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Trial registered on ANZCTR
Registration number
ACTRN12619000020189
Ethics application status
Approved
Date submitted
4/01/2019
Date registered
9/01/2019
Date last updated
1/09/2024
Date data sharing statement initially provided
9/01/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Breathlessness Intervention Service (BLIS) program pilot study
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Scientific title
Breathlessness Intervention Services (BLIS) program in people with chronic lung and heart conditions: a pilot study of feasibility, personal, clinical and cost effectiveness.
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Secondary ID [1]
296969
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nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
chronic breathlessness
310930
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Condition category
Condition code
Respiratory
309594
309594
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0
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Chronic obstructive pulmonary disease
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Cardiovascular
309595
309595
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participation in a brief intervention based on existing clinical research evidence, directed toward reducing the impact of breathlessness by helping the person to better manage their symptoms. The interventions delivered will not impact on their usual care provided and will be an addition to care once they have been medically and pharmacologically optimised. This brief intervention will involve 2-4 home-based or clinic visits (over the first 4 weeks) from a physiotherapist or nurse and 3-4 telephone contacts (over the next 4 weeks) by the same clinicians. The timing and number of these visits will be flexible within this time frame based on participant need and collaboration between participants and clinician. Visits are anticipated to be conducted in the participant's home unless they have a preference for clinic visits.
The visits will involve comprehensive assessment, collaborative goal setting and therapy using non-drug, symptom management-based therapies that fit the patient’s needs in line with existing evidence (eg Brighton LJ et al Thorax 2018;0:1–12. doi:10.1136/thoraxjnl-2018-211589; Booth S et al Managing breathlessness in clinical practice, Springer Verlag, London 2014) The specific evidence-based therapies that will be delivered help people manage breathlessness by addressing issues related to breathing (examples include hand-held fan, breathing techniques, body position) thinking (action plan for breathlessness, cognitive behavioural therapy strategies; relaxation techniques) and functioning (exercise plan using pedometer; walking aids; activity pacing). The intervention will also include care coordination, facilitation of self-management and integration with all other health and community service providers.
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Intervention code [1]
313240
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Rehabilitation
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Intervention code [2]
313241
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Behaviour
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Comparator / control treatment
No control group, this is a feasibility of translation study.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Program feasibility: composite outcome made up of meeting a priori criteria pre-set with regards to program uptake, participant retention, completion of measures, fidelity of program delivery, and participant experience.
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Assessment method [1]
318555
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Timepoint [1]
318555
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Post program, week 9
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Secondary outcome [1]
365372
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Distress due to breathlessness on Multidimensional Dyspnea Profile
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Assessment method [1]
365372
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Timepoint [1]
365372
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At post-program (ie 9 weeks), then 3 and 6 months post program, compared with baseline.
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Secondary outcome [2]
365373
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Perceived control of breathlessness using the CRQ-Self Administered Scale (mastery subscale)
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Assessment method [2]
365373
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Timepoint [2]
365373
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At post-program (ie 9 weeks), then 3 and 6 months post program, compared with baseline
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Secondary outcome [3]
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Perceived ability to manage or live with breathlessness on NRS scale
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Assessment method [3]
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Timepoint [3]
365427
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At post-program (ie 9 weeks), then 3 and 6 months post program, compared with baseline
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Secondary outcome [4]
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Brief Illness Perception Questionnaire
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Assessment method [4]
365428
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Timepoint [4]
365428
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At post-program (ie 9 weeks), then 3 and 6 months post program, compared with baseline
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Secondary outcome [5]
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Depression, Anxiety and Stress Scale (DASS21)
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Assessment method [5]
365429
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Timepoint [5]
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At post-program (ie 9 weeks), then 3 and 6 months post program, compared with baseline
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Secondary outcome [6]
365430
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Number of days admitted to hospital from SA Health electronic record
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Assessment method [6]
365430
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Timepoint [6]
365430
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calculate for the 3 and 6 months before and after program commencement
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Secondary outcome [7]
365431
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Number of emergency department presentations form the SA Health electronic record
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Assessment method [7]
365431
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Timepoint [7]
365431
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calculate for the 3 and 6 months before and after program commencement
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Eligibility
Key inclusion criteria
At SALHN: Diagnosis of chronic obstructive pulmonary disease (COPD) OR diagnosis of heart failure with chronic respiratory comorbidity (eg COPD / asthma / bronchiectasis / suppurative lung disease / interstitial lung disease). At CAHLN: Diagnosed chronic lung condition.
