Chronic DiseaseNCT04611074
Health-related Quality of Life in Patients at Nordic Clinic
An observational study of Chronic Disease, run by Nordic Clinic Stockholm at 1 site in Sweden.
Trial summary
Nordic Clinic is a private clinic for personalised treatment based on the Functional Medicine concept. In summary, functional medicine is aimed at addressing the lifestyle and behavioral factors that are believed to contribute to the symptoms the patient suffers from. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Chronic Disease
- How many people
- 21 participants
- Where
- 1 siteSweden
- Study dates
- 22 Aug 2019to 1 Mar 2023
- Phase
- Observational
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: All Swedish speaking patients (>1= 18 years) visiting the clinic will be asked to participate in the study by clinic personnel when they are visiting the clinic. All patients at the clinic are able to provide informed consent and to fill out online forms.
Who may be able to join
- All Swedish speaking patients (>/= 18 years) visiting the clinic will be asked to participate in the study by clinic personnel when they are visiting the clinic. All patients at the clinic are able to provide informed consent and to fill out online forms.
Who cannot join
- <18 years, non-Swedish speaking
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Health-related Quality of Life and Symptom Burden in Patients at Nordic Clinic Before, During and After Personalised, Functional Medicine Treatments and Lifestyle Interventions
Nordic Clinic is a private clinic for personalised treatment based on the Functional Medicine concept. In summary, functional medicine is aimed at addressing the lifestyle and behavioral factors that are believed to contribute to the symptoms the patient suffers from. In short, the treatment is based on a timeline of health-related life events, current lifestyle factors and behaviors and physiological examinations to develop a personalised lifestyle program. The main component of the treatment provided at Nordic Clinic is in-depth lifestyle coaching to achieve the desired behavioral and lifestyle changes.
Working at the clinic is a clinical physiologist, nutritionist, physician specialist in general medicine and researchers work. The vast majority of people who apply for the clinic have long-standing symptoms that have been investigated by the healthcare system without any organic explanation for the symptoms having been identified. Common causes are gastrointestinal problems, persistent fatigue and insomnia. The aim of the study is to investigate symptom-borne and health-related quality of life during and after treatment and to identify predictors of improvement of health-related quality of life. The main purpose is to investigate whether the health-related quality of life is improved during treatment. This is an observational study and all adult patients who are able to complete the web form in Swedish at the clinic are asked to participate. Participants who give consent will receive a link to the questionnaire via email once a month for one year and once after two years. Participants are recruited for two years, and will be completed after the last questionnaire is completed by the last included participant, ie autumn 2022. In addition to the self-assessments, the number of visits to the clinic, sampling and results, who finances the treatment and treatment plan are recorded.
The first aim is to investigate improvement in symptom burden and health related quality of life during and after treatment (does symptom burden and health related quality of improve during treatment and are improvements stable at the 2 year follow-up?) The second aim is to investigate factors that predict recovery (Do persons with a high level of motivation for behavioural change experience a better improvement in symptom burden and health related quality of life than persons with a low level of motivation for behavioural change?).
Read the detailed description
Research plan
Health related quality of life in patients at the Nordic Clinic
Background
Nordic Clinic is a private clinic that provides personalised treatment based on functional medicine. The vast majority of the patients seeking care at the clinic suffer from unexplained medical symptoms, most commonly fatigue and abdominal symptoms, and have previously been medically evaluated by health care. Working at the clinic are a clinical physiologist, nutritional therapist, licensed physician and a researcher. Patients follow a clinical treatment process starting with the physician progressing through to the nutritionist. Treatment is covered either by the patient themselves, by employers or health insurances.
Before treatment is initialised, an extensive medical history along with current lifestyle habits are taken. The treatment programme is based on lifestyle factors, mainly diet, sleep, stress management and physical activity. Supplements are given. Drugs are prescribed sparsely and by a licenced physician, and may include Rifaximin or other antibiotics for intestinal bacterial overgrowth, motility drugs for constipation, anti-parasitic drugs in case of parasite infection, and melatonin for sleep disturbances.
The components in the treatment programme have been investigated separately. Any supplements used are produced by reputable organisations and most of them have been part of the treatment routine for several years. The aims of the study is to evaluate improvement during and after treatment and to identify predictors of recovery. The goal is to understand the process of recovery with the long term goal to improve care given at the clinic.
