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COVID-19NCT05107440

BREATHE: Virtual Self-management for Long COVID-19

A study testing BREATHE in people with COVID-19, run by University of Calgary at 1 site in Canada.

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

A mixed-methods evaluation of a virtual self-management program for people living with long COVID in Alberta. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
COVID-19
What is being tested?
BREATHE
Could I receive a placebo?
No, everyone receives an active treatment
How many people
27 participants
Where
1 siteCanada
Study dates
3 Jan 2022to 13 Oct 2022
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participant has English language fluency (approximately grade 8-10 reading level) and is able to provide informed consent.
  • Participant is a resident in Alberta, Canada.
  • Participant had confirmed COVID-19 via a positive molecular or antigen test within the past 18 months. Alternatively, in the case of a lack of access to testing, evidence of infection including close contact with a confirmed case of COVID-19 or being linked with a COVID-19 outbreak, or an acute illness including the core symptoms of COVID-19 (cough, fever, shortness of breath, runny nose, sore throat, loss of taste or smell).
  • Experiencing symptoms and ongoing functional limitations that have persisted for ≥3 months (from the first positive test/known exposure date/symptom onset). At least one self-reported symptom is fatigue, shortness of breath, cognitive dysfunction or activity intolerance, and
  • Post-COVID-19 Functional Status Scale (PFSS) score of ≥2 [22,23].
  • Symptoms developed or substantially worsened during or after the acute infection (i.e., they are not explained by a co-occurring condition that pre-dates COVID-19).

Who cannot join

  • Participant does not have access to a smart phone or computer (desktop, laptop, or tablet).
  • Receiving ongoing physical therapy via the Workers' Compensation Board.
  • Participants are currently participating in a regular rehabilitation program such as the Alberta Health Services (AHS) "Breathe Easy Program - Pulmonary Rehabilitation" or "Supervised Transitional Exercise Program (STEP) Forward - program." Previous participation or being on the waitlist for these services are not exclusion criteria.
  • A peripheral oxygen saturation <92% at rest on room air, syncope at rest or on exertion, and any other significant medical complexity that might require medical attention based on clinical judgement.
  • A diagnosis of a post-viral syndrome including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) that pre-dates COVID-19.

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • University of Calgary

    Calgary, Alberta

Other trials in Canada

About this study

Official title: BREATHE: A Mixed-methods Evaluation of a Virtual Self-management Program for People Living With Long COVID-19 in Alberta

A mixed-methods evaluation of a virtual self-management program for people living with long COVID in Alberta.

Read the detailed description

Background \& Rationale

The possible volume of current and future long COVID patients in Alberta is so high (based on the above numbers, more than 20,000) that primary care may not be able to cope given current resources (for example, the waitlist for post-COVID-19 clinics is >3 months). While a Rehabilitation Advice Line and online resources have been created for Albertans with long COVID, many patients are struggling and need more support for self-management to promote recovery. Alongside shortness of breath, long COVID is often characterized by chronic fatigue that is clinically relevant and is at least as severe as fatigue in several other clinical conditions. Other symptoms can include dry cough, cognitive impairment ("brain fog"), heart palpitations, chest tightness, and dizziness. Individuals living with long COVID describe an unpredictable and episodic trajectory with a relapse-remitting nature. Since February 2021, the investigators have been delivering a free virtual program for people with long COVID in Alberta due to an overwhelming demand for physical therapy/support for chronic symptoms. This program has undergone iterative improvements based on new understanding and participant feedback. The program is feasible given the ongoing demand (rapid recruitment of 16-18 participants in three previous programs) and high attendance (>80%). In the most recent cohort, of the participants that responded, 100% found the program helpful, 91% felt more confident about managing symptoms, 91% would recommend the program to other people with long COVID (feedback collected using a brief anonymous survey as part of quality improvement). The objective of this exploratory study is to collect quantitative and qualitative data to evaluate the safety and acceptability of a virtual self-management program for people living with long COVID. Pre-to-post intervention patient-reported outcomes (PROs) will also be collected, and the proportion of participants improving or deteriorating will be reported.

