RecruitingNot ApplicableNCT05671718

Bring BPaL2Me Trial Comparing Nurse-Led RR-TB Treatment to Physician-Led RR-TB Treatment

Bring BPaL2Me Trial Comparing Nurse-Led RR-TB Treatment in Primary Care to Physician-Led, Hospital-Based Outpatient RR-TB Treatment: A Cluster Randomized, Non-Inferiority Trial


Sponsor

Johns Hopkins University

Enrollment

2,944 participants

Start Date

Sep 4, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of the BringBPaL2Me Trial, a multi-principal investigator, multi-site, cluster randomized, non-inferiority trial is to compare nurse-led RR-TB treatment in primary care clinics to standard of care physician-led RR-TB treatment at district hospitals in the provinces of KwaZulu-Natal, Gauteng, and Eastern Cape. The main aim is to conduct a 5-year, analyst and clinical safety review committee blinded, multi-site, cluster randomized trial to evaluate 1) treatment outcome; 2) safety; 3) patient associated catastrophic costs with the following hypotheses: 1. Outpatient nurse-led treatment in PCCs will be non-inferior to outpatient physician-led treatment at hospital-based outpatient sites among RR-TB patients, regardless of HIV co-infection, as determined by a successful treatment outcome \[H1\]. 2. The proportion of SAEs identified will not significantly differ by blinded, independent review \[H2\]. 3. Patient associated catastrophic costs (i.e., costs 20% or more of household income) will be lower in nurse-led treatment \[H3\].


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This trial compares nurse-led versus doctor-led treatment for rifampicin-resistant tuberculosis (RR-TB) using a newer, shorter drug regimen called BPaL, to see if nurses can safely and effectively manage this treatment closer to patients' communities. **You may be eligible if...** - You are 18 years or older - You have a new diagnosis of rifampicin-resistant TB - You are willing to provide consent in Zulu, Xhosa, Afrikaans, or English - You are being treated at a clinic in KwaZulu-Natal, Gauteng, or Eastern Cape, South Africa **You may NOT be eligible if...** - You need to be hospitalized at the start of treatment - Your hemoglobin is very low (below 8 g/dL, indicating significant anemia) - You have liver disease (elevated liver enzymes, ALT above 120) - You have a prolonged heart rhythm interval on ECG (QTc above 470 ms) - Your resting heart rate is above 140 beats per minute - You are pregnant - You have TB outside the lungs (extrapulmonary TB) - You are currently enrolled in another clinical trial Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

OTHERNurse-Led Treatment in Primary Care

At a primary care clinic intervention site, a nurse will be available once or twice weekly. The days/times will be dependent on clinic volume (i.e., cluster size), with scheduled rotations between PCCs. This rotation between PCC sites will mimic the physician's responsibilities/availability at a district hospital and creates parity between the trial arms. In this trial, we will have nurses dedicated to the management of RR-TB treatment, yet the volume at each site will not require the presence of a full-time nurse.


Locations(5)

Doris Goodwin Hospital

Pietermaritzburg, KwaZulu-Natal, South Africa

Murchison Hospital

Port Shepstone, KwaZulu-Natal, South Africa

King Dinuzulu TB Hospital

East London, South Africa

Nkquebela TB Hospital

East London, South Africa

Jose Pearson Hospital

Port Elizabeth, South Africa

View Full Details on ClinicalTrials.gov

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NCT05671718


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