is for
Multiple Chronic Conditions
What is being tested?
mHealth intervention and mHealth Plus
Could I receive a placebo?
No, everyone receives an active treatment
How many people
63 participants
Where
1 siteUnited States
Study dates
14 Oct 2019to 30 Jun 2021
Phase
Interventional
Are there results?
None posted in the registry

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 19 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • multimorbid patients with one of 4 chronic conditions (HF, COPD, diabetes or hypertension) and have at least one other chronic disease (i.e., hypertension, cancer, stroke, heart disease, diabetes, arthritis, hepatitis, current asthma, kidney failure, or COPD),
  • adult patients (age 19 and older)
  • access to smart technology (phone or iPad) and internet access or a phone plan large enough for daily interactions; and d) able to hear, speak and read English.

Who cannot join

  • major surgery while admitted;
  • discharged to somewhere other than home (e.g., long term care facility);
  • receiving home health services;
  • documented dementia; and
  • life expectancy <6 months.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Nebraska Medical Center, College of Nursing

    Lincoln, Nebraska, 68588

Other trials in United States

About this study

The purpose of this pilot study is to evaluate the feasibility and impact of delivering mobile health self-management interventions to improve adherence to the prescribed treatment in a multimorbid population returning home after hospital discharge.

Read the detailed description

The purpose of this three-group repeated-measures randomized controlled trial is to evaluate the use of mobile health (mHealth) self-management technology as a model of care for individuals with multimorbidity. Specifically, this 8-week self-management intervention uses tailored self-management strategies (action planning, goal setting, and individually identified support needs) and mHealth technology for real-time virtual visits, daily messages, and self-monitoring activities. The investigators are testing the additive impact of having the nurse practitioner/community health worker (NP/CHW) team with the mHealth platform (mHealth Plus). The NP evaluates physiological status by evaluating symptoms and tailoring the intervention specific to the individual's multimorbidity while the CHW will assist in recognizing possible solutions to challenging social determinants of health by identifying community resources and guidance in overcoming barriers.

The following specific aims will be addressed:

Aim 1: To evaluate the feasibility of implementing comparative SM interventions (mHealth and mHealth plus virtual visits with a nurse practitioner and community health worker team) in multimorbid individuals by assessing: a) acceptability of each intervention; b) enrollment (recruitment efficiency, attrition, problems and solutions); c) intervention fidelity (delivery, receipt, enactment of the intervention [benefits and barriers]); and d) data collection (technological transfer of data, instrument reliability, the time required, missing data).

Aim 2: To examine the impact of delivering the m-Health and m-Health plus interventions compared to standard care (SC) in multimorbid individuals on: a) primary outcome: adherence to disease-specific lifestyle behaviors (e.g. diet and medication, and self-monitoring of physiological measures as needed (e.g. weight blood pressure, blood glucose, oxygen saturation); b) secondary outcomes: health related quality of life; c) patient-reported health status; d) symptom status; and e) healthcare utilization.

Being tested
mHealth intervention, mHealth Plus
Keywords
multiple chronic conditions, mobile health, multimorbidity
Medical subject headings
Multiple Chronic Conditions

What participants receive

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

  • mHealth interventionBehavioural

    The intervention promotes self-management and adherence to treatment regimens in patients with multimorbidity. This 8-week SM intervention uses mobile health (m-Health) technology for daily messages and reminders to promote self-monitoring activities. Bluetooth devices provided will depend on the participant's need for self-management; heart failure (scale), diabetes (glucometer), COPD (pulse oximeter) or hypertension (BP machine).

  • mHealth PlusBehavioural

    The intervention promotes self-management and adherence to treatment regimens in patients with multimorbidity. This 8-week SM intervention uses tailored self-management strategies (action planning, goal setting, and individual identified support needs) and mobile health (m-Health) technology for virtual visits, daily messages, and self-monitoring activities. The investigators will test the additive impact of having the nurse practitioner/community health worker (NP/CHW) team with the m-health platform. The NP will evaluate physiological and psychosocial status while the CHW will assist in recognizing possible solutions to challenging social determinants of health by identifying community resources and guidance in overcoming barriers. Bluetooth devices provided will depend on the participant's need for self-management; heart failure (scale), diabetes (glucometer), COPD (pulse oximeter) or hypertension (BP machine). Participants will receive reminders through the platform.

Study groups in NCT04566107
Study groupRoleWhat they receive
Enhanced Usual CareNo interventionThe enhanced usual care group will receive evidence-based standardized disease-specific education based on discharge protocols. In addition, individuals in the enhanced usual care group will receive the mobile health platform to record medications taken and BlueTooth devices to record physiologic measurements.
mHealthExperimentalThe mHealth group will receive evidence-based standardized disease-specific education based on discharge protocols. In addition, the mHealth group will receive the mobile health platform with reminders to take medications and engage in an educational tip. Subjects receive BlueTooth devices to record physiologic measurements.
Receives: Behavioral: mHealth intervention
mHealth PlusExperimentalThe mHealth group plus will receive evidence-based standardized disease-specific education based on discharge protocols. In addition, the mHealth plus group will receive the mobile health platform with reminders to take medications and engage in an educational tip. Participants receive BlueTooth devices to record physiologic measurements. The m-Health Plus group will receive real-time virtual visits with a nurse practitioner/community health worker team. Virtual visits are similar to an office follow-up visit with an health care provider using Zoom technology to allow for face-to-face interaction with the patient.
Receives: Behavioral: mHealth Plus

What is being measured

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

  1. Usability and acceptability of the self-management interventions by administering a Usability and Acceptability tool

    A Usability and Acceptability investigator developed tool.

