NCT03248518

Brief Summary

Fatigue is common and disabling for most patients with inflammatory rheumatic disease. Therapies designed to improve physical activity and 'talking' treatments, which positively help patients change the way they think and behave, are both helpful in reducing the burden of the fatigue. However, few patients have access to these treatments in most health services. This situation results from the absence of standardised programmes and limited availability of relevant therapists. The investigators aim to enhance access to fatigue alleviating physical activity and talking therapies by testing innovative,standardised and cost-effective approaches to treatment delivery. The investigators will also use this opportunity to understand how to select the best treatment for a patient based on their individual profile and to better understand how these treatments actually work. This in turn may lead to more refined and effective therapies in the future.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
368

participants targeted

Target at P75+ for not_applicable rheumatoid-arthritis

Timeline
Completed

Started Sep 2017

Typical duration for not_applicable rheumatoid-arthritis

Geographic Reach
1 country

6 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 15, 2017

Completed
6 months until next milestone

First Posted

Study publicly available on registry

August 14, 2017

Completed
22 days until next milestone

Study Start

First participant enrolled

September 5, 2017

Completed
3.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 2, 2020

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 2, 2020

Completed
Last Updated

September 16, 2021

Status Verified

September 1, 2021

Enrollment Period

3.2 years

First QC Date

February 15, 2017

Last Update Submit

September 7, 2021

Conditions

Keywords

Inflammatory Rheumatic DiseaseFatigueExerciseBehavioural InterventionRheumatoid ArthritisSystemic Lupus ErythematosusAxial Spondyloarthritis

Outcome Measures

Primary Outcomes (6)

  • Fatigue (severity) using Chalder Fatigue Scale (Likert)

    Chalder Fatigue Scale (Likert), assessed at 56 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC with main estimate of treatment effect at 56 weeks after randomisation, Main estimate of treatment effect at 56 weeks

    56 weeks

  • Fatigue (severity) using Chalder Fatigue Scale (Likert)

    Chalder Fatigue Scale (Likert), assessed at 10 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC

    10 weeks

  • Fatigue (severity) using Chalder Fatigue Scale (Likert)

    Chalder Fatigue Scale (Likert), assessed at 28 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC

    28 weeks

  • Fatigue (impact) using Fatigue Severity Scale

    Fatigue Severity Scale, co-primary outcome assessed at 56 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC with main estimate of treatment effect at 56 weeks

    56 weeks

  • Fatigue (impact) using Fatigue Severity Scale

    Fatigue Severity Scale, co-primary outcome assessed at 10 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC

    10 weeks

  • Fatigue (impact) using Fatigue Severity Scale

    Fatigue Severity Scale, co-primary outcome assessed at 28 weeks after baseline, between-group change CBA+UC vs UC and PEP+UC vs UC

    28 weeks

Secondary Outcomes (7)

  • Fatigue (physical, living, cognition and emotional aspects) using Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire

    0, 10 weeks, 28 weeks, 56 weeks after randomisation

  • Quality of life & health utility index

    0, 10 weeks, 28 weeks, 56 weeks after randomisation

  • Pain using numerical rating scale

    0, 10 weeks, 28 weeks, 56 weeks after randomisation

  • Anxiety and depression using Hospital anxiety and depression scale

    0, 10 weeks, 28 weeks, 56 weeks after randomisation

  • Impact on work using Work Productivity and Activity Impairment Questionnaire

    0, 10 weeks, 28 weeks, 56 weeks after randomisation

  • +2 more secondary outcomes

Study Arms (3)

Usual Care alone

ACTIVE COMPARATOR

Participants receive written information about fatigue which is designed as self-management guide.

Behavioral: Usual Care

CBA + usual care

ACTIVE COMPARATOR

In addition to usual care, participants receive a talking therapy using a cognitive behavioural approach. The talking therapy will be delivered via telephone by a trained rheumatology health care professional who will contact the participant for 8 sessions over a period of 6 months.

Behavioral: Usual CareBehavioral: Cognitive behavioural approach

PEP + usual care

ACTIVE COMPARATOR

In addition to usual care, participants receive a personalised exercise programme. After an initial face-to-face assessment, the remaining programme will be delivered via telephone by a trained rheumatology health care professional who will contact the participant for 7 sessions over a period of 6 months.

Behavioral: Usual CareBehavioral: Personalised Exercise Programme

Interventions

Usual CareBEHAVIORAL

Information booklet on fatigue which represents usual care in almost all UK rheumatology centres

CBA + usual carePEP + usual careUsual Care alone

A talking therapy which explicitly aims to replace unhelpful beliefs and behaviours through the application of patient-centred strategies and behavioural activities

Also known as: CBA
CBA + usual care

PEP is a graded exposure behaviour therapy which aims to gradually optimise patients levels of physical activity with view to modifying their altered perception of effort and ultimately reduce the severity and impact of fatigue.