Aim and research question
The first aim is to investigate improvement in symptom burden and health related quality of life during and after treatment (does symptom burden and health related quality of improve during treatment and are improvements stable at the 2 year follow-up?) The second aim is to investigate factors that predict recovery (Do persons with a high level of motivation for behavioural change experience a better improvement in symptom burden and health related quality of life than persons with a low level of motivation for behavioural change?).
Methods
Study population and inclusion criteria
All Swedish speaking patients (>1= 18 years) visiting the clinic will be asked to participate in the study by clinic personnel when visiting the clinic. All patients at the clinic are able to provide informed consent and to fill out online forms.
Procedure
This is an observational study where patients are followed over time in terms of symptom burden and health related quality of life. The study participants are asked to fill out forms once a month for one year counting from the first visit, and once again 2 years after baseline. Clinical data is collected from the medial record by the clinician at the end of the study.
Questionnaires
(Jylhä 2009)(K, S et al. 2003)(Westerlund, Brandt et al. 2014)(Smets, Garssen et al. 1995)(Andreasson, Wicksell et al. 2016)(Spitzer, Kroenke et al. 2006)(Spitzer, Kroenke et al. 1999)
Clinical variables
Information on diagnosis, number of visits, tests and test results, treatment programme and background information (including age, gender, lifestyle factors, readiness for change, education, occupation, social support, height and weight, blood pressure), will be collected from the medical record of the patient by the clinician at the end of the study period.
Statistics
Based on experience of these types of analyses, 150 participants would give a reasonable foundation for the statistical analyses. 300 unique patients are expected to enrol during the study inclusion period and expect 200 of these to complete at least the first year of data collection. In the main analysis of the first aim, the effect of time on questionnaire scores will be investigated using mixed effect linear regression to see to what extent symptom burden and health related quality of life is affected during treatment and to investigate the stability in any improvements. Secondly, it will be investigated it a high adherence to the treatment programme is associated with improvement. Thirdly, the level of adherence to the treatment programme will be compared between patients with predominant abdominal symptoms and patients with predominant fatigue.
In the main analysis of the second aim, readiness for change will be tested as a moderator of the effect of time on questionnaire scores. Secondly, the level of improvement will be compared between patients who self-fund the treatment programme and patients with funding from employer or health insurance.
Patients often present with a range of different symptoms. Principal component analysis will be performed in an exploratory analysis to investigate if there are subgroups within the patient population, and if these subgroups differ in terms of treatment response. Covariation over time of symptoms, health related quality of life and self-rated health will be investigated in exploratory analyses.
Ethical considerations
The present study poses little risk to the participant. The treatment programme that the participant would undergo independently of the study is considered safe with few and mild side effects such as rash. As part of the study the participant report health information on a web questionnaire. Health data is sensitive information and the same platform will be used as for all other data collected by the clinic for treatment. The platform that is used is certified safe (add information) and complies to the GDPR regulation.
Risk of missing serious diagnoses
When dealing with symptoms such as persistent fatigue there is a risk that serious conditions such as cancer might be missed. However, the risk is estimated as low as low as in primary care at a Vårdcentral. Our medical doctor is still active in primary health care in parallel to Nordic Clinic and has many years of experience. Most of the patients at Nordic Clinic have been thoroughly investigated in the primary care system before signing up as patients at Nordic Clinic. Should patients however present with symptoms that warrant the investigation of serious conditions like malignancies, it is made sure that a thorough investigation has indeed been performed. If it has not, our medical doctor refers them back to primary or specialist health care.
Importance
There has not been a strong research tradition to evaluate treatment programmes based on functional medicine, albeit the individual components therein have all been evaluated and are found to be safe. However, all treatments given to patients need continuing evaluation. This two-year observational study will provide information regarding treatment outcomes and stability thereof over time, in addition to identifying patient groups that get the most benefit of the treatment. Future randomised controlled trials are needed to evaluate the effectiveness of the treatment programme.
- Conditions
- Chronic Disease
- Keywords
- Chronic Disease
- Medical subject headings
- Chronic Disease
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in gastrointestinal discomfort from baseline as assessed by the Gastrointestinal Symptom Rating Scale for IBS questionnaire (GSRS-IBS)
Self-reported satiety, abdominal pain, diarrhoea, constipation and bloating is measured with GSRS-IBS with the following outcomes: No discomfort at all, Minor discomfort, Mild discomfort, Moderate discomfort, Moderately severe discomfort, Severe discomfort, Very severe discomfort.
