Simeox Therapy At Home Versus Standard of Care in NCFB Patients with CMH
- Conditions
- Non-cystic Fibrosis BronchiectasisChronic Mucus Hypersecretion
- Interventions
- Device: SimeoxCombination Product: Control
- Registration Number
- NCT06237348
- Lead Sponsor
- Physio-Assist
- Brief Summary
This pilot RCT will assess benefits of Simeox technology on lung function, respiratory symptoms, health-related quality of life, subjective efficiency, device adherence at home, Patient satisfaction, tolerance, safety, and telecare feasibility.
- Detailed Description
Non-cystic fibrosis bronchiectasis (NCFB) is a chronic respiratory disease with multiple etiologies characterized by an irreversible dilatation of bronchi and an impair mucociliary clearance. These alterations cause sticky mucus retention and leads to recurrent infections and chronic bronchial inflammations. Chest physiotherapy is one of the cornerstones of the management of NCFB patients, particularly to facilitate airway clearance. In NCFB patients with chronic mucus hypersecretion (CMH), it is recommended that airway clearance sessions be carried out daily or several times a day, which represents a very significant burden of care. Moreover, access to respiratory physiotherapy for patients can be limited due to several causes: geographical, time or healthcare professional availability constraints. In addition, few healthcare professionals are trained for bronchial drainage especially with airway clearance devices.
SIMEOX® (Physio-Assist, France) is an innovative medical device (CE medical mark) for mucus clearance. The device is connected to patient mouth with an expiratory kit circuit. When the patient starts up the device during exhalation only, SIMEOX® disseminates a vibratory pneumatic signal in the bronchi that liquefies mucus and transports it from distal to central airways for sputum expectoration. After device training with respiratory physiotherapist, patients can be treated at hospital and use SIMEOX® in autonomy at home. Device training and patient follow-up can be performed also remotely with telecare with similar efficiency than face to face visits with health care professionals.
The main objective of this Pilot study is to evaluate the effects of mid-term use of SIMEOX® in autonomy at home for 2 months in NCFB patients with CMH and pulmonary exacerbation (in- or outpatients) in comparison to standard of care.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 50
- Patient with confirmed diagnosis of bronchiectasis confirmed by High Resolution Computed Tomography (HRCT): idiopathic, post-infective, systemic disease, ABPA, asthma, COPD, PCD
- Overproduction of mucus (ie: estimated bronchorrhea >10mL/day).
- Pulmonary exacerbation (in- or outpatients)
- Age > 18 years old
- Patient able to understand the study and to perform the 2-month follow up visit
- Pneumothorax/pneumo-mediastinum in the six months prior hospitalization
- Recent episode of severe haemoptysis
- Unstable severe cardiac disease or hemodynamic instability
- Cystic fibrosis or COPD as dominant diagnosis
- Patient on lung transplant list
- Severe lung injuries
- Recent lung surgery
- Inhalation support (continuous ventilatory support)
- Tracheostomy
- Uncontrolled GERD
- Any contraindication to an instrumental bronchial clearance technique (up to the investigator)
- Inability to perform PFT or 6MWT
- Patient not available or wishing to move to a different region within 2 months of inclusion
- Patient considered by the investigator to be physically or mentally inapt to use the device and/or to perform the study procedures.
