Obstructive Sleep ApneaOBSERVENCT03591250
Healthcare Renunciation in Respiratory Chronic Disease and Treatment Compliance (OBSERVE)
An observational study of Obstructive Sleep Apnea and Respiratory Failure, run by University Hospital, Grenoble at 3 sites in France.
Trial summary
Health care renunciation is a factor that can alter patients' health status and increase the costs of its support. To date, there is no national data on the renunciation of care. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Obstructive Sleep Apnea, Respiratory Failure
- How many people
- 1,083 participants
- Where
- 3 sitesFrance
- Study dates
- 7 Dec 2018to 29 Aug 2022
- Phase
- Observational
- 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
Study population: Patients with chronic respiratory diseases treated for at least 12 months by CPAP, NIV therapy and monitored by AGIR à dom.
Who may be able to join
- Male or female over 18 years old
- Patient with respiratory failure or obstructive sleep apnea
- Treated with CPAP, NIV therapy for at least 12 months
- Home monitoring by AGIR a dom
- Voluntary patient to participate in research after adequate information and delivery of the information note
- Patient affiliated with social security or beneficiary of such a scheme
Who cannot join
- Pregnant, lactating or parturient woman
- Person deprived of liberty by judicial or administrative decision, person subject to a measure of legal protection (patient under tutorship or curatorship) Article L1121-8
Trial locations and contacts
3 sites in 1 country.
France3 sites
Bruno LEPAULE
Échirolles, 38130
EFCR HP2 Laboratory
Grenoble, Auvergne-Rhône-Alpes, 38000
Centre Santé Sommeil
Grenoble, 38000
About this study
Official title: Healthcare Renunciation in Patient With Respiratory Chronic Disease and Treatment Compliance
Health care renunciation is a factor that can alter patients' health status and increase the costs of its support.
To date, there is no national data on the renunciation of care. This study will initially characterize the different forms of health care renunciation in patients with chronic respiratory diseases, treated with continuous positive airway pressure (CPAP) or non-invasive ventilation (NIV) , and analyze it impact on treatment compliance and health processes.
Read more
The follow-up of these patients during 5 years will define renunciation trajectories (transition from the state of "renouncing" to "non-renouncing" and vice versa) and their impact on treatment compliance.
The investigators hypothesize that a patient becoming renounced on a given treatment also decreases his treatment compliance (CPAP or NIV ).
The impact of the renunciation trajectory on the patient's follow-up in terms of hospitalizations and deaths will also be studied.
Read the detailed description
A questionnaire of health care renunciation will be administered to the patient at Day 0 and each year during 5 years, to determine whether or not he has given up one or more care in the last 12 months.
The compliance to the CPAP or NIV will be extracted from the database of the Health care provider (AGIR à dom).
The primary outcome is to determine the impact of health care renunciation on treatment compliance and overall health care processes.
The analysis of the primary outcome (compliance) will be performed using a simple or generalized linear model (based on its observed distribution). Variables most associated with compliance will be introduced into a multivariate model, including healthcare renunciation variables.
For the secondary objective (identifying the determinants of cessation of health care) a first approach based on unsupervised learning will make it possible to classify patients according to homogeneous profiles on the basis of the different information collected.
A classical multivariate analysis using a hierarchical logistic regression model will quantify the weight of the different determinants in the renunciation of care. Finally, an exploratory approach based on structural equation models based on latent variables will be implemented to establish the direct and indirect relationships of the different qualitative determinants collected in the questionnaires on caregiving.
Regarding the longitudinal approach, this will be the subject of several analysis steps. Firstly, on an annual basis, a descriptive analysis will be carried out to investigate the determinants of the cessation of care according to the status of patients (renouncing or not renouncing) the previous year. Regarding the five-year follow-up, mixed models will be used to identify different trajectories of patients with regard to the renunciation of care from the initial follow-up and to study their impact on the prognosis at 5 years in terms of deaths and number hospitalizations
- Conditions
- Obstructive Sleep Apnea, Respiratory Failure
- Keywords
- Healthcare renunciation, Continuous positive airway pressure, Non-invasive ventilation
- Medical subject headings
- Sleep Apnea, Obstructive, Respiratory Insufficiency
What is being measured
The primary outcome is the main question the study is designed to answer.
Treatment compliance to CPAP or NIV
Extracted from the database of AGIR à dom
Measured: Baseline and 1 year
Secondary outcomes (12)
Age (years)
This variable will be used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care processes in patients with chronic respiratory diseases.