Also known as: PEP
PEP + usual care

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • be ≥ 18 years at the time of consent
  • have been diagnosed with rheumatoid arthritis (RA), systemic lupus erythematous (SLE), axial spondyloarthritis (AxSpA) or psoriatic arthritis (PSA) by a rheumatologist
  • report fatigue to be a persistent problem
  • have access to a telephone landline or mobile telephone and/or internet based audio/video calls
  • give permission for researchers to access their hospital medical notes
  • currently be under the care of a secondary care physician
  • have stable disease as evidenced by no change in immunomodulatory therapy within the last three months based on the hospital medical record

You may not qualify if:

  • there are significant abnormalities of thyroid function (TSH levels) on the most recent blood test done within the last three months
  • there is evidence of severe anaemia (haemoglobin levels) on the most recent blood test done within the last three months
  • there is evidence of severe renal dysfunction (eGFR) on the most recent blood test done within the last three months
  • they have a medical condition which would make the proposed interventions unsuitable, e.g. significant heart disease
  • they are pregnant
  • they are unable to understand English sufficiently to take part in the intervention
  • they are unable to provide written informed consent
  • they are not willing to be randomised
  • they are currently participating in an interventional clinical trial

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (6)

NHS Grampian

Aberdeen, United Kingdom

Location

NHS Tayside

Dundee, United Kingdom

Location

NHS Lothian

Edinburgh, United Kingdom

Location

NHS Greater Glasgow and Clyde

Glasgow, United Kingdom

Location

Newcastle upon Tyne Hospitals NHS Foundation Trust

Newcastle upon Tyne, NE7 7DN, United Kingdom

Location

Midlands Partnership NHS Foundation Trust

Stoke-on-Trent, ST6 7AG, United Kingdom

Location

Related Publications (3)

  • Gray SR, Montoye AHK, Vondrasek JD, Neph S, Siebert S, Paul L, Bachmair EM, Basu N. Associations of physical activity levels with fatigue in people with inflammatory rheumatic diseases in the LIFT trial. Rheumatol Adv Pract. 2024 Aug 24;8(3):rkae106. doi: 10.1093/rap/rkae106. eCollection 2024.

  • Bachmair EM, Martin K, Aucott L, Dhaun N, Dures E, Emsley R, Gray SR, Kidd E, Kumar V, Lovell K, MacLennan G, McNamee P, Norrie J, Paul L, Packham J, Ralston SH, Siebert S, Wearden A, Macfarlane G, Basu N; LIFT study group. Remotely delivered cognitive behavioural and personalised exercise interventions for fatigue severity and impact in inflammatory rheumatic diseases (LIFT): a multicentre, randomised, controlled, open-label, parallel-group trial. Lancet Rheumatol. 2022 Jun 27;4(8):e534-e545. doi: 10.1016/S2665-9913(22)00156-4. eCollection 2022 Aug.

  • Martin KR, Bachmair EM, Aucott L, Dures E, Emsley R, Gray SR, Hewlett S, Kumar V, Lovell K, Macfarlane GJ, MacLennan G, McNamee P, Norrie J, Paul L, Ralston S, Siebert S, Wearden A, White PD, Basu N. Protocol for a multicentre randomised controlled parallel-group trial to compare the effectiveness of remotely delivered cognitive-behavioural and graded exercise interventions with usual care alone to lessen the impact of fatigue in inflammatory rheumatic diseases (LIFT). BMJ Open. 2019 Jan 30;9(1):e026793. doi: 10.1136/bmjopen-2018-026793.

Related Links

MeSH Terms

Conditions

Arthritis, RheumatoidLupus Erythematosus, SystemicAxial SpondyloarthritisArthritis, PsoriaticSjogren's SyndromeFatigueMotor Activity

Condition Hierarchy (Ancestors)

ArthritisJoint DiseasesMusculoskeletal DiseasesRheumatic DiseasesConnective Tissue DiseasesSkin and Connective Tissue DiseasesAutoimmune DiseasesImmune System DiseasesSpondylarthropathiesSpondylarthritisSpondylitisSpinal DiseasesBone DiseasesAnkylosisPsoriasisSkin Diseases, PapulosquamousSkin DiseasesXerostomiaSalivary Gland DiseasesMouth DiseasesStomatognathic DiseasesDry Eye SyndromesLacrimal Apparatus DiseasesEye DiseasesSigns and SymptomsPathological Conditions, Signs and SymptomsBehavior

Study Officials

  • Gary Macfarlane, PhD

    University of Aberdeen

    PRINCIPAL INVESTIGATOR
  • Neil Basu, MBChB, PhD

    University of Glasgow

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 15, 2017

First Posted

August 14, 2017

Study Start

September 5, 2017

Primary Completion

November 2, 2020

Study Completion

November 2, 2020

Last Updated

September 16, 2021

Record last verified: 2021-09

Data Sharing

IPD Sharing
Will not share

Locations