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N/A N=45 Randomized Double-blind Supportive Care

Mobile Coping Skills Training to Improve Cardiorespiratory Failure Survivors' Psychological Distress

Cardiorespiratory Failure

Enrolled (actual)
45
Serious AEs
0.0%
Results posted
Feb 2023
Primary outcome: Primary: Change in Hospital Anxiety and Depression Scale (HADS) Questionnaire — 11.7; 11.3; 12.1 units on a scale

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Coping skills training mobile app with call from CST therapist (Behavioral); Coping skills training mobile app only (Behavioral)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Duke University
Primary completion
Dec 2021

Outcome Measures

OutcomeResultp-value
PRIMARY
Change in Hospital Anxiety and Depression Scale (HADS) Questionnaire
11.0; 11.4; 13.5
SECONDARY
Change in Hospital Anxiety and Depression Scale (HADS) Questionnaire
11.0; 11.4; 13.5
SECONDARY
Change in Post-Traumatic Stress Symptom Inventory (PTSS)
28.9; 29.4; 31.3
SECONDARY
Change in Post-Traumatic Stress Symptom Inventory (PTSS)
28.9; 29.4; 31.3
SECONDARY
Client Satisfaction Questionnaire (CSQ)
29; 29.5; 25
SECONDARY
Intervention Adherence
36.5; 34.1
SECONDARY
Change in Quality of Life Visual Analog Scale
61.4; 72.5; 67.1
SECONDARY
Change in Quality of Life Visual Analog Scale
61.4; 72.5; 67.1
SECONDARY
Patient Health Questionnaire 10-item Scale (PHQ-10)
7.9; 6.5; 5.7
SECONDARY
Patient Health Questionnaire 10-item Scale (PHQ-10)
7.9; 6.5; 5.7
SECONDARY
Distress Associated With Depression and Anxiety Symptom Frequency
SECONDARY
Distress Associated With Depression and Anxiety Symptom Frequency
SECONDARY
Distress Associated With PTSD Symptom Frequency
SECONDARY
Distress Associated With PTSD Symptom Frequency

Summary

This is a pilot randomized clinical trial involving adult survivors of cardiorespiratory failure treated in intensive care units (ICUs) that is designed to test the acceptability, feasibility, and clinical impact of a coping skills training intervention (Blueprint) delivered via a mobile app. This trial will allow us to determine if new changes to intervention delivery, inclusion criteria, and other factors are successful. It will also inform the development of a next-step efficacy focused trial.

Eligibility Criteria

INCLUSION CRITERIA

  • Adult (age ≥18)
  • Managed in a hospital setting for ≥24 hours during the time inclusion criterion #3 is met.
  • Acute cardiorespiratory failure / insufficiency, defined as ≥1 of the following:
  • mechanical ventilation via endotracheal tube for ≥4 hours
  • non-invasive ventilation (CPAP, BiPAP) for ≥4 hours in a 24-hour period provided for acute respiratory failure
  • new use of supplemental oxygen ≥2 liters per minute (or increase in baseline continuous oxygen)
  • use of vasopressors for shock of any etiology
  • use of inotropes for shock of any etiology
  • use of pulmonary vasodilators
  • use of aortic balloon pump or cardiac assist device for cardiogenic shock
  • use of diuretic intravenous drip
  • Cognitive status intact
  • No history of pre-existing significant cognitive impairment (e.g., dementia) as per medical chart
  • Absence of current significant cognitive impairment (impairment defined as ≥3 errors on the Callahan cognitive status screen)
  • Decisional capacity present
  • Absence of severe and/or persistent mental illness
  • Treatment for severe and/or persistent mental illness (e.g., psychosis, bipolar affective disorder, schizoaffective disorder, schizoid personality disorder, schizophrenia [as per medical record], hospitalization for any psychiatric disorder) within the 6 months preceding the current hospital admission
  • No endorsement of active suicidality at time of admission or informed consent
  • No active substance abuse at a severity that impairs ability to participate
  • Functional English fluency

EXCLUSION CRITERIA (in hospital):

  • Complex medical care expected soon after discharge (e.g., planned surgeries, transplantation evaluation, extensive travel needs for follow up care, disruptive chemotherapy/radiation regimen)
  • Unable to complete study procedures as determined by staff
  • Lack of access to either reliable smartphone with cellular data plan or wifi

INCLUSION CRITERIA (post-discharge)

  • Elevated baseline (T1) psychological distress symptoms, defined as HADS total score of ≥8

EXCLUSION CRITERIA (post-discharge)

  • Failure to randomize within 2 months post-discharge.
  • Failure to access app within 1 month after randomization in the absence of other explanation (e.g., hospitalization).
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04329702). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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