Early Intervention in Pulmonary Exacerbation in CF

CF 肺部病情加重的早期干预

• 批准号: 8149884
• 负责人: Christopher Hooper Goss
• 金额: $ 77.99万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-27 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8149884
• 关键词: Acute; Adherence; Adolescent; Adult; Anxiety; Caring; Chronic Obstructive Airway Disease; Clinical; Clinical Trials; Coughing; Cystic Fibrosis; Data; Data Collection; Diagnosis; Dyspnea; Early identification; Early treatment; Emergency Situation; Enrollment; Equation; Equipment; Ethnic Origin; Failure; Forced expiratory volume function; Gender; Goals; Home environment; Hospitalization; Impairment; Individual; Infection; Intervention; Lung; Lung diseases; Measures; Mental Depression; Modeling; Monitor; Outcome; Outcome Measure; Patients; Plague; Principal Investigator; Pulmonary Cystic Fibrosis; Pulmonary Function Test/Forced Expiratory Volume 1; Quality of life; Questionnaires; Recovery; Recurrence; Reporting; Respiratory Failure; Respiratory physiology; Severity of illness; Social support; Socioeconomic Status; Spirometry; Symptoms; Time; base; care delivery; care seeking; clinical care; computerized; data exchange; depressive symptoms; health related quality of life; improved; mortality; multi-component intervention; novel strategies; primary outcome; programs; public health relevance; pulmonary function; respiratory; standardized care; success; telehealth; treatment as usual

DESCRIPTION (provided by applicant): Individuals with cystic fibrosis (CF) are plagued by daily respiratory symptoms such as cough and dyspnea. In spite of dramatic improvements in care, their lives are greatly shortened due to progressive respiratory failure. The course of CF is marked by recurrent pulmonary exacerbations characterized by worsened symptoms and declines in pulmonary function. CF acute pulmonary exacerbations result in more rapid decline in lung function and increased. Preliminary data from our groups suggest that delays in seeking care are associated with lack of recovery of lung function after an exacerbation. The primary goal of this proposal is to perform a clinical trial to determine the efficacy of early intervention in the treatment of adolescent and adult CF acute pulmonary exacerbation. The study will assess the integration of two novel approaches to the treatment of CF pulmonary exacerbation: 1) the use of home spirometers to identify and trigger treatment of an exacerbation; and 2) the use of home based assessment of patient symptoms to identify and trigger the treatment of a pulmonary exacerbation, both integrated into one protocolized care plan. This novel approach will be compared to usual care with the primary outcome measure being lung function as measured with forced expiratory volume in the first second (FEV1). We hypothesize that if pulmonary exacerbations are treated earlier with a multi-faceted intervention, the progression of lung disease will be slowed. This approach will utilize state of the art, telehealth equipment to improve the assessment and delivery of care to adolescents and adults with CF. PUBLIC HEALTH RELEVANCE: The primary goal of this proposal is to perform a clinical trial to determine the efficacy of early intervention in the treatment of adolescent and adult CF acute pulmonary exacerbation using remote monitoring with home spirometry and respiratory symptom assessment and protocolized management of CF exacerbation. This approach will utilize state of the art, telehealth equipment to improve the assessment and delivery of care to adolescents and adults with CF.

描述（由申请人提供）：囊性纤维化（CF）患者每天都受到咳嗽和呼吸困难等呼吸道症状的困扰。尽管在护理方面有了巨大的改善，但由于进行性呼吸衰竭，他们的生命大大缩短。CF的病程以复发性肺加重为特征，其特征为症状恶化和肺功能下降。CF急性肺加重导致肺功能下降更快，增加。我们小组的初步数据表明，延误就医与急性加重后肺功能恢复不足有关。本提案的主要目标是进行临床试验，以确定早期干预治疗青少年和成人CF急性肺加重的疗效。本研究将评估两种治疗CF肺加重的新方法的整合：1）使用家庭肺活量计识别和触发加重治疗; 2）使用基于家庭的患者症状评估识别和触发肺加重治疗，两者均整合到一个方案化护理计划中。将这种新方法与常规护理进行比较，主要结局指标是肺功能，用第一秒用力呼气量（FEV 1）测量。我们假设，如果肺部急性加重的早期治疗与多方面的干预，肺部疾病的进展将放缓。这种方法将利用最先进的远程保健设备，以改善对患有CF的青少年和成人的评估和护理。 公共卫生关系：本提案的主要目标是进行一项临床试验，以确定早期干预治疗青少年和成人CF急性肺加重的疗效，使用远程监测，家庭肺功能测定和呼吸症状评估以及CF加重的方案化管理。这种方法将利用最先进的远程保健设备，以改善对患有CF的青少年和成人的评估和护理。