Prospective Observational Study Of Naturopathic Approaches To IBS
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Patient-Modified Simple Clinical Colitis Activity Index
研究概览
简要总结
Ulcerative colitis (UC) is a long-term condition that causes inflammation in the large intestine. People with UC often have symptoms such as diarrhea, abdominal pain, and fatigue. These symptoms can come and go over time and can have a major impact on daily life. Although there are many medical treatments available, some patients do not respond well, experience side effects, or prefer to avoid long-term use of medications that affect the immune system. Because of this, many people with UC seek care from naturopathic doctors.
This study aims to better understand how naturopathic care is used to treat UC and whether patients experience changes in their symptoms over time. In this study, adults with UC who are already receiving care from a naturopathic doctor will be followed for 12 weeks. The treatments will not be standardized; instead, each naturopathic doctor will provide individualized care based on their usual practice.
Participants will complete a questionnaire that measures UC symptoms at the start of the study and again after 12 weeks. The study will compare symptom scores before and after treatment. Researchers will also collect information about the types of treatments used and any side effects or adverse events.
This is an observational study, meaning there is no comparison group and no changes are made to participants' usual care. The goal is to gather early information about naturopathic care for UC and to help guide future, more rigorous studies.
详细描述
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) characterized by relapsing and remitting inflammation of the colonic mucosa. UC carries a significant burden in terms of quality of life, healthcare utilization, and long-term risk of colorectal cancer. While numerous pharmaceutical therapies exist-including aminosalicylates, corticosteroids, immunomodulators, biologics, and small molecules-many patients experience suboptimal response, adverse effects, or prefer to avoid long-term immunosuppression. As a result, many individuals with UC seek out complementary and alternative medicine, including naturopathic care. However, naturopathic approaches to UC are understudied. The investigators aim to describe naturopathic approaches to UC and to establish pilot data on before-and-after changes in validated UC instruments. The study will employ a prospective, observational, naturalistic design. The uncontrolled before-and-after study will examine the outcomes associated with individualized, whole system naturopathic care as determined by each respective provider. The investigators will recruit adult patients diagnosed with ulcerative colitis who are under the care of naturopathic doctors. Participants' UC symptoms will be measured using a validated instrument, the Patient-Modified Simple Clinical Colitis Activity Index [P-SCCAI]. Adverse events and treatment descriptions will also be collected. The primary outcomes will be before-and-after differences using week 12 as the primary endpoint. P-values will be set at 0.05 and descriptive and summary data will be presented. This study is designed to address substantial evidence gaps and to gather preliminary evidence to inform the design of a future randomized, controlled trial.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •*Adults (≥18 years of age) who have active UC (P-SCCAI >4)
排除标准
- •*Inability to read and write in English.
结局指标
主要结局
Patient-Modified Simple Clinical Colitis Activity Index
时间窗: 6 months
There are over 30 patient reported outcomes (PRO) instruments in use for patients with IBD.14 The oldest and most widely used is the Patient-Modified Simple Clinical Colitis Activity Index \[P-SCCAI\], a validated, non-proprietary patient-reported outcome measure for ulcerative colitis. The P-SCCAI is a patient-worded version of the Simple Clinical Colitis Activity Index and includes six symptom domains: stool frequency (day and night), urgency, rectal bleeding, general well-being, and extra-intestinal manifestations. Total scores range from 0-19, with ≥5 commonly used to define active disease.
Health Status
时间窗: 6 months
PROMIS-29 The Patient Reported Outcomes Measurement Information System (PROMIS) provides a standardized, reliable, and valid measure of health status. The profile is a collection of self-report short forms containing items from seven PROMIS domains (Physical Function, Anxiety, Depression, Fatigue, Sleep Disturbance, Ability to Participate in Social Roles and Activities, Pain Interference, and Pain Intensity). The PROMIS-29 Profile consists of four questions per domain rated on a 5-point rating scale along with a 1 question Pain Intensity section rated on an 11-point scale. A raw score ranges from 29 to 150, and can be converted into T-scores which are referenced to mean score levels in the general U.S. population. Lower PROMIS scores have been shown to predict reduced health related quality of life for multiple chronic conditions. We will measure average change in each participant's PROMIS - 29 score from week zero to week twelve and twenty four.
次要结局
- CARE(6 months)
- Patient empowerment(6 months)
- The Patient-Centered Care-Perceived Provider Support-Empowerment Scale(6 months)
- Treatment characteristics(6 months)
- Adverse Events(6 months)