- Minimum of 1 admission for an acute exacerbation in the past 12 months
- Lives within the SALHN/CALHN demographic area
- Troubled by breathlessness in spite of optimal medical and pharmacological treatment for underlying condition.
-Stable condition (at least 4 weeks after discharge from hospital) at the time commences pilot study
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients receiving case management from other existing programs
Patients receiving end-stage Palliative Care Services
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
How will you measure, manipulate and/or analyse the information collected?
The aim of this pilot study is to translate an evidence-based chronic Breathlessness Intervention Service to the Adelaide region and (1) examine the feasibility, acceptability, and participant experience of this program;(2) report on the direction and extent of change in patient and carer reported outcome measures; (3) compare hospital-related health care costs in the 3 and 6 months before and after program participation and estimate cost per quality adjusted life year (QALY) gained from the intervention.
Participant characteristics, feasibility and acceptability data and group information about patient and carer reported outcomes and hospital-related health care utilisation will be descriptively reported and summarised. Non-parametric statistics will be used to examine the direction of changes (ie improvement or deterioration) in pre-post program measures of patient and carer reported outcomes and hospital based health care utilisation. Transcripts of post-program interviews will be examined using content analysis to describe participants feedback on their experiences of and acceptability of the program..
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
4/03/2019
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Actual
13/05/2019
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Date of last participant enrolment
Anticipated
4/11/2019
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Actual
18/11/2019
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Date of last data collection
Anticipated
31/07/2020
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Actual
29/07/2020
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Sample size
Target
30
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Accrual to date
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Final
21
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
301537
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Government body
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Name [1]
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Medical Research Future Fund
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Address [1]
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Health Translations SA
based at the South Australian Health and Medical Research Institute (SAHMRI)
North Terrace, Adelaide SA 5000
Australia
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Country [1]
301537
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Australia
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Primary sponsor type
Individual
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Name
Kylie Johnston
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Address
School of Health Sciences, University of South Australia
GPO Box 2471
Adelaide SA 5001
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Country
Australia
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Secondary sponsor category [1]
301240
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None
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Name [1]
301240
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Address [1]
301240
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Country [1]
301240
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
302276
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Southern Adelaide Clinical HREC
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Ethics committee address [1]
302276
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SALHN Office for Research Flinders Medical Centre Flinders Drive, Bedford Park SA 5042
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Ethics committee country [1]
302276
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Australia
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Date submitted for ethics approval [1]
302276
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Approval date [1]
302276
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20/11/2018
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Ethics approval number [1]
302276
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HREC/18/SAC/62
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Ethics committee name [2]
302277
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University of South Australia HREC
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Ethics committee address [2]
302277
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University of South Australia GPO Box 2471 Adelaide SA 5001
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Ethics committee country [2]
302277
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Australia
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Date submitted for ethics approval [2]
302277
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Approval date [2]
302277
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15/11/2018
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Ethics approval number [2]
302277
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201493
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Summary
Brief summary
Many people with lung and heart conditions have persistent breathlessness, even when they are receiving the best possible medical care for their condition. Breathlessness Intervention Services have been shown to reduce people’s distress and improve their confidence to manage breathlessness in the UK and Canada but so far these services have not been studied or made available in South Australia. This study will evaluate the feasibility and outcomes of a home-based brief intervention for people with chronic breathlessness due to lung or heart conditions, involving 2-4 visits and 3-4 telephone contacts for assessment and therapy by nurse and physiotherapist using non-drug, evidence-based symptom management therapies that fit the patient’s needs.
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Trial website
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Trial related presentations / publications
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Public notes
At the CALHN site only, this study is funded in 2019 by disbursements from the Medical Research Future Fund (MRFF) Rapid Applied Research Translation Program, as part of the work undertaken by Health Translation SA.
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Contacts
Principal investigator
Name
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Dr Kylie Johnston
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Address
89662
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School of Health Sciences, University of South Australia
GPO Box 2471, Adelaide SA 5001
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Country
89662
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Australia
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Phone
89662
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+61 8 8302 2086
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Fax
89662
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Email
89662
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[email protected]
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Contact person for public queries
Name
89663
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Kylie Johnston
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Address
89663
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School of Health Sciences, University of South Australia
GPO Box 2471, Adelaide SA 5001
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Country
89663
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Australia
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Phone
89663
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+61 8 8302 2086
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Fax
89663
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Email
89663
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[email protected]
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Contact person for scientific queries
Name
89664
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Kylie Johnston
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Address
89664
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School of Health Sciences, University of South Australia
GPO Box 2471, Adelaide SA 5001
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Country
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Australia
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Phone
89664
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+61 8 8302 2086
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Fax
89664
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Email
89664
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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