Telehealth Support for Artificial Respiration
(TEACH Trial)
Recruiting in Palo Alto (17 mi)
+10 other locations
Age: Any Age
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Intermountain Health Care, Inc.
Disqualifiers: Brain death, Died within 24 hours
No Placebo Group
Trial Summary
What is the purpose of this trial?This trial is testing a telehealth system called 'TEACH' to help doctors and nurses better manage the process of waking up and helping patients on ventilators breathe on their own. The goal is to improve patient outcomes by making it easier for healthcare providers to follow best practices.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment Telehealth-enabled support for SAT/SBT adherence?
Research shows that telehealth technologies can improve adherence to treatment plans, as seen in studies with lung transplant recipients and COPD patients. These technologies help maintain high levels of adherence by providing immediate feedback, reminders, and simplifying communication between patients and healthcare providers.
12345Is telehealth support for artificial respiration generally safe for humans?
The research on telehealth systems for managing conditions like asthma and transplant adherence shows that these systems are generally well-accepted and safe, with participants finding them helpful and easy to use. No significant safety concerns were reported in the studies, and participants often experienced improved adherence and satisfaction with the telehealth interventions.
16789How is the Telehealth-enabled support for SAT/SBT adherence treatment different from other treatments for artificial respiration?
The Telehealth-enabled support for SAT/SBT adherence treatment is unique because it uses telehealth technology to enhance adherence to artificial respiration protocols by providing immediate feedback, reminders, and educational support, which can help maintain high adherence levels over time, unlike traditional methods that may not offer such interactive and continuous support.
110111213Eligibility Criteria
This trial is for patients aged 16 or older who are in the ICU and on artificial breathing support. It's not for those who passed away within a day of being put on a ventilator or were already brain dead when admitted for organ donation.Inclusion Criteria
I am on a breathing machine.
I am 16 or older and currently in the ICU of the study hospital.
Exclusion Criteria
Patient who died within 24 hours of intubation
Patient with pre-existing brain death admitted to study hospital for organ donation
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
1-2 weeks
Treatment
Participants receive coordinated spontaneous awakening and breathing trials with telehealth-enabled support or usual audit and feedback
5 days
Daily monitoring during intubation
Follow-up
Participants are monitored for ventilator-free days and other clinical outcomes
28 days
Participant Groups
The study is testing if adding telehealth support to regular check-ups improves how well clinicians stick to protocols for waking up and breathing trials, which could lead to better outcomes for patients on ventilators.
2Treatment groups
Experimental Treatment
Active Control
Group I: Intervention - Telehealth- enabled support plus usual audit and feedback for SAT/SBT adherenceExperimental Treatment2 Interventions
Usual audit and feedback + telehealth-enabled support
Group II: Control - Usual audit/feedback for SAT/SBT adherence onlyActive Control1 Intervention
Usual audit and feedback
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
American Fork HospitalAmerican Fork, UT
Layton HospitalLayton, UT
Utah Valley HospitalProvo, UT
Intermountain Medical CenterMurray, UT
More Trial Locations
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Who Is Running the Clinical Trial?
Intermountain Health Care, Inc.Lead Sponsor
National Heart, Lung, and Blood Institute (NHLBI)Collaborator
University of UtahCollaborator
References
The design of an Internet-based system to maintain home monitoring adherence by lung transplant recipients. [2019]Regimen adherence is a key factor in the success of home monitoring of lung transplant recipients. Patients generally adhere satisfactorily with home spirometry in the short-term, but adherence tends to decline over time. Telehealth and Internet technology provide new methods to address this issue. The unique contribution of the Adherence Enhancement Internet Program (AEIP) is the integration of multiple adherence enhancement strategies operating in a unified approach to the adherence problem, while meshing all user groups to facilitate interactions. This Internet-based program focused on promoting subject specific strategies was developed to maintain the initial high levels of adherence beyond the first year post transplant. The program provides more immediate subject feedback related to home monitoring data, reminders from the patient's health care providers, educational material, and guidance in dealing with subject specific barriers to maintaining adherence. It also simplifies communication between patients and health care providers, and supports providers in certain patient care tasks. A feasibility trial involving 12 lung transplant recipients demonstrated that subjects were able to use the AEIP with little training, found it acceptable, and were generally enthusiastic regarding it as a tool to maintain or enhance adherence.