Methods

This is a mixed-methods evaluation of a free, virtual, multidisciplinary, patient-centred self-management program for long COVID. The BREATHE program provides education on Breathing, Rest/recovery, Education, Activity management, Thinking/cognition, Healthy voice strategies, and Eating/nutrition. Two previous pilot iterations of the program took place earlier in 2021, and the BREATHE program in its current format is currently taking place (Aug-Oct, 2021) and will be repeated from Oct-Dec 2021. There is no required in-person element to this study; assessments and program sessions take place virtually via REDCap (secure data collection platform) and Zoom (secure video platform). Participant eligibility criteria were based on the World Health Organization's clinical case definition for post COVID-19 condition.

BREATHE is an eight-week intervention involving two sessions per week, hosted virtually on Zoom. The content was developed based on clinical experience, best available evidence for the management of specific symptoms (chronic fatigue, post-exertional malaise, breathing discomfort, sleep disruption) in other conditions, including post-viral syndromes, and the current understanding and recommendations for rehabilitation of people living with long COVID. The remaining sessions were developed and delivered by content experts (occupational therapist, nutritional consultant, mental health professional) who are familiar with the unique difficulties that people with long COVID face. The investigators have incorporated breakout rooms to include elements of peer support (affirmation of feelings and behaviours, expressions of empathy and reassurance, support for coping with negative emotions, encouraging persistence and optimism). Intervention attendance and adverse events will be reported. Because this is a self-management intervention, the main pre-post outcome of interest is participants' confidence in managing their symptoms and daily activities. Additional outcomes are fatigue, breathing discomfort, functional status and health-related quality of life. To gain participant perspectives on the BREATHE program, participants will be asked to take part in a one-on-one interview via Zoom within two weeks following the final intervention session. A semi-structured interview guide was developed, informed by the Theoretical Framework of Acceptability.

Conditions
COVID-19
Being tested
BREATHE
Keywords
Long COVID, Post COVID-19 condition, Post-acute COVID-19 syndrome
Medical subject headings
COVID-19, Post-Acute COVID-19 Syndrome

What participants receive

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

  • BREATHEOther

    A virtual, multidisciplinary, patient-centred self-management program for long COVID. The BREATHE program provides education on Breathing, Rest/recovery, Education, Activity management, Thinking/cognition, Healthy voice strategies, and Eating/nutrition.

Study groups in NCT05107440
Study groupRoleWhat they receive
BREATHEExperimentalThis is an eight-week intervention involving two sessions per week, hosted virtually on Zoom. The main session is scheduled to last 60 min and the session hosts remain online for an additional 15 minutes to answer individual questions on the management of symptoms and activities that have not been addressed during the main session. The content was developed based on clinical experience, best available evidence for the management of specific symptoms (chronic fatigue, post-exertional malaise, breathing discomfort) in other conditions, including post-viral syndromes, and the current understanding and recommendations for rehabilitation of people living with long COVID. Long COVID can be isolating, and challenges often interfere with everyday lifestyle and socialization. The investigators have incorporated breakout rooms (where the group is divided into two smaller groups based on current activity limitations) to include elements of peer support.
Receives: Other: BREATHE

What is being measured

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

  1. Self-efficacy to manage symptoms

    Total score on the 8-item short form, from the Patient-Reported Outcomes Measurement Information System (PROMIS) Self-efficacy for Managing Chronic Conditions item bank. These PROMIS item banks include all include 8 items that are used to determine a T-score. A T-score of 50 represents the average of people managing chronic health conditions, and ten points is one standard deviation.

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  2. Self-efficacy to manage daily activities

    Total score on the 8-item short form, from the PROMIS Self-efficacy for Managing Chronic Conditions item bank

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  3. Self-efficacy to manage emotions

    Total score on the 8-item short form, from the PROMIS Self-efficacy for Managing Chronic Conditions item bank

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

Secondary outcomes (31)
  1. Self-efficacy to manage symptoms

    Total score on the 8-item short form, from the PROMIS Self-efficacy for Managing Chronic Conditions item bank. These PROMIS item banks include all include 8 items that are used to determine a T-score. A T-score of 50 represents the average of people managing chronic health conditions, and ten points is one standard deviation.

