Children and adolescents with overweight and obesity are predisposed to significant health problems. It is known that childhood obesity can adversely affect almost every organ system, and if left untreated, the major impact of childhood overweight is likely to be felt in the next generation of adults. The aim of " Kijk op overgewicht bij kinderen" is to collect and follow-up longitudinal data from a population of different degrees of children with overweight regarding etiological factors, risk factors and early stages of chronic disease in different degrees of childhood overweight.

NCT02091544

Conditions

1. Childhood Obesity

Interventions

1. Other: Lifestyle intervention

MeSH:Pediatric Obesity Overwei Overweight Chronic Disease

Investigators propose to use a natural experiment design to examine the impacts of the new CPT code (99490) for chronic care management on health outcomes. The Investigators will collaborate with partners in the Louisiana Clinical Data Research Network (LaCDRN) who serve more than 90,000 patients with type 2 diabetes mellitus in Louisiana to examine impacts of the CMS reimbursed care coordination. Now, LaCDRN is renamed as Research Action for Health Network (REACHnet). Patient and stakeholder engagement will be planned and implemented across all phases of this natural experiment. This project will examine outcome differences created by the policy change in a natural experiment framework. The analyses will utilize the RE-AIM framework to identify the critical elements of the programs that will enhance the reach, effectiveness, adoption, implementation, and maintenance of these strategies in the diverse LaCDRN diabetes populations. PCORI Proposal COVID-19- Related Enhancement for Existing Research: The proposed enhancement will contribute timely information to address two important implications of the coronavirus pandemic: 1. Disparities in continuity of care and 2. Health systems' responsiveness in terms of telehealth delivery for high risk populations. The enhancement builds upon our current project by further examining effects of CMS payment innovations to expand remotely delivered care. Our proposed study is a rapid assessment of telehealth services, using an existing "learning health system" infrastructure to provide timely, actionable evidence to inform telehealth service provision during the pandemic and recovery.

NCT03136471

Conditions

1. Diabetes Mellitus, Type 2
2. Chronic Disease

MeSH:Diabetes Mellitus, Type 2 Chronic Disease

HPO:Type II diabetes mellitus

The study will enroll 600 people with serious mental illness who receive services at Centerstone in KY or TN and will compare two different evidence-based self-management interventions: Integrated Illness Management and Recovery (I-IMR), a program developed by the study team at Dartmouth that trains people with serious mental illness on physical and mental health self-management, and the Stanford Chronic Disease Self-Management Program (CDSMP), a program largely focused on physical health self-management that has been used widely in the general population. In addition, PCORI is funding an evaluation of a COVID-related intervention that will begin in the Fall 2020.

NCT03966872

Conditions

1. Mental Illness
2. Chronic Disease

Interventions

1. Behavioral: Integrated Illness Management and Recovery
2. Behavioral: Chronic Disease Self-Management Program

MeSH:Chronic Disease Mental Disorders

In this trial, the investigators will examine whether text messages sent to Veterans will help support in meeting nutrition or physical activity health goals. All participants will get text messages over two month to support their goal.

NCT04021472

Conditions

1. Chronic Disease Prevention

Interventions

1. Behavioral: Text message

MeSH:Chronic Disease

Chronic kidney disease (CKD) is a serious and growing public health problem. The purpose of this study is to find out if an educational worksheet, called the Encounter Decision Intervention (EDI), combined with health coaching helps CKD patients improve their blood pressure and other health outcomes. The research team hypothesizes that the intervention group will have greater improvement in CKD outcomes than the control group.

NCT04087798

Conditions

1. Chronic Kidney Diseases
2. Chronic Disease
3. Chronic Kidney Disease, Stage 3 (Moderate)
4. Chronic Kidney Disease, Stage 4 (Severe)
5. Chronic Kidney Disease Stage 5

