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Rheumatoid ArthritisLIFTNCT03248518

Lessening the Impact of Fatigue in Inflammatory Rheumatic Diseases

A study testing Cognitive behavioural approach and Personalised Exercise Programme in people with Rheumatoid Arthritis and Lupus Erythematosus, Systemic, run by University of Aberdeen at 6 sites in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Fatigue is common and disabling for most patients with inflammatory rheumatic disease. Therapies designed to improve physical activity and 'talking' treatments, which positively help patients change the way they think and behave, are both helpful in reducing the burden of the fatigue. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Cognitive behavioural approach and Personalised Exercise Programme
Could I receive a placebo?
No, everyone receives an active treatment
How many people
368 participants
Where
6 sitesUnited Kingdom
Study dates
5 Sep 2017to 2 Nov 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • be ≥ 18 years at the time of consent
  • have been diagnosed with rheumatoid arthritis (RA), systemic lupus erythematous (SLE), axial spondyloarthritis (AxSpA) or psoriatic arthritis (PSA) by a rheumatologist
  • report fatigue to be a persistent problem
  • have access to a telephone landline or mobile telephone and/or internet based audio/video calls
  • give permission for researchers to access their hospital medical notes
  • currently be under the care of a secondary care physician
  • have stable disease as evidenced by no change in immunomodulatory therapy within the last three months based on the hospital medical record

Who cannot join

  • there are significant abnormalities of thyroid function (TSH levels) on the most recent blood test done within the last three months
  • there is evidence of severe anaemia (haemoglobin levels) on the most recent blood test done within the last three months
  • there is evidence of severe renal dysfunction (eGFR) on the most recent blood test done within the last three months
  • they have a medical condition which would make the proposed interventions unsuitable, e.g. significant heart disease
  • they are pregnant
  • they are unable to understand English sufficiently to take part in the intervention
Show all 9Show fewer
  • they are unable to provide written informed consent
  • they are not willing to be randomised
  • they are currently participating in an interventional clinical trial

Trial locations and contacts

6 sites in 1 country.

6 sites in 1 country

United Kingdom6 sites
  • NHS Grampian

    Aberdeen

  • NHS Tayside

    Dundee

  • NHS Lothian

    Edinburgh

  • NHS Greater Glasgow and Clyde

    Glasgow

  • Newcastle upon Tyne Hospitals NHS Foundation Trust

    Newcastle upon Tyne, NE7 7DN

  • Midlands Partnership NHS Foundation Trust

    Stoke-on-Trent, ST6 7AG

Other trials in United Kingdom

About this study

Official title: Lessening the Impact of Fatigue in Inflammatory Rheumatic Diseases: A Randomised Clinical Trial

Fatigue is common and disabling for most patients with inflammatory rheumatic disease. Therapies designed to improve physical activity and 'talking' treatments, which positively help patients change the way they think and behave, are both helpful in reducing the burden of the fatigue. However, few patients have access to these treatments in most health services. This situation results from the absence of standardised programmes and limited availability of relevant therapists.

The investigators aim to enhance access to fatigue alleviating physical activity and talking therapies by testing innovative,standardised and cost-effective approaches to treatment delivery.

The investigators will also use this opportunity to understand how to select the best treatment for a patient based on their individual profile and to better understand how these treatments actually work. This in turn may lead to more refined and effective therapies in the future.

Read the detailed description

Eligible participants will be identified from patients with inflammatory rheumatic diseases attending major secondary care rheumatology services in the United Kingdom. Potential participants will be identified using local databases/clinic lists and will then be mailed a pre-study invite, which will include questions about fatigue. Potentially eligible participants will be invited to attend a baseline assessment.

Once it has been confirmed at the baseline assessement that they are eligible to take part in the study, the consented participant will be allocated to one of three treatment groups. During the course of the trial, the participant will be invited to visit the study centre three more times for assessments.

