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COPD (Chronic Obstructive Pulmonary Disease)RISENCT05572632

Rehabilitation in Safety-net Environments (RISE) to Improve Outcomes in Vulnerable Patients With COPD

A study testing COPD Wellness and COPD Wellness Plus+ in people with COPD (Chronic Obstructive Pulmonary Disease), run by University of California, San Francisco at 3 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Chronic obstructive pulmonary disease (COPD), one of the leading causes of death in the US, disproportionately affects low socioeconomic communities. While few interventions effectively modify the course of COPD and improve outcomes, pulmonary rehabilitation is the one notable exception. Read more about this study

Who is it for?
Ages 40 to 90 years
What is being tested?
COPD Wellness and COPD Wellness Plus+
Could I receive a placebo?
No, everyone receives an active treatment
How many people
387 participants
Where
3 sitesUnited States
Study dates
19 Jan 2023to 30 Jun 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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 40 to 90 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Provision of signed and dated informed consent form
  • Willingness to participate in the COPD Wellness program
  • 40 to 90 years old
  • English or Spanish speaking
  • Physician-diagnosed COPD
  • Spirometry-confirmed FEV1/FVC ratio <= 0.7 and FEV1% predicted <80% based on GLI-O prediction equation
Show all 12Show fewer
  • COPD Assessment Test ≥ 10 or history of 1+ exacerbation requiring hospitalization or 2+ outpatient exacerbations requiring steroid therapy
  • Currently prescribed COPD medication(s)
  • Ability to exercise with lower extremities
  • No COPD exacerbations for ≥ 6 weeks
  • Currently receiving care within SFHN
  • Note: Forced expiratory volume in the first second (FEV1); Forced vital capacity (FVC)

Who cannot join

  • Pregnancy
  • Dementia, cognitive impairment, or symptomatic psychiatric illness that would impair them from participating
  • Unstable cardiovascular disease (includes recent [<6 months] myocardial infarction or pulmonary embolism, uncontrolled arrhythmia, poorly controlled heart failure)
  • Other severe co-morbidity which means exercise is contraindicated (screened by Registered Nurse in consultation with Pulmonologist)
  • Transmittable pulmonary infection (tuberculosis, COVID19)
  • Participated in pulmonary rehabilitation in the past 12-months
Show all 9Show fewer
  • COPD exacerbation in the past 6 weeks
  • Activities restrictions that limit one's ability to engage in moderate physical activity
  • Other diagnosis or condition that carry a prognosis of death within the next year

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Neeta Thakur, MD, MPH contact

628-206-8314

neeta.thakur@ucsf.edu

Valeria M Rojas, BS contact

408-840-1971

Valeria.rojas@ucsf.edu

United States3 sites, 3 recruiting
  • Zuckerberg San Francisco General (ZSFG) Hospital

    San Francisco, California, 94110

    Neeta Thakur, MD, MPH, 628-206-8314, neeta.thakur@ucsf.edu

    Recruiting
  • Maxine Hall Health Center (MHHC)

    San Francisco, California, 94115

    Migdalia Ordonez, MD

    Recruiting
  • Southeast Health Center (SEHC)

    San Francisco, California, 94124

    Keith Seidel, MD

    Recruiting

Other trials in United States

About this study

Official title: Community-based Pulmonary Rehabilitation (COPD Wellness) and Social Navigation (Health Advocates) to Improve Outcomes in Vulnerable Patients With COPD

Chronic obstructive pulmonary disease (COPD), one of the leading causes of death in the US, disproportionately affects low socioeconomic communities. While few interventions effectively modify the course of COPD and improve outcomes, pulmonary rehabilitation is the one notable exception. However, implementation of this resource-intensive program in real-life settings, and in particular, for underserved communities, has proven to be challenging. Safety-net centers that serve primarily under-insured populations lack financial resources to provide pulmonary rehabilitation.

The 10-week COPD Wellness and Plus+ Program directly addresses this gap, and yet, programs like these do not automatically lead to improved outcomes, which leads to the implementation of a Health Advocates program to address participant's social needs and barriers to healthcare.

Read the detailed description

The proposed study will directly test the benefit of the 10-week COPD Wellness and Plus+ Program relative to usual care and explore the added benefit of the HA in COPD Wellness Plus+ to COPD Wellness alone in a three-arm, randomized waitlist-controlled trial conducted in three geographically isolated urban primary care sites that provide care for some of the most socially vulnerable patient populations with COPD. In this Type 1 effectiveness-implementation hybrid design, the investigators aim to 1) determine the effectiveness of COPD Wellness and Plus+ to improve functional and symptom outcomes; and, using a mixed-methods approach 2) to evaluate the implementation of COPD Wellness and Plus+ across study sites applying the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) and Consolidated Framework for Implementation Research (CFIR) frameworks to identify additional barriers and enablers of intervention implementation and patient acceptance and adherence.