Interventions

1. Behavioral: Control-EDI
2. Behavioral: Intervention-EDI and health coaching

MeSH:Kidney Diseases Renal Insufficiency, Chronic Hypertension Chronic Disease

HPO:Abnormality of the kidney Chronic kidney disease Hypertension Nephropathy

The objective of this protocol is to test the effectiveness of a Jumpstart intervention on patient-centered outcomes for patients with chronic illness by ensuring that they receive care that is concordant with their goals over time, and across settings and providers. This study will examine the effect of the EHR-based intervention to improve quality of palliative care for patients over the age of 65 with chronic, life-limiting illness with a particular emphasis on Alzheimer's disease and related dementias (ADRD). The specific aims are: 1) to evaluate the effectiveness of a novel EHR-based (electronic health record) clinician Jumpstart guide, compared with usual care, for improving the quality of care; the primary outcome is documentation of a goals-of-care discussion during the hospitalization. Secondary outcomes focus on intensity of care: ICU use, ICU and hospital length of stay, costs of care during the hospitalization, and 30-day hospital readmissions; and 2) to conduct a mixed-methods evaluation of the implementation of the Jumpstart intervention, guided by the RE-AIM and CFIR frameworks for implementation science, incorporating quantitative assessments of effectiveness, implementation and maintenance and qualitative assessments of clinician perspectives on barriers and facilitators to future implementation and dissemination.

NCT04281784

Conditions

1. Dementia
2. Chronic Disease
3. Neoplasm Metastasis
4. Lung Neoplasm
5. Pulmonary Disease, Chronic Obstructive
6. Heart Failure，Congestive
7. Liver Cirrhosis
8. Kidney Failure, Chronic
9. Lung Diseases, Interstitial
10. Peripheral Vascular Disease
11. Diabetes With End Organ Injury
12. Palliative Care, Patient Care
13. Health Care Quality, Access, and Evaluation
14. Patient Care
15. Inpatients
16. Health Communication
17. Patient Care Planning

Interventions

1. Behavioral: EHR-based Clinician Jumpstart

MeSH:Neoplasms Neoplasm Metastasis Lung Neoplasms Liver Cirrhosis Lung Diseases Pulmonary Disease, Chronic Obstructive Lung Diseases, Interstitial Renal Insufficiency Kidney Failure, Chronic Heart Failure Vascular Diseases Peripheral Vascular Diseases Peripheral Arterial Disease Chronic Disease

HPO:Abnormal left ventricular function Abnormal lung morphology Abnormal pulmonary Interstitial morphology Chronic pulmonary obstruction Cirrhosis Congestive heart failure Hepatic fibrosis Interstitial pneumonitis Neoplasm Neoplasm of the lung Peripheral arterial stenosis Renal insufficiency Right ventricular failure

A dynamic analytical tool is being implemented to monitor the health, psychosocial and economic impacts of the COVID-19 pandemic as the crisis unfolds. A longitudinal survey is distributed via a network of hospitals, provincial/national organizations and web platforms. The survey information can be linked to provincial health administrative data and metrics derived from social media activity based on artificial intelligence methods. Targeted questions are included for critical populations such as healthcare workers and people with chronic illnesses.

NCT04369690

Conditions

1. COVID-19
2. Chronic Disease
3. Psychiatric Disorder
4. Cardiovascular Diseases

MeSH:Cardiovascular Diseases Chronic Disease Mental Disorders Problem Behavior

HPO:Abnormality of the cardiovascular system Behavioral abnormality

The containment associated with the VIDOC-19 pandemic creates an unprecedented societal situation of physical and social isolation. Our hypothesis is that in patients with chronic diseases, confinement leads to changes in health behaviours, adherence to pharmacological treatment, lifestyle rules and increased psychosocial stress with an increased risk of deterioration in their health status in the short, medium and long term. Some messages about the additional risk/danger associated with taking certain drugs in the event of COVID disease have been widely disseminated in the media since March 17, 2020, the date on which containment began in France. This is the case, for example, for corticosteroids, non-steroidal anti-inflammatory drugs but also for converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor antagonists (ARBs2). These four major classes of drugs are widely prescribed in patients with chronic diseases, diseases specifically selected in our study (corticosteroids: haematological malignancies, multiple sclerosis, Horton's disease; ACE inhibitors/ARAs2: heart failure, chronic coronary artery disease). Aspirin used at low doses as an anti-platelet agent in coronary patients as a secondary prophylaxis after a myocardial infarction can be stopped by some patients who consider aspirin to be a non-steroidal anti-inflammatory drug. Discontinuation of this antiplatelet agent, which must be taken for life after an infarction, exposes the patient to a major risk of a new cardiovascular event. The current difficulty of access to care due to travel restrictions (a theoretical limit in the context of French confinement but a priori very real), the impossibility of consulting overloaded doctors, or the cancellation of medical appointments, medical and surgical procedures due to the reorganization of our hospital and private health system to better manage COVID-19 patients also increases the risk of worsening the health status of chronic patients who by definition require regular medical monitoring. Eight Burgundian cohorts of patients with chronic diseases (chronic coronary artery disease, heart failure, multiple sclerosis, Horton's disease, AMD, haemopathic malignancy, chronic respiratory failure (idiopathic fibrosis, PAH) haemophilia cohort) will study the health impact of the containment related to the COVID-19 pandemic.