Measured: Baseline and 1 year
Gender (male/female)
This variable will be used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care
Measured: Baseline
Type of housing (urban , peri-urban or non-urban)
This variable will be defined via the patient's address and used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care
Measured: Baseline and 1 year
Type of pathology (OSAS, Respiratory failure)
This variable will be used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care
Measured: Baseline and 1 year
Number of hospitalizations per year
This variable will be used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care
Measured: Baseline and 1 year
BMI (Kg/m^2)
This variable will be used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care
Measured: Baseline and 1 year
Epworth Sleepiness Scale (ESS)
This scale range from 0 to 24 . ESS from 0 to 5 is interpreted as a lower normal daytime Sleepiness ESS from 6 to 10 is interpreted as a higher Normal Daytime Sleepiness ESS from 11 to 12 is interpreted as a mild Excessive Daytime Sleepiness ESS from 13 to 15 is interpreted as a moderate Excessive Daytime Sleepiness ESS from 16 to 24 is interpreted as a severe Excessive Daytime Sleepiness
This variable will be used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care
Measured: Baseline and 1 year
AHI (event/hour)
This variable will be used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care .
The interpretation of the score :
Score from 0 to 6: Good sleep; score 7 to 8: average; score> 9: Risk of pathological somnolence.
Measured: Baseline and 1 year
Socio-Professional Category
The modalities of the variables are :
- Farmers
- Craftsmen, traders and entrepreneurs
- Senior Managers and Professional Occupations
- Intermediate professions employees
- Workers
- Retired
- Other people without professional activity This variable will be used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care.
Measured: Baseline and 1 year
Family situation The modalities of this variables are : - Alone - Alone with dependent children - Couples without dependent children - Couples with dependent children
This variable will be used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care
Measured: Baseline and 1 year
Type of health insurance
This variable will be used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care
Measured: Baseline and 1 year
Presence or absence and nature of complementary health insurance
This variable will be used to characterize the different forms of health care renunciation and analyze its impact on treatment compliance and overall care
Measured: Baseline and 1 year
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Jul 2018
- Study start7 Dec 2018
- Primary completion29 Aug 2022
- Study completion29 Aug 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Obstructive Sleep ApneaStudies of the same condition, open and under way.
- More trials run by University Hospital, GrenobleThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 1,083 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospital, Grenoble
- Sponsor type
- University, hospital or other
- Collaborators
- AGIR à Dom
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03591250
- Sponsor's protocol ID
- 38RC17.321
- Other IDs
- 2017-A02831-52
- Acronym
- OBSERVE
- Status last verified
- Jan 2024
- First submitted
- 1 Jun 2018
- Last updated
- 3 Jan 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC, Hamilton GS, Dharmage SC. Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med Rev. 2017 Aug;34:70-81. doi: 10.1016/j.smrv.2016.07.002. Epub 2016 Jul 18.
PubMed 27568340Deniz S, Sengul A, Aydemir Y, Celdir Emre J, Ozhan MH. Clinical factors and comorbidities affecting the cost of hospital-treated COPD. Int J Chron Obstruct Pulmon Dis. 2016 Dec 2;11:3023-3030. doi: 10.2147/COPD.S120637. eCollection 2016.
PubMed 27980399Borel JC, Pepin JL, Pison C, Vesin A, Gonzalez-Bermejo J, Court-Fortune I, Timsit JF. Long-term adherence with non-invasive ventilation improves prognosis in obese COPD patients. Respirology. 2014 Aug;19(6):857-65. doi: 10.1111/resp.12327. Epub 2014 Jun 9.
PubMed 24912564Daabek N, Tamisier R, Foote A, Revil H, Joyeux-Jaure M, Pepin JL, Bailly S, Borel JC. Impact of Healthcare Non-Take-Up on Adherence to Long-Term Positive Airway Pressure Therapy. Front Public Health. 2021 Aug 17;9:713313. doi: 10.3389/fpubh.2021.713313. eCollection 2021.
PubMed 34485235
Study at a glance
From the registry record, last updated by the sponsor on 3 Jan 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Healthcare Renunciation in Patient With Respiratory Chronic Disease and Treatment Compliance
- ClinicalTrials.gov ID
- NCT03591250
- Acronym / sponsor ID
- OBSERVE / 38RC17.321
- Conditions
- Obstructive Sleep Apnea, Respiratory Failure
- Keywords
- Healthcare renunciation, Continuous positive airway pressure, Non-invasive ventilation
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 1,083 participants (actual)
- Lead sponsor
- University Hospital, GrenobleUniversity, hospital or other
- Collaborators
- AGIR à Dom
- Study start
- 7 Dec 2018 (actual)
- Primary completion
- 29 Aug 2022 (actual)
- Study completion
- 29 Aug 2022 (actual)
- First posted
- 19 Jul 2018 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Health care renunciation is a factor that can alter patients' health status and increase the costs of its support.
To date, there is no national data on the renunciation of care. This study will initially characterize the different forms of health care renunciation in patients with chronic respiratory diseases, treated with continuous positive airway pressure (CPAP) or non-invasive ventilation (NIV) , and analyze it impact on treatment compliance and health processes.
The follow-up of these patients during 5 years will define renunciation trajectories (transition from the state of "renouncing" to "non-renouncing" and vice versa) and their impact on treatment compliance.
The investigators hypothesize that a patient becoming renounced on a given treatment also decreases his treatment compliance (CPAP or NIV ).
The impact of the renunciation trajectory on the patient's follow-up in terms of hospitalizations and deaths will also be studied.