Measured: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Change in fatigue from baseline as assessed by the Multidimensional Fatigue Inventory
General fatigue, physical fatigue, reduced motivation, reduced activity, and mental fatigue is evaluated on a scale from 1-5, where 1 is true and 5 is not true.
Measured: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Change in health-related quality of life from baseline as assessed by the 36-Item Short Form Health Survey (SF-36)
The SF-36 measures physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health.
Measured: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Change in sleep from baseline as assessed by the Karolinska Sleep Questionnaire (KSQ)
KSQ is a self-assessment form that measures difficulty falling asleep, disturbed sleep, repeated awakenings, early wakings, difficulty waking up, insufficient rest during the night, nightmares, snoring, daytime effects. The questionnaire contains 13 questions about sleep and sleepiness which are answered according to a five-point scale from 1 (never/very good) to 5 (always/very bad).
Measured: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Change in anxiety from baseline as assessed by the Generalised Anxiety Disorder 7-item scale (GAD-7)
GAD-7 is a self-assessment form that measures seven anxiety-related symptoms using the following scale: Not at all (0), Several days (1), More than half the days (2), Nearly every day (3).
Measured: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Change in presence or severity of depression from baseline as assessed by the Patient Health Questionnaire-9 (PHQ-9)
PHQ-9 screens for presence or severity of depression according to the DSM-IV criteria. It measures nine depression-related symptoms using the following scale: Not at all (0), Several days (1), More than half the days (2), Nearly every day (3).
Measured: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Change in overall health from baseline as assessed by the Self-rated health questionnaire
The self-rated health questionnaire is a single question questionnaire, evaluating overall health at the time of the survey using the scale very good" (1), "good" (2), "moderate" (3), "bad" (4) or "very bad" (5).
Measured: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Secondary outcomes (2)
Correlation between motivation for behavioral change and change in symptom burden and health-related quality of life
Correlation between motivation for behavioral change and change in the primary outcome measures
Measured: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Predictability of the predominance of fatigue or abdominal-related symptomatology for adherence to the treatment programme
Correlation between outcome measures in Gastrointestinal Symptom Rating Scale for IBS questionnaire (GSRS-IBS) and adherence to the treatment programme.
Measured: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Nov 2020
- Study start22 Aug 2019
- Primary completion1 Mar 2023
- Study completion1 Mar 2023
Why it stopped: Technical and recruitment issues.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (11)Papers the sponsor has linked to this study.
- Other trials for Chronic DiseaseStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 21 participants (actual)
Sponsor and investigators
- Lead sponsor
- Nordic Clinic Stockholm
- Sponsor type
- University, hospital or other
- Collaborators
- Stockholm University
- Responsible party
- Sponsor
- Investigators
- Annie ML Pettersson, PhD, Principal investigator, Nordic Clinic
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04611074
- Sponsor's protocol ID
- HRQL1
- Status last verified
- Mar 2023
- First submitted
- 30 Aug 2019
- Last updated
- 3 Mar 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Andreasson A, Wicksell RK, Lodin K, Karshikoff B, Axelsson J, Lekander M. A global measure of sickness behaviour: Development of the Sickness Questionnaire. J Health Psychol. 2018 Sep;23(11):1452-1463. doi: 10.1177/1359105316659917. Epub 2016 Jul 24.
PubMed 27458105Bryant PA, Trinder J, Curtis N. Sick and tired: Does sleep have a vital role in the immune system? Nat Rev Immunol. 2004 Jun;4(6):457-67. doi: 10.1038/nri1369. No abstract available.
PubMed 15173834Hallgren M, Stubbs B, Vancampfort D, Lundin A, Jaakallio P, Forsell Y. Treatment guidelines for depression: Greater emphasis on physical activity is needed. Eur Psychiatry. 2017 Feb;40:1-3. doi: 10.1016/j.eurpsy.2016.08.011. Epub 2016 Nov 10. No abstract available.
PubMed 27837666Jylha M. What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med. 2009 Aug;69(3):307-16. doi: 10.1016/j.socscimed.2009.05.013. Epub 2009 Jun 10.
