Evaluation of Allied Healthcare in Patients Recovering From COVID-19
- Conditions
- Performance MeasuresPrimary CareCovid19PROMsNational Dutch ProgramAllied Health ProfessionalsProspective CohortRetrospective Cohort
- Interventions
- Other: Patients recovering from COVID19 receive usual care by allied health professionals
- Registration Number
- NCT04735744
- Lead Sponsor
- Radboud University Medical Center
- Brief Summary
SUMMARY Rationale: Allied health professionals (i.e., dietitians, exercise therapists, physical therapists, occupational therapists and speech and language therapists) might play an important role in the recovery of patients with COVID-19 who experience limitations in daily physical functioning and participation. However, the evidence base for allied healthcare in patients with COVID-19 has yet to be established. To facilitate care for people recovering from COVID-19 and to establish this evidence base, the Dutch ministry has created a temporary regulation for primary care allied healthcare specifically for patients with COVID-19.
Objective: This study is setup alongside the temporary regulation and aims to evaluate the longitudinal recovery trajectories and related costs of patients who visited a primary care allied healthcare professional for the management of severe symptoms and activity limitations and/or participation restrictions related to COVID-19.
Study design: Prospective cohort study. Study population: 1,315 adult patients recovering from COVID-19 with severe symptoms and activity limitations and/or participation restrictions, and who are referred to a primary care allied health professional by a general practitioner or medical specialist within four months of the start of the disease will be eligible for this study.
Intervention (if applicable): Although the nature of this study is non-experimental, the allied healthcare intervention can be considered experimental due to the novelty of the disease.
Main study parameters/endpoints: The primary outcome domain of this study is participation measured with the Utrechtse Schaal voor Revalidatie - Participatie (USER-P). The primary endpoint is set at 6 months. A 5 point difference will be considered clinically relevant for patients with COVID-19.
Nature and extent of the burden and risks associated with participation, benefit and group relatedness: There are no specific risks involved with participation in this study, as it entails the completion of questionnaires over the timeframe of one year (at the start of the treatment, the end of the treatment, 3 months, 6 months, 9 months and 12 months). The load of the survey will be highest at months 3, 6 and 12 with a total of 74 survey items. Input from patient representatives suggested that this number of items was feasible, especially because participants are allowed to complete the survey over a number of days. Finally, none of the items in the survey are considered emotionally distressing. The prescribed interventions are conform the recommendations of the best available evidence and are in line with usual allied healthcare interventions. Therefore, risks are likely to be negligible conform usual allied healthcare.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 1441
Adult patients
- recovering from COVID-19 with severe symptoms and activity limitations and/or participation restrictions, and;
- who are referred to a primary care allied health professional by a general practitioner or medical specialist within four months of the start of the disease; will be eligible for this study. The need for referring the patient to an allied health professional will be judged by the primary care physician or medical specialist. Criteria for referral are described in guidance published by the Long Alliantie Nederland (LAN) with recommendations for treatment of post-COVID-19-patients: the COVID-19 Associated Syndrome (CAS) (Chapters 3.3 and 4).
http://www.longalliantie.nl/files/2515/9359/4621/Handreiking_voor_de_zorg.pdf
Adult patients:
- receiving palliative care; are excluded from this study.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Retrospective cohort Patients recovering from COVID19 receive usual care by allied health professionals Allied health professionals (i.e., dietitians, exercise therapists, physical therapists, occupational therapists and speech and language therapists) that have been treated patients recovering from COVID-19 in Dutch primary care Prospective cohort Patients recovering from COVID19 receive usual care by allied health professionals Allied health professionals (i.e., dietitians, exercise therapists, physical therapists, occupational therapists and speech and language therapists) that treat patients recovering from COVID-19 in Dutch primary care
- Primary Outcome Measures
Name Time Method Nutritional Status end of the treatment as part of usual care (average of 6 months) measured with the BMI (weight and height)
Global Assessment end of the treatment as part of usual care (average of 6 months) measured with the PG-SGA short form weight history, food intake, symptoms, activities and function).
Participation 12 months (T3) Measured with the Utrecht Scale for Evaluation of Rehabilitation Participation (USER-P) (32 items)
Fatigue 12 months (T3) Measured with the Fatigue Severity Scale (FSS)
Costs 12 months (T4) will be measured using a cost questionnaire (18 items)
Patient Specific Activities end of the treatment as part of usual care (average of 6 months) measured with the Canadian Occupational Performance Measure (COPM)
Quality of life measured with EQ-5D-5L 12 months (T3) Measured with the EuroQol five-dimensional questionnaire (EQ-5D-5L) (5 items)
Physical functioning 12 months (T3) PROMIS Physical Functioning Short Form 10b (10 items).
Voice Problems end of the treatment as part of usual care (average of 6 months) measured with Voice Handicap Index (VHI)
Swallowing Problems end of the treatment as part of usual care (average of 6 months) Dysphagia Handicap Index (DHI).
Activities end of the treatment as part of usual care (average of 6 months) measured with the PRO-ergo
- Secondary Outcome Measures
Name Time Method Bioimpedance (BIA end of the treatment as part of usual care (average of 6 months) Voice Problems end of the treatment as part of usual care (average of 6 months) measured with Maximum Phonation Time (MPT)
VAS-appetite, taste and smell end of the treatment as part of usual care (average of 6 months) Liquid medical nutrition end of the treatment as part of usual care (average of 6 months) Sarcopenia end of the treatment as part of usual care (average of 6 months) measured with the SARC-F
Exercise capacity end of the treatment as part of usual care (average of 6 months) Short Physical Performance Battery (SPPB)
Quadriceps strength end of the treatment as part of usual care (average of 6 months) with a hand dynamometer.
Hand grip strength end of the treatment as part of usual care (average of 6 months) with a hand dynamometer.
Dietary goal attainment end of the treatment as part of usual care (average of 6 months) Types of Stool end of the treatment as part of usual care (average of 6 months) measured with the Bristol Stool Chart (BCS)
Swallowing Problems end of the treatment as part of usual care (average of 6 months) measured with Maximum Swallowing Speed (MSP)
Physical Functioning end of the treatment as part of usual care (average of 6 months) measured with the Assessment of Motor and Process Skills (AMPS)
Cognitive Functioning end of the treatment as part of usual care (average of 6 months) measured with the Cognitive Complaints - Participation (CoCo-P)
Trial Locations
- Locations (1)
Radboud University Medical Center
🇳🇱Nijmegen, Gelderland, Netherlands