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MultimorbidityNCT05985044

Living With Multimorbidity: CO-ORDINATE Program

A study testing Care cO-ORDInatioN And sympTom managEment (CO-ORDINATE) Intervention in people with Multimorbidity and Quality of Life, run by Johns Hopkins University at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Multimorbidity is common and is the coexistence of two or more chronic conditions in the same individual. People with multimorbidity suffer from a high symptom burden, directly affecting quality of life (QOL). Read more about this study

Who is it for?
Ages 55 years and older
What is being tested?
Care cO-ORDInatioN And sympTom managEment (CO-ORDINATE) Intervention
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
27 participants
Where
1 siteUnited States
Study dates
16 Nov 2022to 30 May 2024
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 55 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • English speakers who are planned for discharge from Johns Hopkins Hospital (JHH) IMCU
  • Who meet the criteria for being admitted to IMCU and planned discharge with multimorbidity as defined by two or more chronic conditions.

Who cannot join

  • Who can not provide informed consent or have documented cognitive impairment

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Johns Hopkins School of Nursing

    Baltimore, Maryland, 21205

Other trials in United States

About this study

Official title: Living With Multimorbidity: Symptom Management Across the Illness Trajectory

Multimorbidity is common and is the coexistence of two or more chronic conditions in the same individual. People with multimorbidity suffer from a high symptom burden, directly affecting quality of life (QOL). Hospitalization can be a window of opportunity to initiate interventions to promote recovery and resilience and enhance QOL. However, interventions targeting the symptom trajectory and burden of patients with multimorbidity are lacking. Thus, the investigators envisage a nurse-led pre-discharge intervention augmented by telephone support, focusing on care coordination and symptom management. This approach is anticipated to help reduce symptom burden and improve QOL.

Read the detailed description

Aim 1: Describe the symptom trajectory and burden from the perspectives of patients, family caregivers, and health professionals and collectively develop a symptom management toolkit; and

Aim 2: Refine and pilot test the nurse-driven symptom management toolkit/intervention to decrease the symptom burden and increase the QOL of critically ill adults with multimorbidity.

Interventional study (Aim 2):

The study aims to test the feasibility of the Care cOORDInatioN and sympTom managEment (COORDINATE) intervention developed from Aim 1 using an experienced-based co-design methodology. A single-arm feasibility study will be implemented with assumptions on the effectiveness of the COORDINATE intervention on outcomes such as symptom burden and quality of life will be evaluated.

Sample and Setting:

Individuals aged 55 years and older, living with two or more chronic health conditions, and willing to provide informed consent will be included in the study. The exclusion criteria include if participants cannot speak English or have a documented cognitive impairment that would prevent participation. Patients will be approached in the Intermediate Care Unit (IMCU) of an academic teaching hospital while the participants are in-patient before discharge.

Intervention Components and Timing:

The intervention consists of four components- i) needs assessment; ii) question prompt list; iii) goals discussion and; iv) symptom assessment and tracking. The intervention will start with the enrolment of a patient living with multimorbidity. The intervention consists of one in-person pre-discharge visit by the study team and four follow-up telephone calls (at 48 hours, 1 week, 4 weeks, and 6 weeks post-discharge).

Primary Outcomes

  1. Symptom Burden
  2. Quality of Life
Being tested
Care cO-ORDInatioN And sympTom managEment (CO-ORDINATE) Intervention

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Care cO-ORDInatioN And sympTom managEment (CO-ORDINATE) InterventionOther

    The intervention consists of the following four components: i) needs assessment; ii) question prompt list; iii) goals discussion and; iv) symptom assessment and tracking. The intervention will start with the enrolment of a patient living with multimorbidity. The intervention consists of one in-person pre-discharge visit by the study team and four follow-up telephone calls (at 48 hours, 1 week, 4 weeks, and 6 weeks post-discharge).

Study groups in NCT05985044
Study groupRoleWhat they receive
InterventionExperimentalA patient-centered Care cO-ORDInatioN And sympTom managEment (CO-ORDINATE) intervention
Receives: Other: Care cO-ORDInatioN And sympTom managEment (CO-ORDINATE) Intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Symptom Burden Assessed by Edmonton Symptom Assessment System (ESAS) Score - Pain

    The ESAS questionnaire is used to rate the intensity of common symptoms including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath; with ratings ranging from 0 (none, best) to 10 (worst).

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  2. Symptom Burden Assessed by Edmonton Symptom Assessment System (ESAS) Score - Tiredness

    The ESAS questionnaire is used to rate the intensity of common symptoms including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath; with ratings ranging from 0 (none, best) to 10 (worst).

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  3. Symptom Burden Assessed by Edmonton Symptom Assessment System (ESAS) Score - Drowsiness

    The ESAS questionnaire is used to rate the intensity of common symptoms including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath; with ratings ranging from 0 (none, best) to 10 (worst).

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  4. Symptom Burden Assessed by Edmonton Symptom Assessment System (ESAS) Score - Nausea

    The ESAS questionnaire is used to rate the intensity of common symptoms including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath; with ratings ranging from 0 (none, best) to 10 (worst).

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  5. Symptom Burden Assessed by Edmonton Symptom Assessment System (ESAS) Score - Lack of Appetite

    The ESAS questionnaire is used to rate the intensity of common symptoms including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath; with ratings ranging from 0 (none, best) to 10 (worst).