Being tested
COPD Wellness, COPD Wellness Plus+, Usual Care
Keywords
Social Needs, Chronic Disease, Health Disparities, Lung Diseases, Community Resources
Medical subject headings
Pulmonary Disease, Chronic Obstructive, Chronic Disease, Lung Diseases

What participants receive

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

  • COPD WellnessBehavioural

    COPD Wellness consists of 10 weekly sessions led by the COPD Wellness Coach. The intervention was designed to be portable, rely on little equipment, and require limited space (~300sqft). The curriculum was iteratively developed with patient input and builds behavioral capability and self-efficacy through 30 minutes blocks of disease education and self-management skill building, exercise training, and social support.

  • COPD Wellness Plus+Behavioural

    Couples COPD Wellness with the ZSFG Health Advocates Program. The HA will help the participant prioritize identified needs and, using an algorithm informed approach to connect the individual to the needed resource, this includes providing referrals to outside social or legal service agencies, help with applications for social benefits, or other services. The HA will use a checklist to track activities including review and prioritization of needs, referrals or resources provided, and contacts/contact attempts.

  • Usual CareBehavioural

    Includes access to comprehensive primary care services that is standardized across the SFHN. Participants randomized to the usual care arm will be offered referral to the Better Breathing Program that is part of SFHN standard care for COPD. At end of study enrollment, usual care participants will be offered the COPD Wellness intervention.

Study groups in NCT05572632
Study groupRoleWhat they receive
COPD WellnessExperimentalThis arm, COPD Wellness gives low-intensity exercise component with pulmonary rehabilitation for individuals with moderate-to-severe COPD. COPD Wellness is a program that was built from the Better Breathing Program, that is a part of San Francisco Health Network (SFHN) standard care for COPD.
Receives: Behavioral: COPD Wellness
Usual CareActive comparatorThis includes access to comprehensive primary care services. Participants randomized to the usual care arm will be offered referral to the Better Breathing Program that is part of SFHN standard care for COPD. This program consists of an evidence-based curriculum that improves disease knowledge and management skills but has no effect on symptoms or functional status. At end of study enrollment, usual care participants will be offered the COPD Wellness intervention.
Receives: Behavioral: Usual Care
COPD Wellness Plus+ExperimentalThis arm includes COPD Wellness Plus+. This arm is built from COPD Wellness with the addition of Health Advocates (i.e. Plus+). This intervention seeks to understand the effects of addressing social needs on overall health and wellness through Zuckerberg San Francisco General Hospital's (ZSFG) Health Advocate (HA) program; participation and engagement with the HA's will serve as an adherence strategy.
Receives: Behavioral: COPD Wellness Plus+

What is being measured

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

  1. Change from Baseline 6 Minute Walk Test to end-of-intervention (3-month) visit

    Standardized validated test to measure distance walked in 6 minutes

    Measured: 3-month (End of intervention) visit

Secondary outcomes (8)
  1. Change from Baseline 6 Minute Walk Test at 6-month and 9-month visit following end-of-intervention

    Standardized validated test to examine functional status and measure distance walked in 6 minutes (reported in meters)

    Measured: Baseline, 6-month, and 9-month visit following end-of-intervention

  2. Change from Baseline COPD Assessment Test (CAT) at 3-month (End of Intervention) visit, 6-month, and 9-month visit

    Standardized validated comprehensive measure COPD Assessment Test (CAT) of symptom burden for individuals with COPD, minimum score: 0 - maximum score: 40, higher score indicates a more symptomatic COPD

    Measured: Baseline, 3-month (End of intervention) visit, 6-month, and 9-month visit

  3. Change from Baseline Quality of Life (SF-CRQ) assessment at 3-month (End of Intervention) visit, 6-month, and 9-month visit

    Health related quality of life is assessed using the validated Short-Form Chronic Respiratory Disease Questionnaire (SF-CRQ). This includes questions about four domains: dyspnea, fatigue, emotional function, and mastery. Items are answered using a 7-point scale Likert scale and summed within each domain. Higher results indicate a higher health-related quality of life.

