Palliative Care in Pulmonary Fibrosis

NCT ID: NCT02929966

Last Updated: 2020-10-28

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-07-31

Study Completion Date

2019-03-31

Brief Summary

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The investigators will examine the effect of introducing palliative in patients with end-stage idiopathic pulmonary fibrosis, refractory to the pharmacological treatment or not deemed to be treated, on patient-reported outcomes and end-of-life care. The investigators will randomly assign patients who receive either early palliative care integrated with standard respiratory care or standard respiratory care alone.

Quality of life and symptoms will assessed at baseline and at 12 weeks The primary outcome will be the change in the quality of life and symptoms at 12 months.

Detailed Description

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Advanced fibrosing interstitial lung disease (ILD) is a group of often progressive and incurable conditions.

The most common form of ILD, idiopathic pulmonary fibrosis (IPF), is associated with poor survival, and high symptom burden and poor quality of life as the disease progresses.

ILD represents an increasing proportion of patients with chronic hypoxemic respiratory failure.

Despite this poor prognosis, palliative care remains underused in patients with ILD. This may be due to under-recognition of the palliative care needs and symptom burden, or unfamiliarity and discomfort with palliative therapies.

Though oncology has largely embraced earlier integration of palliative care, which has translated into improvements in end-of-life (EOL) care for patients with lung cancer,palliative and EOL care for non-malignant diseases are now gaining increased attention.

In pulmonary disease, this research has mainly focused on COPD and demonstrated a significant burden of unmet palliative care needs and lower quality of EOL care compared with patients with cancer. Similar attention is only beginning to be paid to ILD, but symptom burden and quality of EOL care in patients with ILD have yet to be quantified, and furthermore none has so far investigated the possible role of palliative care in these patients.

The investigators will examine with the present study the effect of introducing palliative in patients with end-stage idiopathic pulmonary fibrosis, refractory to the pharmacological treatment or not deemed to be treated, on patient-reported outcomes and end-of-life care. The investigators will randomly assign patients who receive either early palliative care integrated with standard respiratory care or standard respiratory care alone.

Quality of life and symptoms will assessed at baseline and at 12 weeks The primary outcome will be the change in the quality of life and symptoms at 12 months.

Conditions

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Idiophatic Pulmonary Fibrosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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standard respiratory care

The patients will receive the usual respiratory care that included both the "classical" treatments with antifibrotic drugs and oxygen therapy

Group Type PLACEBO_COMPARATOR

standard respiratory care

Intervention Type OTHER

the usual standard pharmacological care plus oxygen therapy

standard respiratory care PLUS a palliative care program

The patients will receive the usual respiratory care that included both the "classical" treatments with antifibrotic drugs and oxygen therapy PLUS a palliative care program that includes paid to assessing physical and psychosocial symptoms

Group Type EXPERIMENTAL

palliative care program

Intervention Type OTHER

The program includes psychological support, spiritual care and respiratory therapist support

Interventions

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palliative care program

The program includes psychological support, spiritual care and respiratory therapist support

Intervention Type OTHER

standard respiratory care

the usual standard pharmacological care plus oxygen therapy

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* diagnosis of idiophatic pulmonary fibrosis
* resting partial arterial oxygen pressure (PaO2) \< 60 mmHg
* Decline in Forced Vital Capacity (FVC) \> 10% in the last 6 months
* stage 3 according to the GAP index

Exclusion Criteria

* active treatment with antifibrotic drug
* concomitant cancer
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS Azienda Ospedaliero-Universitaria di Bologna

OTHER

Sponsor Role lead

Responsible Party

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dr. Stefano Nava

Professor of Respiratory Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Sant'Orsola Malpighi Hospital

Bologna, Province, Italy

Site Status

San'Orsola Malpighi Hospital, Bologna ITALY

Bologna, , Italy

Site Status

Countries

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Italy

References

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Bassi I, Guerrieri A, Carpano M, Gardini A, Prediletto I, Polastri M, Curtis JR, Nava S. Feasibility and efficacy of a multidisciplinary palliative approach in patients with advanced interstitial lung disease. A pilot randomised controlled trial. Pulmonology. 2023 Dec;29 Suppl 4:S54-S62. doi: 10.1016/j.pulmoe.2021.11.004. Epub 2021 Dec 28.

Reference Type DERIVED
PMID: 34969647 (View on PubMed)

Other Identifiers

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120/2016/O/Sper

Identifier Type: -

Identifier Source: org_study_id