- Patient currently participating or having participated within one month prior to inclusion in a clinical intervention research trial that may impact the study, the impact of which is up to the investigator
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Simeox Control Airway clearance device Simeox Simeox Airway clearance device Control Control Usual chest physiotherapy (manual, breathing exercise, PEP/oPEP)
- Primary Outcome Measures
Name Time Method To describe the evolution in Self-reported home adherence from baseline (hospital discharge) during follow-up 2 months The evolution of device adherence will be described by % of self-reported sessions (0-1; 2-3; 4-7/week) by the patient over the 2-month FU (1 week, 2 weeks, 1 month and 2 months)
- Secondary Outcome Measures
Name Time Method To describe Simeox therapy settings (program selection) during follow-up 2 months Simeox settings will be described by program selection (1, 2 or 3)
To describe Simeox therapy settings (intensity) during follow-up 2 months Simeox settings will be described by intensity (25%, 50%, 75% or 100%)
To describe Simeox therapy settings (number of session) during follow-up 2 months Simeox settings will be described by the number of sessions per day
To describe Simeox therapy settings (session duration) during follow-up 2 months Simeox settings will be described by the session duration in minutes
To evaluate mucus quality with Simeox therapy during follow-up 2 months Mucus quality will be evaluated during follow-up with a score from 1 to 4 (abondant - Scanty)
To evaluate breathing quality with Simeox therapy during follow-up 2 months Breathing quality level will be evaluated during follow-up with a score from 1 to 4 (very good - very poor)
To evaluate ease handling of the Simeox device during follow-up 2 months Ease of handling level will be evaluated during follow-up with a score 1 to 4 (very easy - not easy at all)
To evaluate pain during Simeox therapy 2 months Pain level will be evaluated during follow-up with a scale from 0 to10 (no painful - very painful)
To evaluate fatigue during Simeox therapy 2 months Fatigue level will be evaluated during follow-up with a scale from 0 to 10 (no fatigue - very tired)
To evaluate ease of use of Simeox device after 2 months of therapy 2 months Ease of use level will be evaluated at 2 month with a score from 1 to 4 (very easy - not easy at all)
To evaluate patient preference between Simeox device and usual care after 2 months of therapy 2 months Patient preference will be evaluated at 2 month in comparaison to conventional techniques used (yes/no)
To evaluate patient recommendation to others patients of Simeox device after 2 months of therapy 2 months Patient recommendation to others patients will be evaluated at 2 month (yes/no)
Evaluate the feasibility of telecare during follow-up 2 months Feasibility of telecare during follow-up will be estimated by the percent of call visit performed with the patients compared to the number of call visits scheduled in the protocol
To evaluate the effect of Simeox on respiratory symptoms in NCFB patients after 2 months of therapy 2 months The change in respiratory symptoms score from baseline (hospital discharge) to 2-month FU will be measured with the Chronic Airways Assessment Test (CAT) questionaire
To evaluate the effect of Simeox on the health-related quality of life of NCFB patients after 2 months of therapy 2 months The change in quality of life from baseline (hospital discharge) to 2-month FU will be measured with the St Georges Respiratory Questionnaire (SGRQ)
To evaluate the effect of Simeox on Forced Expiratory Volume at 1 seconde (FEV1) after 2 monts of therapy 2 months The change in FEV1 from baseline (hospital discharge) to 2-month FU will be measured with spirometry
To evaluate the effect of Simeox on Forced Vital Capacity (FVC) after 2 monts of therapy 2 months The change in FVC from baseline (hospital discharge) to 2-month FU will be measured with spirometry
To evaluate the effect of Simeox on Forced Expiratory Flow (FEF) at 25%, 50% and 75% of FVC after 2 monts of therapy 2 months The change in FEF at 25%, 50% and 75% from baseline (hospital discharge) to 2-month FU will be measured with spirometry
To evaluate the effect of Simeox on dyspnea after 2 monts of therapy 2 months The change in dyspnea from baseline (hospital discharge) to 2-month FU will be measured with the modified Medical Research Council (mMRC) questionnaire
To evaluate the effect of Simeox on exercise capacity after 2 monts of therapy 2 months The change in walking distance from baseline (hospital discharge) to 2-month FU will be measured with the 6-min walking test (6MWT)
To evaluate safety of Simeox 2 months The safety of Simeox will be assessed by the rate and severity of Side effects during follow-up
Trial Locations
- Locations (2)
Jagiellonian University Medical College
🇵🇱Kraków, Poland
N. Barlicki University Hospital No 1
🇵🇱Lodz, Poland