    Measured: 3-month follow-up (Change from Baseline)

  2. Self-efficacy to manage daily activities

    Total score on the 8-item short form, from the PROMIS Self-efficacy for Managing Chronic Conditions item bank

    Measured: 3-month follow-up (Change from Baseline)

  3. Self-efficacy to manage emotions

    Total score on the 8-item short form, from the PROMIS Self-efficacy for Managing Chronic Conditions item bank

    Measured: 3-month follow-up (Change from Baseline)

  4. Fatigue severity (FACIT-F)

    Total score on the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Scale

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  5. Fatigue severity (FACIT-F)

    Total score on the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Scale

    Measured: 3-month follow-up (Change from Baseline)

  6. Medical Research Council (MRC) breathlessness scale grade

    Modified according to recommendations for core outcomes for COVID-19 research.

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  7. Medical Research Council (MRC) breathlessness scale grade

    Modified according to recommendations for core outcomes for COVID-19 research.

    Measured: 3-month follow-up (Change from Baseline)

  8. Post-COVID-19 Functional Scale (PCFS) grade

    Post-COVID-19 Functional Scale (PCFS)

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  9. Post-COVID-19 Functional Scale (PCFS) grade

    Post-COVID-19 Functional Scale (PCFS)

    Measured: 3-month follow-up (Change from Baseline)

  10. Recovery grade

    Recommended core outcome measure

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  11. Recovery grade

    Recommended core outcome measure

    Measured: 3-month follow-up (Change from Baseline)

  12. Physical functioning subscale score

    36-Item Short-Form Health Survey

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  13. Physical functioning subscale score

    36-Item Short-Form Health Survey

    Measured: 3-month follow-up (Change from Baseline)

  14. Role limitations due to physical health subscale score

    36-Item Short-Form Health Survey

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  15. Role limitations due to physical health subscale score

    36-Item Short-Form Health Survey

    Measured: 3-month follow-up (Change from Baseline).

  16. Role limitations due to emotional problems subscale score

    36-Item Short-Form Health Survey

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  17. Role limitations due to emotional problems subscale score

    36-Item Short-Form Health Survey

    Measured: 3-month follow-up (Change from Baseline)

  18. Emotional well-being subscale score

    36-Item Short-Form Health Survey

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  19. Emotional well-being subscale score

    36-Item Short-Form Health Survey

    Measured: 3-month follow-up (Change from Baseline)

  20. Social functioning subscale score

    36-Item Short-Form Health Survey

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  21. Social functioning subscale score

    36-Item Short-Form Health Survey

    Measured: 3-month follow-up (Change from Baseline)

  22. Energy/fatigue subscale score

    36-Item Short-Form Health Survey

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  23. Energy/fatigue subscale score

    36-Item Short-Form Health Survey

    Measured: 3-month follow-up (Change from Baseline)

  24. Pain subscale score

    36-Item Short-Form Health Survey

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  25. Pain subscale score

    36-Item Short-Form Health Survey

    Measured: 3-month follow-up (Change from Baseline)

  26. General health subscale score

    36-Item Short-Form Health Survey

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  27. General health subscale score

    36-Item Short-Form Health Survey

    Measured: 3-month follow-up (Change from Baseline)

  28. Physical component score

    36-Item Short-Form Health Survey

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  29. Physical component score

    36-Item Short-Form Health Survey

    Measured: 3-month follow-up (Change from Baseline)

  30. Mental component score

    36-Item Short-Form Health Survey

    Measured: Week 9 i.e. post-intervention (Change from Baseline)

  31. Mental component score

    36-Item Short-Form Health Survey

    Measured: 3-month follow-up (Change from Baseline)

Timeline

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

  1. First posted4 Nov 2021
  2. Study start3 Jan 2022
  3. Primary completion20 Jun 2022
  4. Study completion13 Oct 2022

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
27 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05107440
Sponsor's protocol ID
REB21-1359
Status last verified
Jan 2022
First submitted
13 Oct 2021
Last updated
14 Dec 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: A de-identified data set will be made available on the Open Science Framework. Participant information will only be presented in aggregate in manuscripts, and direct and indirect identifiers will be removed from the open dataset to ensure participant anonymity.

Questions about this trial

What is this clinical trial studying?

A study testing BREATHE in people with COVID-19, run by University of Calgary at 1 site in Canada.

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 6 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 14 Dec 2022. 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 Canada. 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?

Self-efficacy to manage symptoms (time frame: Week 9 i.e. post-intervention (Change from Baseline)). 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 14 Dec 2022.

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