Effects of home telemonitoring to support improved care for chronic obstructive pulmonary diseases. [2019]To assess the impact of a home telemonitoring technology on patients with chronic obstructive pulmonary disease in terms of care satisfaction, patient empowerment, improved quality of life, and utilization of hospital and home care.
Care Technologies to Improve Treatment Adherence in Patients Undergoing Organ Transplant: A Scoping Review. [2022]The objective of this study was to map care technologies being developed to improve treatment adherence in patients undergoing organ transplant.
Innovating the treatment of COPD exacerbations: a phone interactive telesystem to increase COPD Action Plan adherence. [2020]Self-management interventions with Written Action Plans and case management support have been shown to improve outcomes in patients with chronic obstructive pulmonary disease (COPD). Novel telehealth technologies may improve self-management interventions. The objectives of this study were to determine whether the use of an interactive phone telesystem increases Action Plan adherence, improves exacerbation recovery and reduces healthcare use in a real-life practice of a COPD clinic.
Significance of patient self-monitoring for long-term outcomes after lung transplantation. [2019]Lung transplant (LTx) recipients' adherence to regular self-monitoring of lung function (SMLF) is important in maintaining health. This study investigated patients' behavior based on electronic monitoring (EM) and compared these findings with self-reported data.
Usability testing of the Internet program: "Teens Taking Charge: Managing My Transplant Online". [2019]Adolescents with SOT demonstrate high rates of medication non-adherence and higher rates of graft loss compared to all other age groups. Self-management interventions encompass information-based material designed to achieve disease-related learning and changes in the participant's knowledge and skill acquisition, while providing social support. These interventions have had some success in chronic disease populations by reducing symptoms and promoting self-efficacy and empowerment. Using findings from a needs assessment, an Internet-based self-management program, Teens Taking Charge: Managing My Transplant Online, for youth with SOT was developed. This program contains information on transplant, self-management and transition skills, and opportunities for peer support. The purpose of this study was to determine the usability and acceptability of the initial three modules (Medication and Vaccines; Diet after Transplant; and Living with a Transplant Organ) of the online program from the perspectives of youth with SOT. Participants were recruited from SOT clinics at a large pediatric tertiary care center in Canada. Three iterative cycles (seven patients per iteration) of usability testing took place to refine the Web site prototype. Study procedures involved participants finding items from a standardized list of features and talking aloud about issues they encountered, followed by a semi-structured interview to generate feedback about what they liked and disliked about the program. All 21 patients (mean age = 14.9 yr) found the Web site content to be trustworthy, they liked the picture content, and they found the videos of peer experiences to be particularly helpful. Participants had some difficulties finding information within submodules and suggested a more simplistic design with easier navigation. This web-based intervention is appealing to teenagers and may foster improved self-management with their SOT. Nine additional teen and two parent modules are being developed, and the completed Web site will undergo usability testing. In the future, a randomized control trial will determine the feasibility and effectiveness of this online self-management program on adherence, self-efficacy, and transition skills.
