Personalised health education against health damage of COVID-19 epidemic in the elderly Hungarian population (PROACTIVE-19): protocol of an adaptive randomised controlled clinical trial

Erőss, Bálint and Molnár, Zsolt and Szakács, Zsolt and Zádori, Noémi and Szakó, Lajos and Váncsa, Szilárd and Juhász, Márk Félix and Ocskay, Klementina and Vörhendi, Nóra and Márta, Katalin and Szentesi, Andrea and Párniczky, Andrea and Hegyi, Péter J. and Kiss, Szabolcs and Földi, Mária and Dembrovszky, Fanni and Kanjo, Anna and Pázmány, Piroska and Varró, András and Csathó, Árpád and Helyes, Zsuzsanna and Péterfi, Zoltán and Czopf, László and Kiss, István and Zemplényi, Antal and Czapári, Dóra and Hegyi, Eszter and Dobszai, Dalma and Miklós, Emőke and Márta, Attila and Tóth, Dominika and Farkas, Richárd and Farkas, Nelli and Birkás, Béla and Pintér, Erika and Pethő, Gábor and Zsigmond, Borbála and Sárközi, Andrea and Nagy, Anikó and Hegyi, Péter (2020) Personalised health education against health damage of COVID-19 epidemic in the elderly Hungarian population (PROACTIVE-19): protocol of an adaptive randomised controlled clinical trial. TRIALS, 21. pp. 1-9. ISSN 1745-6215

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Abstract

Early reports indicate that COVID-19 may require intensive care unit (ICU) admission in 5-26% and overall mortality can rise to 11% of the recognised cases, particularly affecting the elderly. There is a lack of evidence-based targeted pharmacological therapy for its prevention and treatment. We aim to compare the effects of a World Health Organization recommendation-based education and a personalised complex preventive lifestyle intervention package (based on the same WHO recommendation) on the outcomes of the COVID-19.PROACTIVE-19 is a pragmatic, randomised controlled clinical trial with adaptive "sample size re-estimation" design. Hungarian population over the age of 60 years without confirmed COVID-19 will be approached to participate in a telephone health assessment and lifestyle counselling voluntarily. Volunteers will be randomised into two groups: (A) general health education and (B) personalised health education. Participants will go through questioning and recommendation in 5 fields: (1) mental health, (2) smoking habits, (3) physical activity, (4) dietary habits, and (5) alcohol consumption. Both groups A and B will receive the same line of questioning to assess habits concerning these topics. Assessment will be done weekly during the first month, every second week in the second month, then monthly. The composite primary endpoint will include the rate of ICU admission, hospital admission (longer than 48 h), and mortality in COVID-19-positive cases. The estimated sample size is 3788 subjects per study arm. The planned duration of the follow-up is a minimum of 1 year.These interventions may boost the body's cardiovascular and pulmonary reserve capacities, leading to improved resistance against the damage caused by COVID-19. Consequently, lifestyle changes can reduce the incidence of life-threatening conditions and attenuate the detrimental effects of the pandemic seriously affecting the older population.The study has been approved by the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (IV/2428- 2 /2020/EKU) and has been registered at clinicaltrials.gov ( NCT04321928 ) on 25 March 2020.

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