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Tayside Rehabilitation in Bronchiectasis Exacerbations (TRIBE) : a Randomized Controlled Trial

Not Applicable
Terminated
Conditions
Bronchiectasis
Interventions
Procedure: Pulmonary rehabilitation
Registration Number
NCT02179983
Lead Sponsor
NHS Tayside
Brief Summary

Pulmonary rehabilitation is well established as a treatment in COPD. After exacerbations of COPD, rehabilitation is associated with reduced frequency of exacerbations and improved exercise capacity. No data are available in bronchiectasis.

This study will randomly assign patients with bronchiectasis exacerbations to pulmonary rehabilitation or standard care. The hypothesis is that exercise capacity will be improved by pulmonary rehabilitation at 8 weeks.

Detailed Description

Background: Pulmonary rehabilitation is an effective treatment after exacerbations of COPD to prevent future exacerbations and to improve breathlessness and quality of life. Its effectiveness after exacerbations of bronchiectasis has never been demonstrated.

Aims: To determine if a 6 week course of pulmonary rehabilitation improves exercise capacity at 8 weeks after exacerbation.

Study Design: Randomised controlled trial. Methods: The study will take place in NHS Tayside. 40 patients with a history of bronchiectasis confirmed by HRCT will be included. Patients will be monitored using diary cards for exacerbations. At the onset of an exacerbation patients will be treated with a standard 14 day course of antibiotic therapy and randomised to one of two arms: Pulmonary rehabilitation or standard care. Patients randomised to pulmonary rehabilitation will undergo a 6 week course of supervised pulmonary rehabilitation. Patients will undergo study assessments (6-minute walk test, Quality of life questionnaires, pulmonary function tests (FEV1, FVC, FEF 25-75), symptoms recorded by symptom diaries and sputum microbiology).Assessments will be performed at the start and end of exacerbations, at 6-8 weeks post exacerbation (after completion of pulmonary rehabilitation in patients randomised to rehabilitation) and at 12 weeks.

Outcome: The primary outcome is 6 minute walk distance at 8 week post exacerbation Expected Conclusion: We will determine the effectiveness of pulmonary rehabilitation after exacerbations of bronchiectasis.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
48
Inclusion Criteria

Bronchiectasis confirmed on High Resolution CT scan Clinical Bronchiectasis confirmed by a respiratory physician. Documented exacerbation within the last year. Independently mobile - i.e. able to undertake pulmonary rehabilitation

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Exclusion Criteria
  • Inability to give informed consent to participate
  • Age <18 years
  • Primary diagnosis of Chronic Obstructive Pulmonary Disease
  • Significant comorbidity that would limit the ability to undertake pulmonary rehabilitation - i.e. Cerebrovascular, cardiovascular or musculoskeletal disease.
  • Cystic Fibrosis
  • Aortic aneurysm
  • Recent myocardial infarction (within previous year)or unstable angina
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Pulmonary rehabilitationPulmonary rehabilitation6 weeks of exercise and patient education after exacerbation (pulmonary rehabilitation)
Primary Outcome Measures
NameTimeMethod
6 minute walk distance8 weeks post exacerbation
Secondary Outcome Measures
NameTimeMethod
The Quality of life8 weeks and 12 weeks

St Georges respiratory questionnaire COPD assessment test

Sputum microbiology8 weeks and 12 weeks

Proportion of patients with positive sputum microbiology of potential pathogenic microorganisms (Haemophilus influenzae, Pseudomonas aeruginosa, Moraxella catarrhalis, enterobacteriaceae) versus patients without sputum colonisation.

Time to next exacerbation6 months
Pulmonary function tests8 weeks and 12 weeks

Pulmonary function tests (FEV1, FVC, FEF25-75)

Respiratory symptoms8 weeks and 12 weeks

Patient diary cards

6 minute walk distance12 weeks

Trial Locations

Locations (1)

Clinical Research Centre, University of Dundee

🇬🇧

Dundee, United Kingdom

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