Detailed description
A questionnaire of health care renunciation will be administered to the patient at Day 0 and each year during 5 years, to determine whether or not he has given up one or more care in the last 12 months.
The compliance to the CPAP or NIV will be extracted from the database of the Health care provider (AGIR à dom).
The primary outcome is to determine the impact of health care renunciation on treatment compliance and overall health care processes.
The analysis of the primary outcome (compliance) will be performed using a simple or generalized linear model (based on its observed distribution). Variables most associated with compliance will be introduced into a multivariate model, including healthcare renunciation variables.
For the secondary objective (identifying the determinants of cessation of health care) a first approach based on unsupervised learning will make it possible to classify patients according to homogeneous profiles on the basis of the different information collected.
A classical multivariate analysis using a hierarchical logistic regression model will quantify the weight of the different determinants in the renunciation of care. Finally, an exploratory approach based on structural equation models based on latent variables will be implemented to establish the direct and indirect relationships of the different qualitative determinants collected in the questionnaires on caregiving.
Regarding the longitudinal approach, this will be the subject of several analysis steps. Firstly, on an annual basis, a descriptive analysis will be carried out to investigate the determinants of the cessation of care according to the status of patients (renouncing or not renouncing) the previous year. Regarding the five-year follow-up, mixed models will be used to identify different trajectories of patients with regard to the renunciation of care from the initial follow-up and to study their impact on the prognosis at 5 years in terms of deaths and number hospitalizations
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients with chronic respiratory diseases treated for at least 12 months by CPAP, NIV therapy and monitored by AGIR à dom.
Key inclusion criteria (6 listed)
- Male or female over 18 years old
- Patient with respiratory failure or obstructive sleep apnea
- Treated with CPAP, NIV therapy for at least 12 months
- Home monitoring by AGIR a dom
- Voluntary patient to participate in research after adequate information and delivery of the information note
Key exclusion criteria (2 listed)
- Pregnant, lactating or parturient woman
- Person deprived of liberty by judicial or administrative decision, person subject to a measure of legal protection (patient under tutorship or curatorship) Article L1121-8
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Treatment compliance to CPAP or NIV
Time frame: Baseline and 1 year
Extracted from the database of AGIR à dom
12 secondary outcomes
Age (years)
Time frame: Baseline and 1 year
Gender (male/female)
Time frame: Baseline
Type of housing (urban , peri-urban or non-urban)
Time frame: Baseline and 1 year
Type of pathology (OSAS, Respiratory failure)
Time frame: Baseline and 1 year
Number of hospitalizations per year
Time frame: Baseline and 1 year
BMI (Kg/m^2)
Time frame: Baseline and 1 year
Epworth Sleepiness Scale (ESS)
Time frame: Baseline and 1 year
AHI (event/hour)
Time frame: Baseline and 1 year
Socio-Professional Category
Time frame: Baseline and 1 year
Family situation The modalities of this variables are : - Alone - Alone with dependent children - Couples without dependent children - Couples with dependent children
Time frame: Baseline and 1 year
Type of health insurance
Time frame: Baseline and 1 year
Presence or absence and nature of complementary health insurance
Time frame: Baseline and 1 year
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Jan 2024.
- Background: PubMed 27568340Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC, Hamilton GS, Dharmage SC. Prevalence of obstructive sleep apnea in the general population: A systematic review. Sleep Med Rev. 2017 Aug;34:70-81. doi: 10.1016/j.smrv.2016.07.002. Epub 2016 Jul 18.
- Background: PubMed 27980399Deniz S, Sengul A, Aydemir Y, Celdir Emre J, Ozhan MH. Clinical factors and comorbidities affecting the cost of hospital-treated COPD. Int J Chron Obstruct Pulmon Dis. 2016 Dec 2;11:3023-3030. doi: 10.2147/COPD.S120637. eCollection 2016.
- Background: PubMed 24912564Borel JC, Pepin JL, Pison C, Vesin A, Gonzalez-Bermejo J, Court-Fortune I, Timsit JF. Long-term adherence with non-invasive ventilation improves prognosis in obese COPD patients. Respirology. 2014 Aug;19(6):857-65. doi: 10.1111/resp.12327. Epub 2014 Jun 9.
- Derived from this study: PubMed 34485235Daabek N, Tamisier R, Foote A, Revil H, Joyeux-Jaure M, Pepin JL, Bailly S, Borel JC. Impact of Healthcare Non-Take-Up on Adherence to Long-Term Positive Airway Pressure Therapy. Front Public Health. 2021 Aug 17;9:713313. doi: 10.3389/fpubh.2021.713313. eCollection 2021.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Obstructive Sleep Apnea and Respiratory Failure, run by University Hospital, Grenoble at 3 sites in France.
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 6 inclusion and 2 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 3 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in France. 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?
Treatment compliance to CPAP or NIV (time frame: Baseline and 1 year). 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 NCT03591250, which also lists 4 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 3 Jan 2024.