PubMed 19520474Wiklund IK, Fullerton S, Hawkey CJ, Jones RH, Longstreth GF, Mayer EA, Peacock RA, Wilson IK, Naesdal J. An irritable bowel syndrome-specific symptom questionnaire: development and validation. Scand J Gastroenterol. 2003 Sep;38(9):947-54. doi: 10.1080/00365520310004209.
PubMed 14531531Rezaie A, Pimentel M, Rao SS. How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach. Curr Gastroenterol Rep. 2016 Feb;18(2):8. doi: 10.1007/s11894-015-0482-9.
PubMed 26780631Smets EM, Garssen B, Bonke B, De Haes JC. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res. 1995 Apr;39(3):315-25. doi: 10.1016/0022-3999(94)00125-o.
PubMed 7636775Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999 Nov 10;282(18):1737-44. doi: 10.1001/jama.282.18.1737.
PubMed 10568646Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. doi: 10.1001/archinte.166.10.1092.
PubMed 16717171Westerlund A, Brandt L, Harlid R, Akerstedt T, Lagerros YT. Using the Karolinska Sleep Questionnaire to identify obstructive sleep apnea syndrome in a sleep clinic population. Clin Respir J. 2014 Oct;8(4):444-54. doi: 10.1111/crj.12095.
PubMed 25396257Younge JO, Gotink RA, Baena CP, Roos-Hesselink JW, Hunink MG. Mind-body practices for patients with cardiac disease: a systematic review and meta-analysis. Eur J Prev Cardiol. 2015 Nov;22(11):1385-98. doi: 10.1177/2047487314549927. Epub 2014 Sep 16.
PubMed 25227551
Study at a glance
From the registry record, last updated by the sponsor on 3 Mar 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Health-related Quality of Life and Symptom Burden in Patients at Nordic Clinic Before, During and After Personalised, Functional Medicine Treatments and Lifestyle Interventions
- ClinicalTrials.gov ID
- NCT04611074
- Acronym / sponsor ID
- HRQL1
- Conditions
- Chronic Disease
- Keywords
- Chronic Disease
- Study type
- Observational
- Recruitment status
- TerminatedReason stopped: Technical and recruitment issues.
- Enrolment
- 21 participants (actual)
- Lead sponsor
- Nordic Clinic StockholmUniversity, hospital or other
- Collaborators
- Stockholm University
- Study start
- 22 Aug 2019 (actual)
- Primary completion
- 1 Mar 2023 (actual)
- Study completion
- 1 Mar 2023 (actual)
- First posted
- 2 Nov 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Nordic Clinic is a private clinic for personalised treatment based on the Functional Medicine concept. In summary, functional medicine is aimed at addressing the lifestyle and behavioral factors that are believed to contribute to the symptoms the patient suffers from. In short, the treatment is based on a timeline of health-related life events, current lifestyle factors and behaviors and physiological examinations to develop a personalised lifestyle program. The main component of the treatment provided at Nordic Clinic is in-depth lifestyle coaching to achieve the desired behavioral and lifestyle changes.
Working at the clinic is a clinical physiologist, nutritionist, physician specialist in general medicine and researchers work. The vast majority of people who apply for the clinic have long-standing symptoms that have been investigated by the healthcare system without any organic explanation for the symptoms having been identified. Common causes are gastrointestinal problems, persistent fatigue and insomnia. The aim of the study is to investigate symptom-borne and health-related quality of life during and after treatment and to identify predictors of improvement of health-related quality of life. The main purpose is to investigate whether the health-related quality of life is improved during treatment. This is an observational study and all adult patients who are able to complete the web form in Swedish at the clinic are asked to participate. Participants who give consent will receive a link to the questionnaire via email once a month for one year and once after two years. Participants are recruited for two years, and will be completed after the last questionnaire is completed by the last included participant, ie autumn 2022. In addition to the self-assessments, the number of visits to the clinic, sampling and results, who finances the treatment and treatment plan are recorded.
The first aim is to investigate improvement in symptom burden and health related quality of life during and after treatment (does symptom burden and health related quality of improve during treatment and are improvements stable at the 2 year follow-up?) The second aim is to investigate factors that predict recovery (Do persons with a high level of motivation for behavioural change experience a better improvement in symptom burden and health related quality of life than persons with a low level of motivation for behavioural change?).
