Clinical trials: Care Transitions
HIV, Noncommunicable Diseases
UNCPM 22322 - Adaption of the Transition of Care Model for Post-Discharge HIV-NCD Care in Lilongwe, Malawi - MLATHO
This is an implementation research study that will adapt and pilot test the Transitional Of Care Model (TCM), originally conceived and developed in the USA, for targeted use as a post-discharge intervention for adults…
- Trial name
- MLATHO (NCT06931431)
- Testing
- Transition of Care Model (TCM)
- Where
- Malawi
- Volunteers
- 75 people
- Sponsor
- University of North Carolina, Chapel Hill
First Episode Psychosis, Psychosis
ED to EPI: Using SMS to Improve the Transition From the Emergency Department to Early Psychosis Intervention
Psychosis is a disabling condition that typically has its onset in adolescence and early adulthood. Many young people with psychosis have difficulty navigating services or are reluctant to engage in treatment until their illness…
- Conditions
- First Episode Psychosis, Psychosis, Psychotic Episode, Psychoses, Affective
- Trial name
- NCT04298450
- Testing
- Active SMS Intervention
- Where
- Canada
- Volunteers
- 186 people
- Sponsor
- Centre for Addiction and Mental Health
Transition of Care
Pharmacy Transitional Team: Evaluating the Value for Patients With Limited English Proficiency
The overall goal of this proposed study is to characterize the experiences, barriers and facilitators related to providing effective care transitions from hospital to post-acute care settings to elucidate the failures that drive…
- Trial name
- NCT07437508
- Where
- United States
- Volunteers
- 17 people
- Sponsor
- University of Washington
Osteoporosis, Lower Limb Fracture
OsteoPorotic fracTure preventION System (OPTIONS) Research Study
Osteoporosis is a disease that weakens bones so the bones may break easily. The risk for osteoporosis increases with age in both women and men. Osteoporosis affects 10 million older adults in the US.
- Trial name
- OPTIONS (NCT06731608)
- Testing
- OPTIONS, Enhanced usual care
- Where
- 2 sites in United States
- Volunteers
- 1,344 people
- Sponsor
- Brigham and Women's Hospital
Diabetes Mellitus
A Transition of Care Model From Hospital to Community for Hispanic/Latino Adult Patients With Diabetes.
This pilot study was designed to address the existing gap in the transition of care of Hispanic/Latino Adults with diabetes from hospital to community.
- Trial name
- TOC (NCT04864639)
- Testing
- Transition of Care Model
- Where
- United States
- Volunteers
- 12 people, healthy volunteers welcome
- Sponsor
- Duke University
Acute Kidney Injury
Acute Kidney Injury In Care Transitions (ACT): Pragmatic Clinical Trial
The purpose of this study is to determine the effect of a multidisciplinary intervention at care transitions for acute kidney injury survivors on patient-centered outcomes.
- Trial name
- ACT (NCT07670520)
- Testing
- Acute Kidney Injury in Care Transitions (ACT), Usual Care
- Where
- 3 sites in United States
- Volunteers
- 2,260 people
- Sponsor
- Mayo Clinic
Acute Stroke
Michigan Stroke Transitions Trial
The Michigan Stroke Transitions Trial (MISTT) is a patient-centered randomized control trial that aims to improve the experience of stroke patients after they return home.
- Trial name
- MISTT (NCT02653170)
- Testing
- SCM, SCM and VSSP
- Where
- 3 sites in United States
- Volunteers
- 320 people
- Sponsor
- Michigan State University
Transition From Pediatric to Adult HIV Care
Planning the mPACT Trial - mHealth Strategies for the Pediatric to Adult HIV Care Transition
In contrast all other age groups, adolescents (age 10-19 years) have experienced constant, rather than declining, HIV-related mortality in the last decade.
- Trial name
- mPACT (NCT03876483)
- Testing
- Virtual peer support group
- Where
- Kenya
- Volunteers
- 120 people, healthy volunteers welcome
- Sponsor
- University of Washington
Human Immunodeficiency Virus, HIV
Support for Adolescents Living With HIV in South Africa
This is a cluster randomized controlled trial determining the effectiveness of in-person or mHealth-based adolescent-friendly transition interventions compared to standard care on retention in care and viral suppression among…
- Trial name
- InTSHA VIP (NCT06035445)
- Testing
- In-person adolescent-friendly service (iPAS) intervention, mHealth (InTSHA) intervention, Standard of Care
- Where
- South Africa
- Volunteers
- 570 people
- Sponsor
- Emory University
Chronic Kidney Disease
Putting Patients at the Center of Kidney Care Transitions (PREPARE NOW)
Objective: The investigators will change the health system to improve care patients receive as they transition through earlier stages of kidney disease toward kidney failure.