An Internet-based store-and-forward video home telehealth system for improving asthma outcomes in children. [2019]The adherence and disease-control outcomes associated with the use of an Internet-based store-and-forward video home telehealth system to manage asthma in children were studied. Pediatric patients with persistent asthma were provided with home computers and Internet access and monitored biweekly over the Internet. All patients were seen in the pediatric clinic at 0, 2, 6, 12, and 24 weeks. Half of the patients received asthma education in person and half via an interactive Web site. Adherence measures were assessed by therapeutic and diagnostic monitoring. Therapeutic monitoring included digital videos of patients using their controller medication inhaler. Diagnostic monitoring included an asthma symptom diary and a video of peak flow meter use. Videos were submitted electronically twice a week by using in-home telemonitoring with store-and-forward technology. Feedback was provided electronically to each patient. Disease control was assessed by examining quality of life, utilization of services, rescue-therapy use, symptom control, satisfaction with home telemonitoring, and retention of asthma knowledge. Patients were randomly assigned to an asthma education group (Internet versus office), and the data were analyzed by comparing results for study days 0-90 and 91-180. Ten children participated. A total of 321 videos of inhaler use and 309 videos of peak flow meter use were submitted. Inhaler technique scores improved significantly in the second study period. Submission of diagnostic monitoring videos and asthma diary entries decreased significantly. Peak flow values as a percentage of personal best values increased significantly. Overall, there was no change in quality of life reported by patients. However, the caregivers in the virtual-education group reported an increase in the patients' quality-of-life survey scores. Emergency department visits and hospital admissions for asthma were avoided. Rescue therapy was infrequent. A high rate of satisfaction with home telemonitoring was reported. Internet-based, store-and-forward video assessment of children's use of asthma medications and monitoring tools in their homes appeared effective and well accepted.
Directly observed therapy to promote medication adherence in adolescent heart transplant recipients. [2022]HT recipients experience high levels of medication non-adherence during adolescence. This pilot study examined the acceptability and feasibility of an asynchronous DOT mHealth application among adolescent HT recipients. The app facilitates tracking of patients' dose-by-dose adherence and enables transplant team members to engage patients. The DOT application allows patients to self-record videos while taking their medication and submit for review. Transplant staff review the videos and communicate with patients to engage and encourage medication adherence.
Internet-based home asthma telemonitoring: can patients handle the technology? [2019]To evaluate the validity of spirometry self-testing during home telemonitoring and to assess the acceptance of an Internet-based home asthma telemonitoring system by asthma patients.
Telehealth Pulmonary Rehabilitation for Patients With Severe Chronic Obstructive Pulmonary Disease. [2020]For patients with chronic obstructive pulmonary disease, a home-based, interactive telehealth program can improve accessibility to pulmonary rehabilitation and reduce travel costs.
Access to technology to support telehealth in areas without specialty care for liver disease. [2023]Telehealth may be a successful strategy to increase access to specialty care for liver disease, but whether the areas with low access to care and a high burden of liver-related mortality have the necessary technology access to support a video-based telehealth strategy to expand access to care is unknown.
A telehealth program for CPAP adherence reduces labor and yields similar adherence and efficacy when compared to standard of care. [2022]This study evaluated the effectiveness and coaching labor requirements of a web-based automated telehealth (TH) messaging program compared with standard of care (SOC) in newly diagnosed patients with obstructive sleep apnea (OSA).
The current use of telehealth in ALS care and the barriers to and facilitators of implementation: a systematic review. [2021]Objective: We aimed to provide an overview of telehealth used in the care for patients with amyotrophic lateral sclerosis (ALS), and identify the barriers to and facilitators of its implementation. Methods: We searched Pubmed and Embase to identify relevant articles. Full-text articles with original research reporting on the use of telehealth in ALS care, were included. Data were synthesized using the Consolidation Framework for Implementation Research. Two authors independently screened articles based on the inclusion criteria. Results: Sixteen articles were included that investigated three types of telehealth: Videoconferencing, home-based self-monitoring and remote NIV monitoring. Telehealth was mainly used by patients with respiratory impairment and focused on monitoring respiratory function. Facilitators for telehealth implementation were a positive attitude of patients (and caregivers) toward telehealth and the provision of training and ongoing support. Healthcare professionals were more likely to have a negative attitude toward telehealth, due to the lack of personal evaluation/contact and technical issues; this was a known barrier. Other important barriers to telehealth were lack of reimbursement and cost-effectiveness analyses. Barriers and facilitators identified in this review correspond to known determinants found in other healthcare settings. Conclusions: Our findings show that telehealth in ALS care is well-received by patients and their caregivers. Healthcare professionals, however, show mixed experiences and perceive barriers to telehealth use. Challenges related to finance and legislation may hinder telehealth implementation in ALS care. Future research should report the barriers and facilitators of implementation and determine the cost-effectiveness of telehealth.