Detailed description
Research plan
Health related quality of life in patients at the Nordic Clinic
Background
Nordic Clinic is a private clinic that provides personalised treatment based on functional medicine. The vast majority of the patients seeking care at the clinic suffer from unexplained medical symptoms, most commonly fatigue and abdominal symptoms, and have previously been medically evaluated by health care. Working at the clinic are a clinical physiologist, nutritional therapist, licensed physician and a researcher. Patients follow a clinical treatment process starting with the physician progressing through to the nutritionist. Treatment is covered either by the patient themselves, by employers or health insurances.
Before treatment is initialised, an extensive medical history along with current lifestyle habits are taken. The treatment programme is based on lifestyle factors, mainly diet, sleep, stress management and physical activity. Supplements are given. Drugs are prescribed sparsely and by a licenced physician, and may include Rifaximin or other antibiotics for intestinal bacterial overgrowth, motility drugs for constipation, anti-parasitic drugs in case of parasite infection, and melatonin for sleep disturbances.
The components in the treatment programme have been investigated separately. Any supplements used are produced by reputable organisations and most of them have been part of the treatment routine for several years. The aims of the study is to evaluate improvement during and after treatment and to identify predictors of recovery. The goal is to understand the process of recovery with the long term goal to improve care given at the clinic.
Aim and research question
The first aim is to investigate improvement in symptom burden and health related quality of life during and after treatment (does symptom burden and health related quality of improve during treatment and are improvements stable at the 2 year follow-up?) The second aim is to investigate factors that predict recovery (Do persons with a high level of motivation for behavioural change experience a better improvement in symptom burden and health related quality of life than persons with a low level of motivation for behavioural change?).
Methods
Study population and inclusion criteria
All Swedish speaking patients (>1= 18 years) visiting the clinic will be asked to participate in the study by clinic personnel when visiting the clinic. All patients at the clinic are able to provide informed consent and to fill out online forms.
Procedure
This is an observational study where patients are followed over time in terms of symptom burden and health related quality of life. The study participants are asked to fill out forms once a month for one year counting from the first visit, and once again 2 years after baseline. Clinical data is collected from the medial record by the clinician at the end of the study.
Questionnaires
(Jylhä 2009)(K, S et al. 2003)(Westerlund, Brandt et al. 2014)(Smets, Garssen et al. 1995)(Andreasson, Wicksell et al. 2016)(Spitzer, Kroenke et al. 2006)(Spitzer, Kroenke et al. 1999)
Clinical variables
Information on diagnosis, number of visits, tests and test results, treatment programme and background information (including age, gender, lifestyle factors, readiness for change, education, occupation, social support, height and weight, blood pressure), will be collected from the medical record of the patient by the clinician at the end of the study period.
Statistics
Based on experience of these types of analyses, 150 participants would give a reasonable foundation for the statistical analyses. 300 unique patients are expected to enrol during the study inclusion period and expect 200 of these to complete at least the first year of data collection. In the main analysis of the first aim, the effect of time on questionnaire scores will be investigated using mixed effect linear regression to see to what extent symptom burden and health related quality of life is affected during treatment and to investigate the stability in any improvements. Secondly, it will be investigated it a high adherence to the treatment programme is associated with improvement. Thirdly, the level of adherence to the treatment programme will be compared between patients with predominant abdominal symptoms and patients with predominant fatigue.
In the main analysis of the second aim, readiness for change will be tested as a moderator of the effect of time on questionnaire scores. Secondly, the level of improvement will be compared between patients who self-fund the treatment programme and patients with funding from employer or health insurance.
Patients often present with a range of different symptoms. Principal component analysis will be performed in an exploratory analysis to investigate if there are subgroups within the patient population, and if these subgroups differ in terms of treatment response. Covariation over time of symptoms, health related quality of life and self-rated health will be investigated in exploratory analyses.
Ethical considerations
The present study poses little risk to the participant. The treatment programme that the participant would undergo independently of the study is considered safe with few and mild side effects such as rash. As part of the study the participant report health information on a web questionnaire. Health data is sensitive information and the same platform will be used as for all other data collected by the clinic for treatment. The platform that is used is certified safe (add information) and complies to the GDPR regulation.
