RecruitingNot Applicable

Functional Improvement in OSA and COPD With a Telehealth LifeStyle and Exercise Intervention

United States400 participantsStarted 2024-07-29

Plain-language summary

The investigators will conduct a Type I hybrid effectiveness-implementation study to test an integrated telehealth intervention among 400 overweight and obese patients with Chronic Obstructive Pulmonary Disease (COPD) and Obstructive Sleep Apnea (OSA). The investigators will include eligible participants receiving primary care at one of five Department of Veterans Affairs (VA) medical centers and their community-based outpatient clinics. The investigators will randomize patients in a 1:1 ratio to the multi-component intervention or "enhanced" usual care, stratifying by age (≥65 vs. \< 65) and site. Participants randomized to the intervention will receive an integrated, telehealth-delivered intervention composed of a self-directed lifestyle program and supervised pulmonary rehabilitation. At the end of 3 months, the investigators will offer to enter a recommendation for weight management medications on behalf of eligible intervention participants. In the post-core period (months 4-12), participants will continue to have as-needed access to the lifestyle coach. For participants randomized to the "enhanced" usual care group, study staff will prompt the patient's primary care provider to refer them to existing weight loss management and pulmonary rehabilitation programs. Follow-up will occur at virtual visits at 3 and 12 months. The primary effectiveness outcome at 1-year is quality of life measured by the SF-12 Physical Component Summary Score. Secondary effectiveness outcomes will include other measures of quality of life (including sleep related impairment), sleep disturbance, disease severity (COPD exacerbations and respiratory event index for OSA), depression, social support, weight loss and cardiovascular risk. In addition to assessing effectiveness, investigators will also conduct a concurrent implementation process evaluation using the RE-AIM framework.

Who can participate

Age range

18 Years

Sex

ALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * COPD: Defined by presence of airflow obstruction (FEV1/FVC \< 0.70) on post-bronchodilator spirometry * ≥10 pack year history of tobacco use * Self-reported clinician diagnosis of OSA (or presence of OSA on research HSAT) * BMI ≥ 25 kg/m2 * Symptoms of dyspnea defined by MMRC score of ≥1 Exclusion Criteria: * Self-report of weight change \>15 lbs. during prior 3 months * Current active weight loss treatment, including: 1) research-based commercial weight loss programs (e.g., Weight Watchers, Jenny Craig, HMR, Omada, TOPS, MOVE!); 2) other weight loss or related behavioral health or wellness programs led by trained personnel (professional or lay) in the local community; 3) prescription weight loss medication within last 3 months; and scheduled bariatric surgery. * Severe illness from any cause * Diagnosis of bulimia or history of purging behavior * Active enrollment in pulmonary rehabilitation * Safety and/or adherence concerns due to severe physical or mental health issues or life expectancy \< 12 months. These include but may not be limited to: unstable cardiac arrhythmias, active or recent (within one month) myocardial infarction, active or recent (within one month) COPD exacerbation, angina not well-controlled with medication, significant musculoskeletal comorbidities or physical infirmities that preclude participation in an exercise program, and the need for supplemental oxygen ≥ 5 lpm at rest or with exertion. * Pregnant, lactating, or planning t…

Questions worth asking your doctor

Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.

1This trial uses a telehealth lifestyle and exercise program for people who have both COPD and obstructive sleep apnea — do I actually have both of those conditions, and would that make me a potential candidate worth discussing with you?
2The trial is measuring something called the SF-12 Physical Component Score as its main outcome — can you explain what that measures and whether improving physical functioning is a realistic goal for where I am in my disease right now?
3Since this is a Phase NA or non-drug behavioral trial delivered via telehealth, what do we actually know so far about the safety and real-world benefit of exercise interventions for people managing both COPD and sleep apnea at the same time?
4The program involves lifestyle and exercise changes done remotely — given my current breathing capacity and any other health issues I have, is my condition stable enough to safely participate in an exercise-based program like this?
5Before considering a trial like this, should I first focus on optimizing my current COPD or sleep apnea treatments — like my inhaler regimen or CPAP use — or could this kind of program actually complement what I'm already doing?

Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.

Questions for the trial coordinator

The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.

1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?

A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.

What they're measuring

The SF-12 PCS

Timeframe: 1 year

Trial details

NCT IDNCT06390345

SponsorSeattle Institute for Biomedical and Clinical Research

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2028-07-01

Contact for this trial

Brianna Moss

206.277.4166 brianna.moss@va.gov

View on ClinicalTrials.gov More Chronic Obstructive Pulmonary Disease trials