Long COVID Optimal Health Programme (LC-OHP) to enhance psychological and physical health: a feasibility randomised ... protocol, 2022, Al-Jabr et al

Andy

Andy

Retired committee member
ABSTRACT

Background:

Long COVID is a collection of symptoms that develop during or following a confirmed or suspected case of COVID-19, that continue for more than 12 weeks. Despite the negative impact of long COVID on people’s lives and functioning, there is no validated treatment or even rehabilitation guidance. What has been recommended thus far, is adoption of holistic management approaches. The Optimal Health Programme (OHP) is a brief 5-session, plus booster, psychosocial programme designed to support mental and physical wellbeing that has been used effectively for a range of chronic conditions.

Objective:

This study examines the feasibility and acceptability of employing a specially customised version of OHP (long COVID OHP or LC-OHP) to improve psychological and physical health of people with long COVID.

Methods:

This is a feasibility randomised controlled trial. Eligible participants aged 18 years or older who are experiencing symptoms of long COVID will be identified through their secondary practitioners with recruitment to be undertaken by the research team. Sixty participants will be randomised into a control (usual care) or an intervention (LC-OHP) group. Outcomes will be feasibility and acceptability of the programme (primary); and efficacy of the LC-OHP in improving anxiety, depression, fatigue, self-efficacy and quality of life (secondary). Up to 20 participants will be interviewed at the end of the trial to explore their experience with the programme. Quantitative data will be analysed using SPSS and differences between groups will be compared using inferential tests where appropriate. Qualitative data will be transcribed and thematically analysed to identify common emerging themes.

Results:

This is an ongoing study which began in November 2021. The study received approval from the University of Suffolk Ethics committee (RETH21/004) and from the NHS Health Research Authority (IRAS no. 304234).

Conclusions:

Long COVID has a significant impact on an individual’s mental and physical functioning. The LC-OHP offers a holistic approach that can aid people through recovery and improve self-efficacy. This would ultimately contribute to reducing the unprecedented and unsustainable demand on healthcare services including mental health seen during the pandemic. Clinical Trial: Trial registration number ISRCTN38746119.

Open access, https://preprints.jmir.org/preprint/36673/accepted
 
Hiyam Al-Jabr 1
Karen Windle 1
David R Thompson 2
Zoe Jenkins 3
David J Castle 4
Chantal Ski 1

1 Integrated Care Academy University of Suffolk Ipswich GB
2 School of Nursing and Midwifery Queen’s University Belfast Belfast GB
3 Mental Health Service St Vincent's Hospital Melbourne AU
4 Department of Psychiatry University of Toronto Toronto CA

Note the Australian and Canadian connections.

A feasibility, randomised controlled trial (RCT) to be conducted from November 2021 to October 2022 by investigators from the University of Suffolk. Potential participants will be identified from a long COVID clinic located within a hospital setting.
Click to expand...
Potential for selection bias, 'standard care' control, no objective outcomes. So, a waste of time as usual.
They could have had a control where patients have some chats on zoom with others with Long Covid and a facilitator; they could have incorporated activity monitoring.


The OHP is a person-centred model that focuses on health as defined by patients.
Click to expand...
By enhancing self- efficacy and self-management skills, the programme works on shifting the focus of an individual’s illness from being “dependent on services” to being “supported by services” [79], which is thus anticipated to reduce pressure and financial demands on healthcare systems.
Click to expand...

It's quite muddy in its objectives, talking about recovery and reduced fatigue, but sort of being happy with just keeping people away from health care services.


Table 2 Long COVID OHP programme sessions

Session Title
  1. 1 Optimal health

  2. 2 I-Can-Do-Model

  3. 3 Factors of wellbeing

  4. 4 Visioning and goal setting

  5. 5 Building Health Plans
Booster Reflecting on the learning in the transformational journey to sustain well being
Click to expand...
 
Ha, it seems people with Long Covid are regarded as too befuddled to contribute to the study design.

Patient and public involvement

The OHP was tailored to long COVID with input from the long COVID clinic clinicians (two occupational therapists). In addition, guidance was provided on the mode and timing of questionnaire administration with changes made to processes of administration to ensure participants will be prepared and supported.

Mindful that the most common symptom of long COVID is fatigue and brain fog, and along with the overall focus of this study (i.e., assessing the feasibility and acceptability of LC-OHP), patients with long COVID were not involved in refining the OHP at this stage. However, feedback from patients who used this programme in previous studies has been implemented to make the programme more succinct, colourful, and visual.

Additionally, the delivery of the LC- OHP sessions will be arranged at patients’ convenience, in terms of time and mode of delivery. Moreover, the views of patient participants who receive the programme sessions will be collected by interviewing the pilot participants and the intervention participants at the end of the trial, to further implement and adapt the programme to people with long COVID. Finally, members of the public will form part of the trial DMC to monitor the progress of the study and contribute to the dissemination of its findings.​
 
Stand by for a bigger more expensive trial:
This feasibility trial uses a mixed methods design to assess procedural and methodological data in preparation for a fully powered large-scale trial.
Click to expand...

These are the organisations that funded the study - clearly they need some advice on trial design.
Acknowledgments
This work is funded by the Mental Health Alliance (East Suffolk, West Suffolk and North East Essex) Board, grant number SIV02/0000555 and is sponsored by the University of Suffolk.
Click to expand...
 
By enhancing self- efficacy and self-management skills, the programme works on shifting the focus of an individual’s illness from being “dependent on services” to being “supported by services” [79], which is thus anticipated to reduce pressure and financial demands on healthcare systems.
Click to expand...

A classic penny-wise pound-stupid approach. All they are doing is showing that they are unwilling to properly treat such patients so they will be disgusted at the lack of progress and stop showing up. This will lead to short term disability not improving and thus translating into very high long-term disability costs.

The fact that they've failed to bother to ask the patients themselves, nor doctors with decades of expertise dealing with post-viral condition shows the true intent of this study - it isn't to help patients.
 
There is something fundamentally broken with a system that allows physical illnesses (including ones not yet proven otherwise) to be researched purely by psychs, especially when they employ trial methodologies which pose risks to participants' physical health due to the investigators' blinkered incompetence. They seem driven primarily to prove themselves right, rather than any great desire to get to discover truths. Seems rotten to the core.
 
You must log in or register to reply here.
Back
Top Bottom