    Measured: Baseline, 3-month (End of intervention) visit, 6-month, and 9-month visit

  4. Intervention Adherence at End-of-intervention (3 month)

    Adherence as defined by the proportion of sessions attended out of ten

    Measured: Assessed during 10-week COPD Wellness Intervention

  5. Change from Baseline COPD exacerbation history at 3-month (End of Intervention) visit, 6-month, and 9-month follow up

    Self-report non-standardized questionnaire on COPD exacerbation episodes; Exacerbation defined as a visit to an urgent care or emergency department for COPD, a hospitalization for COPD, or a prescription of an oral steroid for worsening COPD symptoms; not scored, higher exacerbations indicate more symptomatic COPD

    Measured: Baseline, 3-month (End of intervention) visit, 6-month, and 9-month visit

  6. Health System Proportion of patients referred to the intervention

    Proportion of patients referred who enroll and participate in the study, which refers to the percent of patients referred that accept (attend 1+ session) COPD Wellness and Plus+ (intervention reach)

    Measured: Baseline, 24-months after study implementation

  7. Health System Adoption of intervention for patients referred

    Proportion of de novo referrals from primary care/post-hospitalization versus prompted referrals from research coordinator

    Measured: Baseline, 24-months after study implementation

  8. Healthy System Maintenance of intervention from start of study to end of study activities

    Referral pattern at start vs. at end of study period; staff and leadership intension to continue COPD Wellness and Plus+

    Measured: Baseline, Year 3 of study period (end of study activities)

Timeline

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

  1. First posted10 Oct 2022
  2. Study start19 Jan 2023
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion30 Jun 2027 (estimated)

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
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Model description
Wait-list randomized controlled trial.
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
387 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05572632
Sponsor's protocol ID
21-35495
Other IDs
R01HL161049
Acronym
RISE
Status last verified
Oct 2026
First submitted
22 Sep 2022
Last updated
27 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: De-identified questionnaire data merged with objectively measured data (6 minute walk test) would be shared. To facilitate interpretation of the data, data dictionary, and data collection instruments will be shared and associated with the relevant datasets. To obtain a copy of the data, a researcher will have to submit a request in writing identifying themselves and their affiliated institution, indicate what they plan to do with the data, include assurances that they will not share the data with others without the written permission of the project principal investigator and agree to give proper credit to the project and the investigators who collected the data in any publications resulting from the data. Researchers will have to sign a Data Use Agreement that included these terms, as well as a commitment that they will not attempt to identify individual respondents.

Publications

  • Troosters T, Gosselink R, Decramer M. Short- and long-term effects of outpatient rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Am J Med. 2000 Aug 15;109(3):207-12. doi: 10.1016/s0002-9343(00)00472-1.

    PubMed 10974183
  • Baumann HJ, Kluge S, Rummel K, Klose H, Hennigs JK, Schmoller T, Meyer A. Low intensity, long-term outpatient rehabilitation in COPD: a randomised controlled trial. Respir Res. 2012 Sep 27;13(1):86. doi: 10.1186/1465-9921-13-86.

    PubMed 23017153
  • Selzler AM, Simmonds L, Rodgers WM, Wong EY, Stickland MK. Pulmonary rehabilitation in chronic obstructive pulmonary disease: predictors of program completion and success. COPD. 2012 Aug;9(5):538-45. doi: 10.3109/15412555.2012.705365.

    PubMed 23030585
  • Fischer MJ, Scharloo M, Abbink JJ, van 't Hul AJ, van Ranst D, Rudolphus A, Weinman J, Rabe KF, Kaptein AA. Drop-out and attendance in pulmonary rehabilitation: the role of clinical and psychosocial variables. Respir Med. 2009 Oct;103(10):1564-71. doi: 10.1016/j.rmed.2008.11.020. Epub 2009 May 29.

    PubMed 19481919
  • Rochester CL, Vogiatzis I, Holland AE, Lareau SC, Marciniuk DD, Puhan MA, Spruit MA, Masefield S, Casaburi R, Clini EM, Crouch R, Garcia-Aymerich J, Garvey C, Goldstein RS, Hill K, Morgan M, Nici L, Pitta F, Ries AL, Singh SJ, Troosters T, Wijkstra PJ, Yawn BP, ZuWallack RL; ATS/ERS Task Force on Policy in Pulmonary Rehabilitation. An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation. Am J Respir Crit Care Med. 2015 Dec 1;192(11):1373-86. doi: 10.1164/rccm.201510-1966ST.

    PubMed 26623686

Questions about this trial

What is this clinical trial studying?

A study testing COPD Wellness and COPD Wellness Plus+ in people with COPD (Chronic Obstructive Pulmonary Disease), run by University of California, San Francisco at 3 sites in United States.

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 12 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: looking for participants now, as of the sponsor's last update on 27 Oct 2026. 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 United States. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Neeta Thakur, MD, MPH (628-206-8314, neeta.thakur@ucsf.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from Baseline 6 Minute Walk Test to end-of-intervention (3-month) visit (time frame: 3-month (End of intervention) visit). 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 NCT05572632, which also lists 5 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 27 Oct 2026.

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