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Trial registered on ANZCTR
Registration number
ACTRN12623001053617p
Ethics application status
Submitted, not yet approved
Date submitted
15/08/2023
Date registered
29/09/2023
Date last updated
29/09/2023
Date data sharing statement initially provided
29/09/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
An Educational tool targeting the symptoms of constipation among people prescribed Clozapine.
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Scientific title
Addressing the prevalence and severity of clozapine-induced constipation in adults with schizophrenia or schizoaffective disorder using a nurse-delivered education session: A randomised controlled trial
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Secondary ID [1]
310365
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None
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Universal Trial Number (UTN)
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Trial acronym
CONSTIP
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Constipation
331104
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Condition category
Condition code
Diet and Nutrition
327889
327889
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0
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Other diet and nutrition disorders
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Oral and Gastrointestinal
328190
328190
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Mental Health
328191
328191
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0
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Schizophrenia
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Public Health
328192
328192
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0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention will consist of a one hour educational session with a registered nurse, and a brochure to take home. The educational material will incorporate definitions of constipation, risk factors, signs and symptoms, and non-pharmacological interventions. Pharmacological interventions will be noted, with a view to consult with their physician regarding medications. The educational intervention will be conducted via one-to-one sessions, alongside a routine appointment with the clozapine clinic. A PowerPoint presentation will be provided, with opportunity following to discuss the subject matter, and answer any questions. The brochure has been specifically been designed for this project. The non-pharmacological interventions consist of commencing or increasing cardiovascular activity via exercise, and increase in fluid intake, and increase in fibre intake, with suggested methods of doing so (foods with known high fibre content) and behavioural modifications - Making a routine to attempt passing stool, making an exercise routine.
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Intervention code [1]
326761
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Treatment: Other
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Comparator / control treatment
The control will consist of routine clinical care. This involves screening and assessment by the Clozapine coordinator (registered nurse) and a member of the psychiatry team every 3 months.
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Control group
Active
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Outcomes
Primary outcome [1]
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Using the Patient Assessment of Constipation Symptoms (PAC SYM) tool which measures constipation across a spectrum. The primary outcome is to measure possible changes in constipation prevalence across both groups.
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Assessment method [1]
335735
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Timepoint [1]
335735
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This occurs across a 3 month period. At the initial consultation, a base measurement will be taken. Then, the participant will record measurements at two week intervals for the total of 12 weeks.
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Secondary outcome [1]
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Secondary outcome would be that consumers prescribed clozapine have a change in their understanding of the signs, symptoms, cause, and treatment of constipation. This will be assessed as a composite outcome, measured with the PAC SYM tool.
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Assessment method [1]
425392
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Timepoint [1]
425392
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3 months. This occurs across a 3 month period. At the initial consultation, a base measurement will be taken. Then, the participant will record measurements at two week intervals for the total of 12 weeks.
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Eligibility
Key inclusion criteria
A diagnosis of schizophrenia or schizoaffective disorder, prescribed Clozapine.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
A formal diagnosis of an intellectual disability, or cognitive disorder, impacting ability to provide informed consent. Similarly, any consumer with an appointed decision maker.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised sequence generation
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
ABS Sample size calculator, with a confidence interval of 95%.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
23/10/2023
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Actual
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Date of last participant enrolment
Anticipated
4/03/2024
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Actual
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Date of last data collection
Anticipated
27/05/2024
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Actual
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Sample size
Target
66
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment postcode(s) [1]
41109
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2204 - Marrickville
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Recruitment postcode(s) [2]
41110
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2132 - Croydon
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Recruitment postcode(s) [3]
41111
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2193 - Canterbury
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Funding & Sponsors
Funding source category [1]
314800
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Government body
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Name [1]
314800
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Sydney Local Health District
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Address [1]
314800
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67 Misseden Road, Camperdown, NSW, 2050
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Country [1]
314800
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Australia
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Primary sponsor type
Hospital
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Name
Sydney Local Health District
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Address
67 Missenden Road, Camperdown, NSW, 2050
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
316846
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Address [1]
316846
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Country [1]
316846
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
313603
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Sydney Local Health District Ethics Review Committee (RPAH Zone)
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Ethics committee address [1]
313603
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Sydney Local Health DistrictAddress: Level 11, KGV Building Missenden Road CAMPERDOWN NSW 2050
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Ethics committee country [1]
313603
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Australia
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Date submitted for ethics approval [1]
313603
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24/08/2023
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Approval date [1]
313603
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Ethics approval number [1]
313603
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Summary
Brief summary
consumers prescribed Clozapine suffer from constipation; essentially double that of the general population. Clozapine consumers are 3 times more likely to develop constipation, compared to their contemporaries prescribed other antipsychotics. Ongoing questioning and screening by mental health professionals is strongly recommended, in order to detect and treat constipation in a timely manner. In my experience as a mental health case manager, and more recently as a Clozapine coordinator, the screening, detection, and management of clozapine induced constipation is severely lacking. Non-pharmacological interventions are considered the first and most important step in managing constipation. One hour of exercise, five days a week; increased fibre and fluid intake. These can be achieved with minimal support clinically, and financially. Clozapine clinics have been seen as a place to develop health agency and providing education during clinics, with a view to have the consumers engage in their own treatment interventions for constipation would be the goal. I would aim to incorporate the peer workforce and current consumers prescribed clozapine in the development of the education aspect. This RCT will consist of a control and intervention group. The control group will receive current health practices, which include 3 monthly screening and assessment for constipation by a registered nurse and /or physician. The intervention group will receive an hour of education, targeted at improving their knowledge and understanding of constipation, and given them lifestyle interventions to manage it. All participants will complete a 2 weekly constipation self-report measure called the PAC - SYM to collect data.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Mr Marc Lamond
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Address
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Marrickville Community Mental Health, 155 Livingstone Road, Marrickville, NSW. 2204
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Country
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Australia
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Phone
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+61 2 95620500
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Fax
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+61 2 95620501
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Email
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[email protected]
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Contact person for public queries
Name
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Marc Lamond
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Address
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Marrickville Community Mental Health, 155 Livingstone Road, Marrickville, NSW. 2204
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Country
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Australia
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Phone
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+61 2 95620500
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Fax
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+61 2 95620501
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Email
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[email protected]
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Contact person for scientific queries
Name
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Marc Lamond
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Address
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Marrickville Community Mental Health, 155 Livingstone Road, Marrickville, NSW. 2204
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Country
128720
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Australia
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Phone
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+61 2 95620500
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Fax
128720
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+61 2 95620501
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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