Evaluating the Effectiveness of Incentive Spirometry

NCT ID: NCT02952027

Last Updated: 2018-08-07

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

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-08-31

Study Completion Date

2018-01-31

Brief Summary

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Post-operative pulmonary complications (PPCs) have a major impact on patients and healthcare expenses. The goal of perioperative respiratory therapy is to improve airway clearance, increase lung volume, and mitigate atelectasis. Incentive spirometers (IS) are ubiquitously used to prevent atelectasis and PPCs-implementation of which requires substantial provider time and healthcare expenses. However, meta-analyses have demonstrated that the effectiveness of ISs is unclear due to poor patient compliance in past studies.

The goal of this investigation is evaluate the effectiveness of IS on post-operative clinical outcomes. The aims of this investigation are to evaluate 1) if IS use compliance can be improved by adding a use-recording patient reminder alarm, and 2) the clinical outcomes of the more compliant IS users vs. the less-compliant IS users.

Detailed Description

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Conditions

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Dyspnea Respiratory Rate Oxygen Saturation Oxygen Requirements FEV1 FVC Atelectasis Pneumonia Re-intubation Hospital Length of Stay Nursing Workload Incentive Spirometry

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Bell On

Subjects in the Bell On arm will receive a timer where the alarm will sound every hour.

Group Type EXPERIMENTAL

Use-recording, patient-reminder alarm for incentive spirometry

Intervention Type BEHAVIORAL

Bell Off

Subjects in the Bell Off arm will receive a timer where the alarm will not sound, but still record incentive spirometer usage

Group Type PLACEBO_COMPARATOR

Use-recording, patient-reminder alarm for incentive spirometry

Intervention Type BEHAVIORAL

Interventions

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Use-recording, patient-reminder alarm for incentive spirometry

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Undergoes any cardiothoracic surgery
* Is transferred to the cardiothoracic surgery intermediate (step-down) unit at Rhode Island Hospital
* Already prescribed an incentive spirometer as standard-of-care
* Followed by any healthcare provider
* Ability to sign informed consent and comply with all study procedures including follow-up for up to 1 year

Exclusion Criteria

* \<18 years of age
* Vulnerable population who in the judgment of the investigator is unable to give Informed Consent for reasons of incapacity, immaturity, adverse personal circumstances or lack of autonomy.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Lifespan

OTHER

Sponsor Role lead

Responsible Party

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Adam Eltorai

Research Fellow

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Rhode Island Hospital

Providence, Rhode Island, United States

Site Status

Countries

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United States

References

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Freitas ER, Soares BG, Cardoso JR, Atallah AN. Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft. Cochrane Database Syst Rev. 2012 Sep 12;2012(9):CD004466. doi: 10.1002/14651858.CD004466.pub3.

Reference Type BACKGROUND
PMID: 22972072 (View on PubMed)

do Nascimento Junior P, Modolo NS, Andrade S, Guimaraes MM, Braz LG, El Dib R. Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. Cochrane Database Syst Rev. 2014 Feb 8;2014(2):CD006058. doi: 10.1002/14651858.CD006058.pub3.

Reference Type BACKGROUND
PMID: 24510642 (View on PubMed)

Narayanan AL, Hamid SR, Supriyanto E. Evidence regarding patient compliance with incentive spirometry interventions after cardiac, thoracic and abdominal surgeries: A systematic literature review. Can J Respir Ther. 2016 Winter;52(1):17-26.

Reference Type BACKGROUND
PMID: 26909010 (View on PubMed)

Joyce CJ, Baker AB. What is the role of absorption atelectasis in the genesis of perioperative pulmonary collapse? Anaesth Intensive Care. 1995 Dec;23(6):691-6. doi: 10.1177/0310057X9502300606.

Reference Type BACKGROUND
PMID: 8669602 (View on PubMed)

Qaseem A, Snow V, Fitterman N, Hornbake ER, Lawrence VA, Smetana GW, Weiss K, Owens DK, Aronson M, Barry P, Casey DE Jr, Cross JT Jr, Fitterman N, Sherif KD, Weiss KB; Clinical Efficacy Assessment Subcommittee of the American College of Physicians. Risk assessment for and strategies to reduce perioperative pulmonary complications for patients undergoing noncardiothoracic surgery: a guideline from the American College of Physicians. Ann Intern Med. 2006 Apr 18;144(8):575-80. doi: 10.7326/0003-4819-144-8-200604180-00008.

Reference Type BACKGROUND
PMID: 16618955 (View on PubMed)

Canet J, Gallart L, Gomar C, Paluzie G, Valles J, Castillo J, Sabate S, Mazo V, Briones Z, Sanchis J; ARISCAT Group. Prediction of postoperative pulmonary complications in a population-based surgical cohort. Anesthesiology. 2010 Dec;113(6):1338-50. doi: 10.1097/ALN.0b013e3181fc6e0a.

Reference Type BACKGROUND
PMID: 21045639 (View on PubMed)

Ephgrave KS, Kleiman-Wexler R, Pfaller M, Booth B, Werkmeister L, Young S. Postoperative pneumonia: a prospective study of risk factors and morbidity. Surgery. 1993 Oct;114(4):815-9; discussion 819-21.

Reference Type BACKGROUND
PMID: 8211699 (View on PubMed)

Shander A, Fleisher LA, Barie PS, Bigatello LM, Sladen RN, Watson CB. Clinical and economic burden of postoperative pulmonary complications: patient safety summit on definition, risk-reducing interventions, and preventive strategies. Crit Care Med. 2011 Sep;39(9):2163-72. doi: 10.1097/CCM.0b013e31821f0522.

Reference Type BACKGROUND
PMID: 21572323 (View on PubMed)

Khan NA, Quan H, Bugar JM, Lemaire JB, Brant R, Ghali WA. Association of postoperative complications with hospital costs and length of stay in a tertiary care center. J Gen Intern Med. 2006 Feb;21(2):177-80. doi: 10.1111/j.1525-1497.2006.00319.x.

Reference Type BACKGROUND
PMID: 16606377 (View on PubMed)

Agostini P, Singh S. Incentive spirometry following thoracic surgery: what should we be doing? Physiotherapy. 2009 Jun;95(2):76-82. doi: 10.1016/j.physio.2008.11.003. Epub 2009 Mar 3.

Reference Type BACKGROUND
PMID: 19627688 (View on PubMed)

Restrepo RD, Wettstein R, Wittnebel L, Tracy M. Incentive spirometry: 2011. Respir Care. 2011 Oct;56(10):1600-4. doi: 10.4187/respcare.01471.

Reference Type BACKGROUND
PMID: 22008401 (View on PubMed)

Eltorai AEM, Baird GL, Eltorai AS, Healey TT, Agarwal S, Ventetuolo CE, Martin TJ, Chen J, Kazemi L, Keable CA, Diaz E, Pangborn J, Fox J, Connors K, Sellke FW, Elias JA, Daniels AH. Effect of an Incentive Spirometer Patient Reminder After Coronary Artery Bypass Grafting: A Randomized Clinical Trial. JAMA Surg. 2019 Jul 1;154(7):579-588. doi: 10.1001/jamasurg.2019.0520.

Reference Type DERIVED
PMID: 30969332 (View on PubMed)

Other Identifiers

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Lifespan

Identifier Type: -

Identifier Source: org_study_id

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