Mobile Decision Support System for Nurse Management of Neuromodulation Therapy

NCT ID: NCT02474459

Last Updated: 2020-06-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

123 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-31

Study Completion Date

2020-04-29

Brief Summary

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The purpose of this study is to test the use of a clinical decision support tool for postoperative care of Parkinson's disease patients who are treated using deep brain stimulation (DBS). The central hypothesis is that the use of a DBS clinical decision support system for individual patient management will enable considerable time savings and reduced burden on patients and caregivers.

Detailed Description

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The proposed study will evaluate outcomes for Parkinson's disease (PD) patients who are treated with unilateral deep brain stimulation (DBS); patients who consent to the study will be randomized to standard care or the experimental group. The study will occur in two phases.

Phase I:

Both the standard care and experimental groups will be medically evaluated identically, but the programming will be different between the groups as the experimental group will be programmed using the iPad. Patients in the control and experimental groups will be monitored with the same frequency at each participating clinic. Data and safety monitoring is the responsibility of each participating PI and the lead PI as the protocol involves minimal risk or no more than a minor increase over minimal risk. We anticipate that a single nurse at each site will perform DBS programming.

Phase II:

Patients in the experimental group will be evaluated and programmed by home health nurses in the patient's home setting. Neurological exams in the clinic will be performed at the first post-operative DBS programming session and 6 months later (the proposed end of the experimental period for each patient). During the intervening period, DBS programming and patient evaluations will be performed by a home health nurse. during this phase, data and safety monitoring will be conducted by a DSMB, which will meet regularly to review all cases and ensure safety. All subjects will be recruited directly through the participating sites' clinic systems, and all subjects will have oral and written informed consent before participation in the study. We anticipate that up to two home health registered nurses (RNs) will be performing DBS programming in phase 2.

Conditions

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Parkinson's Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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iPad-based Clinical Support Care

Subjects in this treatment arm will receive deep brain stimulation (DBS) programming at regular intervals as part of routine clinical care. DBS stimulation programming will be performed using an iPad-based decision support system. Outcomes will be measured using the Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire (PDQ-39) and the Multi-Dimensional Caregiver Strain Index (MCSI).

Group Type ACTIVE_COMPARATOR

iPad-Based Clinical Support Care

Intervention Type DEVICE

Subjects in this treatment arm will receive deep brain stimulation (DBS) programming at regular intervals as part of routine clinical care. DBS stimulation programming will be done with the use of a iPad-based decision support system.

Standard Clinical Care

Subjects in this treatment arm will receive DBS programming at regular intervals as part of routine clinical care. Outcomes will be measured using the Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire (PDQ-39) and the Multi-Dimensional Caregiver Strain Index (MCSI).

Group Type ACTIVE_COMPARATOR

Standard Clinical Care

Intervention Type OTHER

Subjects in this treatment arm will receive DBS programming at regular intervals as part of routine clinical care.

Interventions

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iPad-Based Clinical Support Care

Subjects in this treatment arm will receive deep brain stimulation (DBS) programming at regular intervals as part of routine clinical care. DBS stimulation programming will be done with the use of a iPad-based decision support system.

Intervention Type DEVICE

Standard Clinical Care

Subjects in this treatment arm will receive DBS programming at regular intervals as part of routine clinical care.

Intervention Type OTHER

Other Intervention Names

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iPad-Based Tool

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of idiopathic Parkinson's Disease
* Planning to receive a DBS device at a participating site.
* Had a DBS device implanted, at a participating site, that hasn't been programmed yet

Exclusion Criteria

* Had a DBS device implanted at a non-participating site.
* Any previous DBS programming
Minimum Eligible Age

30 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Florida

OTHER

Sponsor Role collaborator

National Institute of Nursing Research (NINR)

NIH

Sponsor Role collaborator

Wake Forest University Health Sciences

OTHER

Sponsor Role collaborator

Baylor College of Medicine

OTHER

Sponsor Role collaborator

NYU

UNKNOWN

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role collaborator

University of Utah

OTHER

Sponsor Role lead

Responsible Party

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Christopher Butson

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christopher Butson, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Utah Scientific Computing and Imaging Institute

Locations

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University of California San Francisco

San Francisco, California, United States

Site Status

University of Florida Center for Movement Disorders & Neurorestoration

Gainesville, Florida, United States

Site Status

NYU Langone Medical Center

New York, New York, United States

Site Status

Wake Forest School of Medicine

Winston-Salem, North Carolina, United States

Site Status

Baylor College of Medicine

Houston, Texas, United States

Site Status

University of Utah Imaging and Neurosciences Center

Salt Lake City, Utah, United States

Site Status

Countries

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United States

References

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Duffley G, Lutz BJ, Szabo A, Wright A, Hess CW, Ramirez-Zamora A, Zeilman P, Chiu S, Foote KD, Okun MS, Butson CR. Home Health Management of Parkinson Disease Deep Brain Stimulation: A Randomized Clinical Trial. JAMA Neurol. 2021 Aug 1;78(8):972-981. doi: 10.1001/jamaneurol.2021.1910.

Reference Type DERIVED
PMID: 34180949 (View on PubMed)

Other Identifiers

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R01NR014852

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB # 82859

Identifier Type: -

Identifier Source: org_study_id

NCT02066779

Identifier Type: -

Identifier Source: nct_alias

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