- Trial name
- NCT02722382
- Testing
- Patient-Centered Kidney Transitions Care
- Where
- United States
- Volunteers
- 1,572 people
- Sponsor
- Duke University
Alzheimer Disease and Related Dementias
Designing Care Management for Hospice Transitions for Persons Living With Advanced Dementia
This study will test a care management intervention to guide end-of-life care and hospice transitions for persons with dementia and their care partners receiving home healthcare and ascertain feasibility, acceptability, fidelity…
- Trial name
- ENGAGE-D (NCT07182357)
- Testing
- Dementia Care Management Checklist for Hospice Transitions
- Where
- United States
- Volunteers
- 96 people, healthy volunteers welcome
- Sponsor
- New York University
Transition of Care
Evaluating Intervention Allocation Policies for Reducing Hospital Readmissions at Michigan Medicine
The researchers are investigating if using a risk-based prediction score or benefit-based prediction score to allocate transition of care (TOC) interventions is more effective in reducing the rate of unplanned hospital…
- Trial name
- NCT07690657
- Testing
- C-HARP TOC assignment, The LACE Index TOC assignment
- Where
- United States
- Volunteers
- 5,000 people
- Sponsor
- University of Michigan
Stroke
Adaptive Dance Activities for People With Stroke
The project will investigate the effects of a novel 12-week Movement Improvisation Skill-building and Adaptive Dance Intervention (MDI) on participation, balance, mobility, balance confidence, psychological well-being, and…
- Trial name
- MDI (NCT07591272)
- Testing
- Movement Improvisation Skill-building and Adaptive Dance Intervention
- Where
- Hong Kong
- Volunteers
- 160 people
- Sponsor
- Chinese University of Hong Kong
Heart Failure, Caregiver Burden
Effect of the PLAN CUIDARTE on the Caregiving Competence of People With Heart Failure
According to the World Health Organization (WHO), by 2021 cardiovascular diseases (CVD) will be a public health problem, among them heart failure (HF), since this is a chronic disease, patients should be competent in their care.
- Conditions
- Heart Failure, Caregiver Burden, Discharge Plan, Care Transitions
- Trial name
- PLANCUIDARTE (NCT06309875)
- Testing
- PLAN CUIDARTE, Conventional care
- Where
- Colombia
- Volunteers
- 84 people
- Sponsor
- Universidad de la Sabana
Chronic Diseases
A Randomised Control Trial of a Transitional Care Model in Singapore General Hospital
To find out if a transitional care model can reduce the rate of unscheduled readmission to the Department of Internal Medicine (DIM) in SGH
- Trial name
- NCT02351648
- Testing
- a transitional care model, Control
- Where
- Singapore
- Volunteers
- 840 people
- Sponsor
- Singapore General Hospital
HPV Vaccines
Giving Immunizations Through Vaccine Education
This study will test the effectiveness of clinician-focused health IT-based decision support, family-focused health IT-based decision support, and a combination of both efforts, in increasing HPV and other adolescent vaccine…
- Trial name
- GIVE (NCT01159093)
- Testing
- Family Decision Support, Clinician Decision Support, Family Decision Support and Clinician Decision Support
- Where
- United States
- Volunteers
- 23,675 people
- Sponsor
- Children's Hospital of Philadelphia
Care Transitions
Achieving Patient-Centered Care and Optimized Health In Care Transitions by Evaluating the Value of Evidence
Funded by the Patient Centered Outcome Research Institute (PCORI), nationally recognized leaders in health care and research methods are partnering with patients and caregivers to evaluate the effectiveness of current efforts at…
- Trial name
- ACHIEVE (NCT02354482)
- Testing
- Patient Communication and Care Management, Home-Based Trust, Plain Language, and Coordination, Hospital-Based Trust, Plain Language, and Coordination
- Where
- United States
- Volunteers
- 7,939 people
- Sponsor
- Mark Williams
Cardiovascular Diseases, Cardiac Rehabilitation
Modified Application of Cardiac Rehabilitation for Older Adults
Modified Application of Cardiac Rehabilitation for Older Adults (MACRO) responds to a critical underuse of cardiac rehabilitation in older adults with a coaching model that addresses issues related to aging as a means to better…
- Conditions
- Cardiovascular Diseases, Cardiac Rehabilitation, Transition of Care
- Trial name
- MACRO (NCT03922529)
- Testing
- MACRO-I, Usual Care
- Where
- 3 sites in United States
- Volunteers
- 416 people
- Sponsor
- Daniel Forman, MD
Cancer, Follow-Up Care
Care Transition Intervention for Hospitalized Patients With Advanced Cancer
This study is examining whether a care transition intervention, CONTINUUM (CONTINUity of care Under Management by video visits), consisting of a supportive care-focused video visit with an oncology nurse practitioner (NP) within…
- Conditions
- Cancer, Follow-Up Care, Consultation, Remote, Advanced Cancer
- Trial name
- NCT05142345
- Testing
- CONTINUUM Intervention, Usual Care
- Where
- United States
- Volunteers
- 286 people
- Sponsor
- Massachusetts General Hospital
Stroke
Optimizing Hospital-to-home Transitions for Older Adults With Stroke and Multimorbidity
Stroke is the leading cause of death and adult disability in Canada. Sixty percent of these older adults (> 65 years) will return to their homes after a stroke and will require ongoing rehabilitation.
- Trial name
- NCT04278794
- Testing
- Transitional Care Stroke Intervention (TCSI)
- Where
- 2 sites in Canada
- Volunteers
- 90 people
- Sponsor
- McMaster University