Randomized controlled non-inferiority trial of a telehealth treatment for chronic stuttering: the Camperdown Program
Randomized controlled non-inferiority trial of a telehealth treatment for chronic stuttering: the Camperdown Program
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DOI：
10.3109/13682820902763944
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发表时间：
2010-01-01
影响因子：
2.4
通讯作者：
Packman, Ann
中科院分区：
文献类型：
--
作者：
Carey, Brenda;O'Brian, Sue;Packman, Ann
背景资料：虽然有一些治疗方法可以在临床上显著缓解成年人的口吃，但在澳大利亚，最佳实践治疗的可及性和可用性存在障碍。这个平行组，非劣效性随机对照试验与多盲结果评估调查是否远程保健交付的坎珀当计划提供了一个非劣效替代面对面治疗的成年人谁口吃。操作步骤：40名到大学言语诊所就诊的参与者被随机分配：20人被分配到远程医疗组，20人被分配到面对面组。排除标准是年龄小于18岁，口吃频率低于2%的音节口吃，以及在过去12个月内接受过言语重建治疗。针对口吃成年人的坎珀当计划就是干预措施。主要结果指标为治疗前和随机分组后9个月时的口吃频率（以口吃音节百分比（%SS）表示）和效率（通过计算每位参与者使用的语言病理学家接触小时数来衡量）。使用末次观察值结转法进行意向治疗分析。次要结果的措施是语音自然，自我报告口吃的严重程度，和治疗satisfactions.Outcomes & Results：有没有统计学或临床显着差异%SS两组之间在9个月后随机化。调整基线%SS的协方差分析显示，远程医疗的音节口吃绝对百分比比面对面低0.8%。治疗后即刻或治疗后6个月和12个月时，两组之间的%SS也无差异（p = 0.9）。在第二个主要结果测量中，远程医疗组使用的平均接触时间（221分钟）在统计学上少于面对面组（95%置信区间= -387至-56分钟，p = 0.01）。结果提供证据支持使用远程医疗提供的Camperdown计划作为面对面的替代方案。为口吃的成年人提供面部治疗。这种模式将增加目前与治疗服务隔离的成年人获得这种循证治疗的机会。
Background: Although there are treatments that can alleviate stuttering in adults for clinically significant periods, in Australia there are barriers to the accessibility and availability of best-practice treatment.Aims: This parallel group, non-inferiority randomized controlled trial with multiple blinded outcome assessments investigated whether telehealth delivery of the Camperdown Program provides a non-inferior alternative to face-to-face treatment for adults who stutter.Methods & Procedures: Forty participants who presented to a university speech clinic were randomized: 20 to the telehealth arm and 20 to the face-to-face arm. Exclusion criteria were age younger than 18 years, frequency of stuttering less than 2% of syllables stuttered and previous speech-restructuring treatment within the past 12 months. The Camperdown Program for adults who stutter was the intervention. Primary outcome measures were frequency of stuttering measured in per cent syllables stuttered (%SS) before treatment and at 9 months post-randomization and efficiency, measured by counting the number of speech pathologist contact hours used by each participant. Intention to treat analysis was conducted using last observation carried forward. Secondary outcome measures were speech naturalness, self-reported stuttering severity, and treatment satisfaction.Outcomes & Results: There was no statistically or clinically significant difference in %SS between the two groups at 9 months post-randomization. Analysis of covariance adjusting for baseline %SS showed telehealth had 0.8% absolute lower per cent syllables stuttered than face-to-face. There were also no differences in %SS between groups immediately post-treatment, or at 6 months and 12 months post-treatment (p = 0.9). In the second primary outcome measure, the telehealth group used statistically less contact time (221 min) on average than the face-to-face group (95% confidence interval = -387 to -56 min, p = 0.01).Conclusions & Implications: The results provide evidence to support the use of the Camperdown Program delivered by telehealth as an alternate to the face-to-face treatment delivery of this programme for adults who stutter. Such a model will increase accessibility to this evidence-based treatment for adults currently isolated from treatment services.