Risk of missing serious diagnoses
When dealing with symptoms such as persistent fatigue there is a risk that serious conditions such as cancer might be missed. However, the risk is estimated as low as low as in primary care at a Vårdcentral. Our medical doctor is still active in primary health care in parallel to Nordic Clinic and has many years of experience. Most of the patients at Nordic Clinic have been thoroughly investigated in the primary care system before signing up as patients at Nordic Clinic. Should patients however present with symptoms that warrant the investigation of serious conditions like malignancies, it is made sure that a thorough investigation has indeed been performed. If it has not, our medical doctor refers them back to primary or specialist health care.
Importance
There has not been a strong research tradition to evaluate treatment programmes based on functional medicine, albeit the individual components therein have all been evaluated and are found to be safe. However, all treatments given to patients need continuing evaluation. This two-year observational study will provide information regarding treatment outcomes and stability thereof over time, in addition to identifying patient groups that get the most benefit of the treatment. Future randomised controlled trials are needed to evaluate the effectiveness of the treatment programme.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- All Swedish speaking patients (>1= 18 years) visiting the clinic will be asked to participate in the study by clinic personnel when they are visiting the clinic. All patients at the clinic are able to provide informed consent and to fill out online forms.
Key inclusion criteria (1 listed)
- All Swedish speaking patients (>/= 18 years) visiting the clinic will be asked to participate in the study by clinic personnel when they are visiting the clinic. All patients at the clinic are able to provide informed consent and to fill out online forms.
Key exclusion criteria (1 listed)
- <18 years, non-Swedish speaking
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Change in gastrointestinal discomfort from baseline as assessed by the Gastrointestinal Symptom Rating Scale for IBS questionnaire (GSRS-IBS)
Time frame: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Self-reported satiety, abdominal pain, diarrhoea, constipation and bloating is measured with GSRS-IBS with the following outcomes: No discomfort at all, Minor discomfort, Mild discomfort, Moderate discomfort, Moderately severe discomfort, Severe discomfort, Very severe discomfort.
Change in fatigue from baseline as assessed by the Multidimensional Fatigue Inventory
Time frame: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
General fatigue, physical fatigue, reduced motivation, reduced activity, and mental fatigue is evaluated on a scale from 1-5, where 1 is true and 5 is not true.
Change in health-related quality of life from baseline as assessed by the 36-Item Short Form Health Survey (SF-36)
Time frame: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
The SF-36 measures physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health.
Change in sleep from baseline as assessed by the Karolinska Sleep Questionnaire (KSQ)
Time frame: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
KSQ is a self-assessment form that measures difficulty falling asleep, disturbed sleep, repeated awakenings, early wakings, difficulty waking up, insufficient rest during the night, nightmares, snoring, daytime effects. The questionnaire contains 13 questions about sleep and sleepiness which are answered according to a five-point scale from 1 (never/very good) to 5 (always/very bad).
Change in anxiety from baseline as assessed by the Generalised Anxiety Disorder 7-item scale (GAD-7)
Time frame: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
GAD-7 is a self-assessment form that measures seven anxiety-related symptoms using the following scale: Not at all (0), Several days (1), More than half the days (2), Nearly every day (3).
Change in presence or severity of depression from baseline as assessed by the Patient Health Questionnaire-9 (PHQ-9)
Time frame: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
PHQ-9 screens for presence or severity of depression according to the DSM-IV criteria. It measures nine depression-related symptoms using the following scale: Not at all (0), Several days (1), More than half the days (2), Nearly every day (3).
Change in overall health from baseline as assessed by the Self-rated health questionnaire
Time frame: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
The self-rated health questionnaire is a single question questionnaire, evaluating overall health at the time of the survey using the scale very good" (1), "good" (2), "moderate" (3), "bad" (4) or "very bad" (5).
2 secondary outcomes
Correlation between motivation for behavioral change and change in symptom burden and health-related quality of life
Time frame: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Predictability of the predominance of fatigue or abdominal-related symptomatology for adherence to the treatment programme
Time frame: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.
Results and safety
The study was stopped early (reason given: Technical and recruitment issues.). Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Mar 2023.
- Background: PubMed 27458105Andreasson A, Wicksell RK, Lodin K, Karshikoff B, Axelsson J, Lekander M. A global measure of sickness behaviour: Development of the Sickness Questionnaire. J Health Psychol. 2018 Sep;23(11):1452-1463. doi: 10.1177/1359105316659917. Epub 2016 Jul 24.
