Cirrhosis, Liver, Hepatic Encephalopathy
Conditions
Brief summary
The personalized nutrition and exercise app was designed for use by individuals living with chronic conditions. The pilot study examines the acceptance and use of the online, interactive program to support self-management in cirrhosis.
Detailed description
Patients living with chronic disease are at-risk for frailty because of their potentially sedentary lifestyle and/or symptoms. Supervised exercise programs are useful for improving or maintaining physical capacity as measured by common physical function measures. However, accessibility is limited due to scheduling, transportation, employment, and residential location. Unsupervised, self-directed home-based programs have had limited success due to absence of peer support and accountability. An alternative is an app-based program that offers interactive engagement with study staff and accountability. Further, follow-along videos and tracking for both nutrition and exercise can be completed at the patient's convenience. A 12-week pilot study with patients living with cirrhosis will assess the acceptability of the programming. The hypothesis is that study participants will find the customization of the app and interaction with the study staff acceptable as measured by completion rates (primary study endpoint). Secondary outcomes include change in measures (0-12 weeks) for the 6-minute walk test (6MWT), thigh muscle thickness, and chair sit-to-stands. At the end of the study, participants will also complete a program satisfaction survey (developed in-house). Interviews with participants, caregivers, and study staff, conducted via videoconference at 4-6 weeks and end of study, will be descriptively analysed to identify feasibility, acceptability, and perceived utility of the program. Analyses will also identify areas for program improvement.
Interventions
BEHAVIORALNutrition and Exercise app
Personalized, home-based, interactive therapy app
Sponsors
Canadian National Transplant Research Program
Nutricia Foundation
University of Alberta
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Pilot study
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* adult (aged 18 years and older) * diagnosis of cirrhosis (MELD\<25) according to biopsy, imaging, elastography, or other * fulfill the guideline-based prophylaxis in place for high risk gastroesophageal varices * able to communicate (e.g., speak, read, and write) in English * provide informed written consent for self
Exclusion criteria
* hepatocellular carcinoma (HCC) outside of the Edmonton liver transplant criteria * previous myocardial infarction * EF \<50% * ischemia on stress testing * oxygen saturation \<95% * non-HCC malignancy * end-stage renal disease. * at the discretion of the healthcare team if a participant can participate in the pilot study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Participant Retention/Adherence | 12 weeks | The number of participants who complete the 12-week nutrition and exercise program and meet 70% of the nutrition and exercise goals. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 6-MWT | 12 weeks | The change in distance walked in 6 minutes. |
| Program Satisfaction | 12 weeks | Self-reported satisfaction with the nutrition and exercise program. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Chair Sit-to-Stand | 12 weeks | The change in time required to complete 5x sit-to-stands from baseline to end of study. |
| Thigh Muscle Measures | 12 weeks | The change in thigh muscle thickness and echogenicity from baseline to end of study. |
Countries
Canada
Outcome results
None listed