    Measured: 60 days after enrolled

  2. Enrollment of participants to the comparative self-management (SM) interventions by calculating frequency and percentage of available participants and enrolled participants.

    measure of enrollment and recruitment

    Measured: 90 days after enrolled

  3. Number of times the participant records activities within the application.

    Measurement of engagement with the application, participant records will be downloaded from the application and frequency and percent will be calculated

    Measured: 90 days after enrollment

Secondary outcomes (21)
  1. Frequency and percent of the participants recording a weight in pounds in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of weights recorded for heart failure participant)

    Measured: 30 days after intervention initiated

  2. Frequency and percent of the participants recording a weight in pounds in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of weights recorded for heart failure participant)

    Measured: 60 days after intervention initiated

  3. Frequency and percent of the participants recording a weight in pounds in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of weights recorded for heart failure participant)

    Measured: 90 days after intervention initiated

  4. Frequency and percent of the participants recording a blood pressure (BP) in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of BP recorded for hypertension participant)

    Measured: 30 days after intervention initiated

  5. Frequency and percent of the participants recording a blood pressure (BP) in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of BP recorded for hypertension participant)

    Measured: 60 days after intervention initiated

  6. Frequency and percent of the participants recording a blood pressure (BP) in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of BP recorded for hypertension participant)

    Measured: 90 days after intervention initiated

  7. Frequency and percent of the participants recording a pulse oximetry in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease. (number of oximetry readings recorded for chronic obstructive pulmonary disease (COPD) participant)

    Measured: 30 days after intervention initiated

  8. Frequency and percent of the participants recording a pulse oximetry in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of oximetry readings recorded for (COPD) participant)

    Measured: 60 days after intervention initiated

  9. Frequency and percent of the participants recording a pulse oximetry in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of oximetry readings recorded for the chronic obstructive pulmonary disease (COPD) participant)

    Measured: 90 days after intervention initiated

  10. Frequency and percent of the participants recording a blood glucose in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of blood glucose readings recorded for the diabetic participant)

    Measured: 30 days after intervention initiated

  11. Frequency and percent of the participants recording a blood glucose in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of blood glucose readings recorded for the diabetic participant)

    Measured: 60 days after intervention initiated

  12. Frequency and percent of the participants recording a blood glucose in the mHealth app

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of blood glucose readings recorded for the diabetic participant)

    Measured: 90 days after intervention initiated

  13. Health related quality of life assessed by the EQ-5D-5L developed by the EuroQol group scored as an index and a visual analogue scale.

    monitoring of physiological measures for each of the physiologic parameters appropriate for the participants chronic disease (number of blood glucose readings recorded for the diabetic participant)

    Measured: 30 days after intervention initiated

  14. Health related quality of life assessed by the EQ-5D-5L developed by the EuroQol group scored as an index and a visual analogue scale.

    Measure of quality of life

    Measured: 60 days after intervention initiated

  15. Health related quality of life assessed by the EQ-5D-5L developed by the EuroQol group scored as an index and a visual analogue scale.

    measure of quality of life

    Measured: 90 days after intervention initiated

  16. Patient Reported Outcomes Measurement Information System (PROMIS®) (Promis29 V2.0) score of mobility, self-care, usual activities, pain/ discomfort, anxiety/ depression and a visual analogue scale rating of health today

    Measure of health status and symptoms

    Measured: 30 days after intervention initiated

  17. Patient Reported Outcomes Measurement Information System PROMIS® (Promis29 V2.0) score of mobility, self-care, usual activities, pain/ discomfort, anxiety/ depression and a visual analogue scale rating of health today

    measure of health status and symptoms

    Measured: 60 days after intervention initiated

  18. Patient Reported Outcomes Measurement Information System PROMIS® (Promis29 V2.0) score of mobility, self-care, usual activities, pain/ discomfort, anxiety/ depression and a visual analogue scale rating of health today

    measure of health status and symptoms

    Measured: 90 days after intervention initiated

  19. Emergency rooms visits and re-hospitalizations assessed by frequency and percent assessed by reviewing the electronic medical record

    measure of health care utilization

    Measured: 30 days after intervention initiated

  20. Emergency rooms visits and re-hospitalizations assessed by frequency and percent assessed by reviewing the electronic medical record

    measure of health care utilization

    Measured: 60 days after intervention initiated

  21. Emergency rooms visits and re-hospitalizations assessed by frequency and percent assessed by reviewing the electronic medical record

    measure of health care utilization

    Measured: 90 days after intervention initiated

Timeline

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

  1. First posted28 Sep 2020
  2. Study start14 Oct 2019
  3. Primary completion30 Jun 2021
  4. Study completion30 Jun 2021

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
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
63 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04566107
Sponsor's protocol ID
0445-18-EP
Status last verified
Sep 2023
First submitted
4 May 2020
Last updated
26 Sep 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing mHealth intervention and mHealth Plus in people with Multiple Chronic Conditions, run by University of Nebraska 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 3 inclusion and 5 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: finished, as of the sponsor's last update on 26 Sep 2023. 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. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Usability and acceptability of the self-management interventions by administering a Usability and Acceptability tool (time frame: 60 days after enrolled). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 26 Sep 2023.

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