At each of the four assessment visits (baseline, and approximately 2, 7 and 13 months after) they will be asked:

  1. To complete questionnaires which collect information about various outcomes which we think will improve in response to the therapies under evaluation as well as factors which will help us understand how the treatments may work, and factors which may help identify those patients better suited to one therapy over another
  2. To provide a blood sample for research
  3. To take part in an aerobic fitness test
  4. To wear an activity monitor for the next 7 days which will be fitted at each visit
  5. To answer three short questions about engagement with intervention delivered by telephone from trial office at the time of session 4 and 8 (CBA and PEP intervention only). Similarly, the allocated therapists will be asked to give their view of the participants' engagement with the intervention.

All participants will be asked to keep a diary on any other treatments they are using in addition to the treatments they may receive during the study and how costly these other treatments are. The diary period will last for the first 6 months and then for 2 weeks after the third visit and 2 weeks before the last visit.

After they finished the study, the investigators may approach a subgroup of participants who received either the talking therapy or the personalised exercise programme again and ask for an interview to enable more detailed feedback on if they found the intervention helpful and how it has changed their daily life.

Being tested
Usual Care, Cognitive behavioural approach, Personalised Exercise Programme
Keywords
Inflammatory Rheumatic Disease, Fatigue, Exercise, Behavioural Intervention, Rheumatoid Arthritis, Systemic Lupus Erythematosus, Axial Spondyloarthritis
Medical subject headings
Arthritis, Rheumatoid, Lupus Erythematosus, Systemic, Axial Spondyloarthritis, Arthritis, Psoriatic, Sjogren's Syndrome, Fatigue, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Usual CareBehavioural

    Information booklet on fatigue which represents usual care in almost all UK rheumatology centres

  • Cognitive behavioural approachBehavioural

    Also called CBA

    A talking therapy which explicitly aims to replace unhelpful beliefs and behaviours through the application of patient-centred strategies and behavioural activities

  • Personalised Exercise ProgrammeBehavioural

    Also called PEP

    PEP is a graded exposure behaviour therapy which aims to gradually optimise patients levels of physical activity with view to modifying their altered perception of effort and ultimately reduce the severity and impact of fatigue.

Study groups in NCT03248518
Study groupRoleWhat they receive
Usual Care aloneActive comparatorParticipants receive written information about fatigue which is designed as self-management guide.
Receives: Behavioral: Usual Care
CBA + usual careActive comparatorIn addition to usual care, participants receive a talking therapy using a cognitive behavioural approach. The talking therapy will be delivered via telephone by a trained rheumatology health care professional who will contact the participant for 8 sessions over a period of 6 months.
Receives: Behavioral: Usual Care; Behavioral: Cognitive behavioural approach
PEP + usual careActive comparatorIn addition to usual care, participants receive a personalised exercise programme. After an initial face-to-face assessment, the remaining programme will be delivered via telephone by a trained rheumatology health care professional who will contact the participant for 7 sessions over a period of 6 months.
Receives: Behavioral: Usual Care; Behavioral: Personalised Exercise Programme

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Fatigue (severity) using Chalder Fatigue Scale (Likert)

    Chalder Fatigue Scale (Likert), assessed at 56 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC with main estimate of treatment effect at 56 weeks after randomisation, Main estimate of treatment effect at 56 weeks

    Measured: 56 weeks

  2. Fatigue (severity) using Chalder Fatigue Scale (Likert)

    Chalder Fatigue Scale (Likert), assessed at 10 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC

    Measured: 10 weeks

  3. Fatigue (severity) using Chalder Fatigue Scale (Likert)

    Chalder Fatigue Scale (Likert), assessed at 28 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC

    Measured: 28 weeks

  4. Fatigue (impact) using Fatigue Severity Scale

    Fatigue Severity Scale, co-primary outcome assessed at 56 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC with main estimate of treatment effect at 56 weeks

    Measured: 56 weeks

  5. Fatigue (impact) using Fatigue Severity Scale

    Fatigue Severity Scale, co-primary outcome assessed at 10 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC

    Measured: 10 weeks

  6. Fatigue (impact) using Fatigue Severity Scale

    Fatigue Severity Scale, co-primary outcome assessed at 28 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC

    Measured: 28 weeks

Secondary outcomes (7)
  1. Fatigue (physical, living, cognition and emotional aspects) using Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire

    Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire

    Measured: 0, 10 weeks, 28 weeks, 56 weeks after randomisation

  2. Quality of life & health utility index

    SF-12

    Measured: 0, 10 weeks, 28 weeks, 56 weeks after randomisation

  3. Pain using numerical rating scale

    Pain numerical rating scale

    Measured: 0, 10 weeks, 28 weeks, 56 weeks after randomisation

  4. Anxiety and depression using Hospital anxiety and depression scale

    Hospital anxiety and depression scale

    Measured: 0, 10 weeks, 28 weeks, 56 weeks after randomisation

  5. Impact on work using Work Productivity and Activity Impairment Questionnaire

    Work Productivity and Activity Impairment Questionnaire: Specific Health Problem

    Measured: 0, 10 weeks, 28 weeks, 56 weeks after randomisation

  6. Impact on activities using Valued Life Activities Scale

    Valued Life Activities Scale

    Measured: 0, 10 weeks, 28 weeks, 56 weeks after randomisation

  7. Change of global health

    Single question to indicate perceived change in global health compared with last assessment visit

    Measured: 10 weeks, 28 weeks, 56 weeks after randomisation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Aug 2017
  2. Study start5 Sep 2017
  3. Primary completion2 Nov 2020
  4. Study completion2 Nov 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
368 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03248518
Sponsor's protocol ID
2.049.16
Other IDs
Epi029
Acronym
LIFT
Status last verified
Sep 2021
First submitted
15 Feb 2017
Last updated
16 Sep 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Gray SR, Montoye AHK, Vondrasek JD, Neph S, Siebert S, Paul L, Bachmair EM, Basu N. Associations of physical activity levels with fatigue in people with inflammatory rheumatic diseases in the LIFT trial. Rheumatol Adv Pract. 2024 Aug 24;8(3):rkae106. doi: 10.1093/rap/rkae106. eCollection 2024.

    PubMed 39257857
  • Bachmair EM, Martin K, Aucott L, Dhaun N, Dures E, Emsley R, Gray SR, Kidd E, Kumar V, Lovell K, MacLennan G, McNamee P, Norrie J, Paul L, Packham J, Ralston SH, Siebert S, Wearden A, Macfarlane G, Basu N; LIFT study group. Remotely delivered cognitive behavioural and personalised exercise interventions for fatigue severity and impact in inflammatory rheumatic diseases (LIFT): a multicentre, randomised, controlled, open-label, parallel-group trial. Lancet Rheumatol. 2022 Jun 27;4(8):e534-e545. doi: 10.1016/S2665-9913(22)00156-4. eCollection 2022 Aug.

    PubMed 36388001
  • Martin KR, Bachmair EM, Aucott L, Dures E, Emsley R, Gray SR, Hewlett S, Kumar V, Lovell K, Macfarlane GJ, MacLennan G, McNamee P, Norrie J, Paul L, Ralston S, Siebert S, Wearden A, White PD, Basu N. Protocol for a multicentre randomised controlled parallel-group trial to compare the effectiveness of remotely delivered cognitive-behavioural and graded exercise interventions with usual care alone to lessen the impact of fatigue in inflammatory rheumatic diseases (LIFT). BMJ Open. 2019 Jan 30;9(1):e026793. doi: 10.1136/bmjopen-2018-026793.

    PubMed 30705244

Questions about this trial

What is this clinical trial studying?

A study testing Cognitive behavioural approach and Personalised Exercise Programme in people with Rheumatoid Arthritis and Lupus Erythematosus, Systemic, run by University of Aberdeen at 6 sites in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Sep 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Fatigue (severity) using Chalder Fatigue Scale (Likert) (time frame: 56 weeks). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03248518, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Sep 2021.

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LIFT Clinical Trial NCT03248518 | AzTrials