Chronic obstructive pulmonary disease (COPD) breathing record study

ISRCTN ISRCTN56492264
DOI https://doi.org/10.1186/ISRCTN56492264
ClinicalTrials.gov number NCT02814253
Secondary identifying numbers 19599
Submission date
18/05/2016
Registration date
13/06/2016
Last edited
10/05/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Chronic obstructive pulmonary disease (COPD) is the name used to refer to a number of progressive devastating and debilitating lung diseases, which includes chronic bronchitis, emphysema and chronic obstructive airways disease. People that have COPD typically feel breathless after physical activity, have a persistent cough with phlegm and suffer frequently from chest infections. There is no cure for the condition, but making lifestyle changes (such as stopping smoking) and taking medications (inhalers and/or tablets) can alleviate symptoms. This study is being done to collect information that will be used in the development of a new medical device. The new device is intended to help people with chronic obstructive pulmonary disease (COPD) to monitor their condition at home on a daily basis. The device used in this study is called a capnometer. Different types of capnometer have been in use by doctors for many years. Capnometers measure the amount of carbon dioxide in the breath. The device that is used in this study is called the N-Tidal C. It is a small, battery-powered personal device to use indoors either at home, at work or in hospital.

Who can participate?
COPD patients aged at least 18

What does the study involve?
The study fits around the a COPD patient’s normal treatment, tests and medication and there are no changes made to this treatment. At the start of the study each participant is trained in the use of the device and they are asked to use the device to record their normal relaxed breathing, 3 times a day (morning, afternoon and evening) every day for the next six weeks. A reading takes 75 seconds of ordinary breathing through the device. Participants who feel unwell, or have an infection, are asked to take more frequent breath records of up to six times a day if possible – that is twice in the morning, twice in the afternoon and twice in the evening - leaving at least an hour between readings. Standard care clinical assessments are taken at the start of the study, after 2 weeks, 4 weeks and, finally, 6 weeks. The tests for COPD include a check-up by the study doctor or nurse including the usual spirometry and blood gas tests. Each assessment visit takes between 15-20 minutes. Participants are also asked to complete a simple daily diary of how their health and COPD changes and information on the use of the device. Finally, all participants receive a telephone call 2 weeks after their last assessment visit to check how they are and to ask if any of their medicines have changed.

What are the possible benefits and risks of participating?
Participants will not benefit directly from taking part in this study and the device used in the study does not provide any feedback to them. The information the researchers get from this study will help them to develop the device, and to learn more about the treatment and management of COPD. The study researchers do not believe that there are any risks to participants who use the N-Tidal C device in accordance with the instructions for use. An early version of it was tested on people with COPD and they did not report any side effects or difficulties with breathing through the device.

Where is the study run from?
Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Lung Function Unit (UK)

When is the study starting and how long is it expected to run for?
January 2016 to July 2016

Who is funding the study?
The Small Business Research Initiative for Healthcare (UK)

Who is the main contact?
Dr Ravi Mahadeva

Contact information

Dr Ravi Mahadeva
Public

Consultant Chest Physician
Cambridge University Hospitals NHS Foundation Trust
Cambridge Biomedical Campus
Hills Road
Cambridge
CB2 0QQ
United Kingdom

ORCiD logoORCID ID 0000-0001-6111-5555

Study information

Study designObservational longitudinal study
Primary study designObservational
Secondary study designLongitudinal study
Study setting(s)Hospital
Study typeOther
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleAn exploratory, observational clinical evaluation of the CRiL N­-Tidal C data-collector capnometer to collect breathing records in patients with COPD
Study acronymCBRS
Study objectivesThe purpose of this planned investigation is to collect data from patients whose COPD is undergoing change. Such patients are either at risk of an acute exacerbation of COPD, or they have already been hospitalised for treatment of an acute exacerbation. The intention is to correlate capnometric data during this journey with existing measurements (spirometry, blood gas, partial pressure of carbon dioxide [PaCO2], clinical symptoms and clinical assessments). It should then be possible to predict the exhaled CO2 signature of an exacerbation of COPD in normocapnic and hypercapnic patients.
The eventual aim of the N-Tidal C is to facilitate the monitoring and management of patients in the community with moderate to severe COPD. In its final developed form, the N-Tidal C will detect any changes in the patient’s exhaled CO2 capnograph, which would indicate a worsening of their condition and risk of exacerbation. The device would then use a ‘traffic light’ warning system to advise the patient of a change of condition, prompting the patient to seek medical attention. This timely intervention in the community should reduce the number of COPD admissions to hospital.
Ethics approval(s)NRES Committee Yorkshire & The Humber - Bradford Leeds, 10/09/2015, ref: 15/YH/0369
Health condition(s) or problem(s) studiedSpecialty: Respiratory disorders, Primary sub-specialty: COPD
InterventionPatients will be enrolled into one of two cohorts:

1. Stable patients with chronic hypercapnia (raised blood levels of CO2). They will be monitored in the community (community-based case managed group)
2. Hospitalised patients admitted with COPD related respiratory failure. They will be monitored during  recovery in hospital and post discharge (acute admission group)

Patients who give informed consent will be screened for the study. Patients in the case-managed group will be screened at home or in routine clinic visits. Patients in the acute admission group will be screened after admission to hospital as soon as they are well enough to understand the study and to give written informed consent.

The N-Tidal C data-collector capnometer will be explained to the patients and they will be trained how to use it. Case-managed patients will be asked to use the device at home over a period of approximately 6 weeks, 3 times per day (morning, afternoon and evening), or 6 times per day if they feel that they are starting an infection or an exacerbation. Hospitalised patients will also use the device 3 times per day as in-patients and will then continue with the monitoring after discharge from hospital for a total period of 6 weeks. All patients will complete a daily diary record.

Case-managed patients will undergo clinical assessment of COPD during screening at home or in the COPD clinic; in-patients will undergo clinical assessment of COPD following admission and before discharge from hospital. All patients will be assessed a further 3 times: during the second and fourth week in the community, and at the end of the 6-week assessment period. A brief follow-up review will be conducted approximately 8 weeks after the start of capnometer monitoring. At each assessment, capnometry measurements will be taken in addition to routine spirometry, and arterial (in-patients) or capillary (in the community) blood gasses. The trial will not interfere with routine management of the patient’s condition.
Intervention typeDevice
Pharmaceutical study type(s)
Phase
Drug / device / biological / vaccine name(s)
Primary outcome measureChanges in exhaled CO2 profiles obtained by the N-Tidal C data-collector capnometer. The reading, which typically takes 60 seconds to collect, will be repeated three times daily, for a period of six weeks.
Secondary outcome measuresNo secondary outcome measures
Overall study start date07/01/2016
Completion date01/07/2016

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned Sample Size: 30; UK Sample Size: 30
Key inclusion criteria1. Patients of either sex, age 18 years and over, diagnosed with COPD, who have given written, informed consent
2. Patients in the case-managed group will have chronically elevated partial pressure of
carbon dioxide (PaCO2) and will be susceptible to frequent exacerbations of COPD
3. Patients in the acute admission group will have been admitted to hospital via the emergency room for treatment of COPD­related ventilatory failure
Key exclusion criteria1. Diagnosis of neuromuscular disorders or kyphoscoliosis
2. Patients who, in the opinion of the investigator are unlikely to comply with the requirements of the study, 
use the device correctly, or keep the diary records
Date of first enrolment17/02/2016
Date of final enrolment05/05/2016

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital
Lung Function Unit, Box 40
Cambridge Biomedical Campus
Hills Road
Cambridge
CB2 0QQ
United Kingdom

Sponsor information

Cambridge Respiratory Innovations Ltd
Industry

The Grange
20 Market Street
Swavesey
Cambridge
CB24 4QG
United Kingdom

Website http://criltd.co.uk

Funders

Funder type

Government

The Small Business Research Initiative for Healthcare (SBRI Healthcare)

No information available

Results and Publications

Intention to publish date01/08/2019
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planThe first publication from the study will be a poster at the 2017 European Respiratory Society conference. Further publications are planned in high impact peer-reviewed journals.
IPD sharing planThe datasets generated and/or analysed during the current study are not expected to be made publicly available due to commercial sensitivity with the development of N-Tidal technology and personal respiratory monitors.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Basic results 25/07/2017 01/08/2017 No No
HRA research summary 28/06/2023 No No

Additional files

ISRCTN56492264_BasicResults_25July17.pdf
Uploaded 01/08/2017

Editorial Notes

10/05/2019: No publications found. Verifying results with principal investigator. The intention to publish date was changed from 01/08/2018 to 01/08/2019.
01/08/2017: The basic results of this trial have been uploaded as an additional file.
25/07/2017: Publication and dissemination plan and IPD sharing statement added.