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  6. Symptom Burden Assessed by Edmonton Symptom Assessment System (ESAS) Score - Shortness of Breath

    The ESAS questionnaire is used to rate the intensity of common symptoms including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath; with ratings ranging from 0 (none, best) to 10 (worst).

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  7. Symptom Burden Assessed by Edmonton Symptom Assessment System (ESAS) Score - Depression

    The ESAS questionnaire is used to rate the intensity of common symptoms including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath; with ratings ranging from 0 (none, best) to 10 (worst).

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  8. Symptom Burden Assessed by Edmonton Symptom Assessment System (ESAS) Score - Anxiety

    The ESAS questionnaire is used to rate the intensity of common symptoms including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath; with ratings ranging from 0 (none, best) to 10 (worst).

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  9. Symptom Burden Assessed by Edmonton Symptom Assessment System (ESAS) Score - Well-being

    The ESAS questionnaire is used to rate the intensity of common symptoms including pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath; with ratings ranging from 0 (none, best) to 10 (worst).

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  10. Quality of Life Assessed by Short Form Survey (SF-36) Score - Physical Functioning

    Short Form Survey (SF-36) is a 36-item self-reported quality of life that covers 8 domains; score range 0 to 100. Higher score is better quality of life.

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  11. Quality of Life Assessed by Short Form Survey (SF-36) Score - Role Physical

    Short Form Survey (SF-36) is a 36-item self-reported quality of life that covers 8 domains; score range 0 to 100. Higher score is better quality of life.

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  12. Quality of Life Assessed by Short Form Survey (SF-36) Score - Role Emotional

    Short Form Survey (SF-36) is a 36-item self-reported quality of life that covers 8 domains; score range 0 to 100. Higher score is better quality of life.

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  13. Quality of Life Assessed by Short Form Survey (SF-36) Score - Vitality

    Short Form Survey (SF-36) is a 36-item self-reported quality of life that covers 8 domains; score range 0 to 100. Higher score is better quality of life.

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  14. Quality of Life Assessed by Short Form Survey (SF-36) Score - Mental Health

    Short Form Survey (SF-36) is a 36-item self-reported quality of life that covers 8 domains; score range 0 to 100. Higher score is better quality of life.

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  15. Quality of Life Assessed by Short Form Survey (SF-36) Score - Social Functioning

    Short Form Survey (SF-36) is a 36-item self-reported quality of life that covers 8 domains; score range 0 to 100. Higher score is better quality of life.

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  16. Quality of Life Assessed by Short Form Survey (SF-36) Score - Bodily Pain

    Short Form Survey (SF-36) is a 36-item self-reported quality of life that covers 8 domains; score range 0 to 100. Higher score is better quality of life.

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

  17. Quality of Life Assessed by Short Form Survey (SF-36) Score - General Health

    Short Form Survey (SF-36) is a 36-item self-reported quality of life that covers 8 domains; score range 0 to 100. Higher score is better quality of life.

    Measured: Baseline, 6-weeks post intervention, 3 months post intervention

Secondary outcomes (4)
  1. Health-care Utilization - Total Healthcare Utilization

    Health-care utilization data will be retrieved from electronic medical records. The study team is defining healthcare utilization by identifying no. of total healthcare utilization, hospitalizations, emergency visits, and critical care admissions. Higher the numbers higher the healthcare utilization.

    Measured: 3 months before and after entering the program

  2. Health-care Utilization - Emergency Department (ED) Visit s

    Health-care utilization data will be retrieved from electronic medical records. The study team is defining healthcare utilization by identifying no. of total healthcare utilization, hospitalizations, emergency visits, and critical care admissions. Higher the numbers higher the healthcare utilization.

    Measured: 3 months before and after entering the program

  3. Health-care Utilization - Hospitalization

    Health-care utilization data will be retrieved from electronic medical records. The study team is defining healthcare utilization by identifying no. of total healthcare utilization, hospitalizations, emergency visits, and critical care admissions.. Higher the numbers higher the healthcare utilization.

    Measured: 3 months before and after entering the program

  4. Health-care Utilization - Critical Care Admission

    Health-care utilization data will be retrieved from electronic medical records. The study team is defining healthcare utilization by identifying no. of total healthcare utilization, hospitalizations, emergency visits, and critical care admissions. Higher the numbers higher the healthcare utilization.

    Measured: 3 months before and after entering the program

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Aug 2023
  2. Study start16 Nov 2022
  3. Primary completion2 Mar 2024
  4. Study completion30 May 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
27 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05985044
Sponsor's protocol ID
IRB00244792
Other IDs
P30NR018093
Status last verified
Jan 2025
First submitted
2 Aug 2023
Last updated
28 Jan 2025
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Koirala B, Badawi S, Frost S, Ferguson C, Hager DN, Street L, Perrin N, Dennison Himmelfarb C, Davidson P. Study protocol for Care cOORDInatioN And sympTom managEment (COORDINATE) programme: a feasibility study. BMJ Open. 2023 Dec 18;13(12):e072846. doi: 10.1136/bmjopen-2023-072846.

    PubMed 38110376

Questions about this trial

What is this clinical trial studying?

A study testing Care cO-ORDInatioN And sympTom managEment (CO-ORDINATE) Intervention in people with Multimorbidity and Quality of Life, run by Johns Hopkins University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 28 Jan 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Symptom Burden Assessed by Edmonton Symptom Assessment System (ESAS) Score - Pain (time frame: Baseline, 6-weeks post intervention, 3 months post intervention). The study lists 17 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05985044, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jan 2025.

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