NCT04390126

Conditions

1. Chronic Coronary Syndrome
2. Heart Failure
3. AMD and Macular Edema
4. Chronic Respiratory Failure
5. Hemophilia
6. Malignant Hemopathy
7. Multiple Sclerosis
8. Horton's Disease

Interventions

1. Other: life questionnaires
2. Other: questionnaire

MeSH:Polymyalgia Rheumatica Respiratory Insufficiency Multiple Sclerosis Giant Cell Arteritis Macular Edema Chronic Disease

HPO:Cystoid macular edema Macular edema

Chronic illness (CI) presents a significant and negative effect on quality of life and mental health. Further, emotion regulation has been considered of particular importance on the determination of chronic patients' well-being. Evidence suggests that Acceptance and Commitment Therapy (ACT) is an effective approach to improve psychological health in patients with CI. Further, there is some, although limited, evidence, that self-compassion training may be also useful in this context, and the inclusion of self-compassion elements in ACT interventions has even been the focus of attention by recent studies. Nevertheless, no study yet has compared the efficacy of these two types of intervention in CI. This is the aim of the present project - to analyse, in a low intensity eHealth intervention context, whether ACT or Compassion Focused Therapy (CFT) present superiority over the other in improving mental health and illness-related outcomes in CI.

NCT04408651

Conditions

1. Chronic Medical Conditions

Interventions

1. Behavioral: LIIT.CI ACT
2. Behavioral: LIIT.CI CFT

MeSH:Chronic Disease

In Barbados, levels of hypertension are high (40.7%) and cause of a high proportion of deaths due to cardiovascular diseases. In this study, the Stanford University-led Chronic Disease Self-Management Program (CDSMP) will be modified to form one of the basic components of a three-pronged intervention to improve blood pressure control. Our overall goal is to evaluate the effectiveness of a hypertension self-management program in community-based settings. With the advent of the Coronavirus disease 2019 (COVID-19) we recognize that it may be necessary to adapt the programme to accommodate virtual delivery. Our specific aims are to: 1. Adapt the Stanford (CDSMP) to ensure cultural appropriateness to Barbados. In view of the need to adhere to physical distance guidelines in the era of COVID-19 disease, modifications will be made to enhance virtual delivery while maintaining programme fidelity. We will engage stakeholders in performing modifications related to content, context and mode of delivery of the CDSMP program with the goal of ensuring cultural appropriateness. 2. Determine the clinical effectiveness of CDSMP combined with medication enhancement tools. We will conduct a cluster randomized trial in twelve faith-based organizations(FBOs) in Barbados. We are primarily interested in studying the changes in systolic blood pressure. Secondarily, we will also assess change in weight, medication adherence, dietary behavior and physical activity. 3. Understand the barriers and facilitators to implementation and sustainability of CDSMP plus self-monitoring tools in faith-based organizations. We will assess cost and sustainability of the intervention and qualitatively assess factors associated with barriers and facilitators of implementation in FBOs in Barbados. Impact and novelty: We aim to increase the proportion of patients with controlled hypertension leading to reduced illness and deaths from strokes and heart attacks in particular. Few studies have looked at a blended approach to CDSMP delivery and these will become more necessary in the era of COVID-19. Findings on the factors impacting implementation will be transferable to small island developing states and other predominantly black populations.