- Background: PubMed 15173834Bryant PA, Trinder J, Curtis N. Sick and tired: Does sleep have a vital role in the immune system? Nat Rev Immunol. 2004 Jun;4(6):457-67. doi: 10.1038/nri1369. No abstract available.
- Background: PubMed 27837666Hallgren M, Stubbs B, Vancampfort D, Lundin A, Jaakallio P, Forsell Y. Treatment guidelines for depression: Greater emphasis on physical activity is needed. Eur Psychiatry. 2017 Feb;40:1-3. doi: 10.1016/j.eurpsy.2016.08.011. Epub 2016 Nov 10. No abstract available.
- Background: PubMed 19520474Jylha M. What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med. 2009 Aug;69(3):307-16. doi: 10.1016/j.socscimed.2009.05.013. Epub 2009 Jun 10.
- Background: PubMed 14531531Wiklund IK, Fullerton S, Hawkey CJ, Jones RH, Longstreth GF, Mayer EA, Peacock RA, Wilson IK, Naesdal J. An irritable bowel syndrome-specific symptom questionnaire: development and validation. Scand J Gastroenterol. 2003 Sep;38(9):947-54. doi: 10.1080/00365520310004209.
- Background: PubMed 26780631Rezaie A, Pimentel M, Rao SS. How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach. Curr Gastroenterol Rep. 2016 Feb;18(2):8. doi: 10.1007/s11894-015-0482-9.
- Background: PubMed 7636775Smets EM, Garssen B, Bonke B, De Haes JC. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res. 1995 Apr;39(3):315-25. doi: 10.1016/0022-3999(94)00125-o.
- Background: PubMed 10568646Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999 Nov 10;282(18):1737-44. doi: 10.1001/jama.282.18.1737.
- Background: PubMed 16717171Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. doi: 10.1001/archinte.166.10.1092.
- Background: PubMed 25396257Westerlund A, Brandt L, Harlid R, Akerstedt T, Lagerros YT. Using the Karolinska Sleep Questionnaire to identify obstructive sleep apnea syndrome in a sleep clinic population. Clin Respir J. 2014 Oct;8(4):444-54. doi: 10.1111/crj.12095.
- Background: PubMed 25227551Younge JO, Gotink RA, Baena CP, Roos-Hesselink JW, Hunink MG. Mind-body practices for patients with cardiac disease: a systematic review and meta-analysis. Eur J Prev Cardiol. 2015 Nov;22(11):1385-98. doi: 10.1177/2047487314549927. Epub 2014 Sep 16.
- Individual participant dataSharing planned: Undecided
Related trials for Chronic Disease
RecruitingPhase 2
Tafasitamab With Acalabrutinib and Venetoclax for the Treatment of Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
Chronic Lymphocytic Leukemia, Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
Not yet recruiting
Feasibility of a Robot-Guided Active Play Intervention for Children With Cerebral Palsy
Cerebral Palsy
Recruiting
PAW-Hydrogel for Chronic Wound Healing
Diabetic Foot Ulcer (DFU), Pressure Ulcer (PU)
Active, not recruitingPhase 2
Safety and Efficacy of Empagliflozin in Hemodialysis
End Stage Renal Disease
Not yet recruitingPhase 1
Phase I Open-Label Safety Trial of Pembrolizumab for Neurological Post- Acute Sequelae of SARS-CoV-2 (PD1-PASC I)
Post-Acute COVID-19 Syndrome
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Annie ML Pettersson, PhD principal investigator
Nordic Clinic
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Chronic Disease, run by Nordic Clinic Stockholm at 1 site in Sweden.
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 1 inclusion and 1 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 3 Mar 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 Sweden. 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 was stopped early (reason given: Technical and recruitment issues.). Results are not available in the source record.
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?
Change in gastrointestinal discomfort from baseline as assessed by the Gastrointestinal Symptom Rating Scale for IBS questionnaire (GSRS-IBS) (time frame: Baseline (time of enrollment), then each month 1-12 months after baseline, and then at 24 months.). The study lists 7 primary outcomes in all. 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 NCT04611074, which also lists 11 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 3 Mar 2023.