Feasibility of an App-based Nutrition & Exercise Program in Cirrhosis

NCT ID: NCT05033327

Last Updated: 2023-02-01

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

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-04-20

Study Completion Date

2022-12-31

Brief Summary

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The personalized nutrition and exercise app was designed for use by individuals living with chronic conditions. The pilot study examines the acceptance and use of the online, interactive program to support self-management in cirrhosis.

Detailed Description

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Patients living with chronic disease are at-risk for frailty because of their potentially sedentary lifestyle and/or symptoms. Supervised exercise programs are useful for improving or maintaining physical capacity as measured by common physical function measures. However, accessibility is limited due to scheduling, transportation, employment, and residential location. Unsupervised, self-directed home-based programs have had limited success due to absence of peer support and accountability.

An alternative is an app-based program that offers interactive engagement with study staff and accountability. Further, follow-along videos and tracking for both nutrition and exercise can be completed at the patient's convenience.

A 12-week pilot study with patients living with cirrhosis will assess the acceptability of the programming. The hypothesis is that study participants will find the customization of the app and interaction with the study staff acceptable as measured by completion rates (primary study endpoint). Secondary outcomes include change in measures (0-12 weeks) for the 6-minute walk test (6MWT), thigh muscle thickness, and chair sit-to-stands. At the end of the study, participants will also complete a program satisfaction survey (developed in-house).

Interviews with participants, caregivers, and study staff, conducted via videoconference at 4-6 weeks and end of study, will be descriptively analysed to identify feasibility, acceptability, and perceived utility of the program. Analyses will also identify areas for program improvement.

Conditions

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Cirrhosis, Liver Hepatic Encephalopathy

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Pilot study
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Nutrition and Exercise App

The exercise and nutrition app intervention will be provided to study participants. The app offers self-directed and supervised (virtual) programming to support nutrition and exercise self-management. Each participant follows a program that has been tailored to their overall health, physical function, and needs.

Group Type OTHER

Nutrition and Exercise app

Intervention Type BEHAVIORAL

Personalized, home-based, interactive therapy app

Interventions

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Nutrition and Exercise app

Personalized, home-based, interactive therapy app

Intervention Type BEHAVIORAL

Other Intervention Names

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Heal-Me

Eligibility Criteria

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Inclusion Criteria

* adult (aged 18 years and older)
* diagnosis of cirrhosis (MELD\<25) according to biopsy, imaging, elastography, or other
* fulfill the guideline-based prophylaxis in place for high risk gastroesophageal varices
* able to communicate (e.g., speak, read, and write) in English
* provide informed written consent for self

Exclusion Criteria

* hepatocellular carcinoma (HCC) outside of the Edmonton liver transplant criteria
* previous myocardial infarction
* EF \<50%
* ischemia on stress testing
* oxygen saturation \<95%
* non-HCC malignancy
* end-stage renal disease.
* at the discretion of the healthcare team if a participant can participate in the pilot study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Canadian National Transplant Research Program

OTHER

Sponsor Role collaborator

Nutricia Foundation

OTHER

Sponsor Role collaborator

University of Alberta

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Puneeta Tandon, MD

Role: PRINCIPAL_INVESTIGATOR

University of Alberta

Locations

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University of Alberta

Edmonton, Alberta, Canada

Site Status

Countries

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Canada

References

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Tandon P, Ismond KP, Riess K, Duarte-Rojo A, Al-Judaibi B, Dunn MA, Holman J, Howes N, Haykowsky MJF, Josbeno DA, McNeely M. Exercise in cirrhosis: Translating evidence and experience to practice. J Hepatol. 2018 Nov;69(5):1164-1177. doi: 10.1016/j.jhep.2018.06.017. Epub 2018 Jun 30.

Reference Type BACKGROUND
PMID: 29964066 (View on PubMed)

Eslamparast T, Montano-Loza AJ, Raman M, Tandon P. Sarcopenic obesity in cirrhosis-The confluence of 2 prognostic titans. Liver Int. 2018 Oct;38(10):1706-1717. doi: 10.1111/liv.13876. Epub 2018 May 25.

Reference Type BACKGROUND
PMID: 29738109 (View on PubMed)

Mazurak VC, Tandon P, Montano-Loza AJ. Nutrition and the transplant candidate. Liver Transpl. 2017 Nov;23(11):1451-1464. doi: 10.1002/lt.24848.

Reference Type BACKGROUND
PMID: 29072825 (View on PubMed)

Ney M, Gramlich L, Mathiesen V, Bailey RJ, Haykowsky M, Ma M, Abraldes JG, Tandon P. Patient-perceived barriers to lifestyle interventions in cirrhosis. Saudi J Gastroenterol. 2017 Mar-Apr;23(2):97-104. doi: 10.4103/1319-3767.203357.

Reference Type BACKGROUND
PMID: 28361840 (View on PubMed)

Ney M, Haykowsky MJ, Vandermeer B, Shah A, Ow M, Tandon P. Systematic review: pre- and post-operative prognostic value of cardiopulmonary exercise testing in liver transplant candidates. Aliment Pharmacol Ther. 2016 Oct;44(8):796-806. doi: 10.1111/apt.13771. Epub 2016 Aug 19.

Reference Type BACKGROUND
PMID: 27539029 (View on PubMed)

Zenith L, Meena N, Ramadi A, Yavari M, Harvey A, Carbonneau M, Ma M, Abraldes JG, Paterson I, Haykowsky MJ, Tandon P. Eight weeks of exercise training increases aerobic capacity and muscle mass and reduces fatigue in patients with cirrhosis. Clin Gastroenterol Hepatol. 2014 Nov;12(11):1920-6.e2. doi: 10.1016/j.cgh.2014.04.016. Epub 2014 Apr 24.

Reference Type BACKGROUND
PMID: 24768811 (View on PubMed)

Related Links

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Other Identifiers

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Pro00087451

Identifier Type: -

Identifier Source: org_study_id

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