NCT04437966

Conditions

1. Hypertension

Interventions

1. Behavioral: Enhanced Chronic Disease Self-management program

MeSH:Hypertension Chronic Disease

HPO:Hypertension

As of May 30th more than 23,000 cases of COVID -19 cases were confirmed in Egypt with total deaths of 913. Post viral entry, intense immune response against the virus with infiltration of monocytes and macrophages into alveolar cells with decreasing number of lymphocytes in peripheral blood along with reduced lymphocytes in lymphoid organs, hypercoagulability, thrombosis and multiple organ damage, The gut microbiota and immune homeostasis seem to have a back and forth relationship. Also, gut microbiota derived signals are known to tune the immune cells for pro and anti-inflammatory responses thereby affecting the susceptibility to various diseases. Healthy gut microbiome essentially could be pivotal in maintaining an optimal immune system to prevent an array of excessive immune reactions that eventually become detrimental to lungs and vital organ systems. Numerous studies have shown that the patient's nutritional status have a significant effect on an individual's immunity and over all health status and it has been suggested that nutritional deficiencies may predispose to severe forms of COVID-19 infections. Co-existing non-communicable chronic diseases (NCDs) in COVID-19 patients have been found to delay patients recovery and worsen their prognosis, the reason may be due to aggravated inflammatory pathology found in NCDs exacerbating COVID-19 infection. The aim of the study is to evaluate the role dietary habits among COVID-19 Egyptian patients and whether type of diet (Mediterranean or Western) will affect disease outcomes

NCT04447144

Conditions

1. Covid19
2. Chronic Inflammation
3. Non-Communicable Chronic Diseases

MeSH:Inflammation Chronic Disease Noncommunicable Diseases

Data show that the coronavirus disease 2019 (COVID-19) symptoms can be severe in 4% and 3% of the adolescents aged 11-15 years and ≥ 16 years, respectively. In addition, the prevalence of chronic diseases among adolescents has increased in the last years. About 20% of the adolescents have some chronic disease, resulting in increased morbidity and mortality. In march, 2020, the quarantine was officially implemented in Sao Paulo, while elective medical appointments for adolescents with chronic disease were temporarily suspended. To mitigate the deleterious effect of the social isolation on physical and mental health among these patients, this study aims to test the effects of an online, home-based, exercise training program.

NCT04458246

Conditions

1. Chronic Disease
2. Chronic Diseases in Adolescence
3. Chronic Disease of Immune System
4. Chronic Kidney Diseases

Interventions

1. Other: Exercise training group

MeSH:Kidney Diseases Renal Insufficiency, Chronic Immune System Diseases Chronic Disease

HPO:Abnormality of the kidney Chronic kidney disease Nephropathy

The principal objective of the study is to determine if patient-empowered, real-time and home- based patient monitoring of vital parameters can lead to: - Reduction in admission rates and improved clinical management of chronically ill patients - Reduction in use of medications - Reported quality of life A minimum of 100 patients will be recruited, monitored and observed over 6 months from home with the Coala Heart Monitor. The study population will be representative of rural, high-risk, Medicare (65+ of age) subjects with chronic conditions and will be recruited by the Perry Community Hospital in Linden, TN.

NCT04483154

Conditions

1. COPD
2. Arrhythmia
3. Murmur, Heart
4. Chronic Disease

Interventions

1. Device: Coala Heart Monitor

MeSH:Chronic Disease Heart Murmurs

HPO:Heart murmur

The purpose of this study is to ensure effective health management among community-living older adults during unprecedented times, such as the current COVID-19 pandemic.

NCT04492527

Conditions

1. Chronic Disease
2. Aging
3. Aging Problems
4. Health Behavior
5. Multiple Chronic Conditions
6. Chronic Illness
7. Chronic Illnesses, Multiple
8. Healthy Lifestyle
9. Healthy Aging
10. Aging Well
11. Healthy Life Style
12. Self-management
13. Self Care

Interventions

1. Behavioral: Telehealth coaching sessions

MeSH:Chronic Disease Multiple Chronic Conditions

The sustainability of the United Kingdom's National Health Service's (NHS) is threatened immediately by Covid-19 and continually by an increasing prevalence of long-conditions that cannot be cured but can be maintained. Shifting traditional face-to-face outpatient appointments to remote video consultations may help the NHS continue to serve patients efficiently. While much research has examined healthcare providers' attitudes and beliefs about remote video consultations, less has attempted to understand how NHS service providers should invite patients to attend them. The present study examines how the framing of an invitation to attend a hospital outpatient appointment by video influences the proportion of people who agree to attend by video. It also explores some of the barriers and facilitators people may experience to attending appointments by video across diagnostic complexities and age groups. The results of this study should help hospitals better present patients with the option to attend video consultations where appropriate, and provide support to mitigate common barriers to people's willingness to give video consultations a go.

NCT04536259

Conditions

1. Hospital Outpatient Cli
2. Hospital Outpatient Clinics
3. Chronic Disease

Interventions

1. Behavioral: Video Default
2. Behavioral: In-Person Default
3. Behavioral: Active Choice

MeSH:Chronic Disease