Clinical trials: Transitional Care Planning
Hospitalization, Malignant Neoplasm
Checklist Tool in Engaging Patients in the Discharge Planning Process
This clinical trial studies how well a checklist tool works in engaging patients in the discharge planning process. Engaging patients in the discharge process may increase participation in the discharge process and improve…
- Conditions
- Hospitalization, Malignant Neoplasm, Transitional Care Planning
- Trial name
- TEPID (NCT02942524)
- Testing
- Communication Intervention, Questionnaire Administration, Survey Administration
- Where
- United States
- Volunteers
- 450 people
- Sponsor
- Ohio State University Comprehensive Cancer Center
Neurogenic Bladder, Incomplete Spinal Cord Injury
Effects Of App-Supported Transitional Care On Neurogenic Bladder In Spinal Cord Injury Patients
This is a single-blind randomized controlled trial for patients with neurogenic bladder after incomplete spinal cord injury. Participants are randomly divided into two groups.
- Trial name
- NCT07641101
- Testing
- Mobile Application Based Transitional Care, routine standardized inpatient bladder nursing
- Where
- China
- Volunteers
- 88 people
- Sponsor
- Xiamen University
Diabetes Mellitus Type 2
Bridging the Gap by Transitional Care
The purpose of the study is to evaluate patient adherence with discharge diabetes medications up to 120 days following pharmacist counseling during hospital stay about diabetes self management
- Trial name
- NCT01330121
- Testing
- Pharmacist Counseling
- Where
- United States
- Volunteers
- 130 people
- Sponsor
- Cook County Health
Colorectal Cancer, Comprehensive Transitional Care Program
A Pilot Randomized Trial of a Comprehensive Transitional Care Program for Colorectal Cancer Patients
The primary hypothesis is that a comprehensive transitional care program based on the premise of a patient-centered medical home versus routine care reduces emergency room visits and hospital readmissions without increasing costs…
- Trial name
- NCT02202096
- Testing
- Patient education: One-on-one visit, Discharge planning: Assessment of barriers to discharge, Medication reconciliation: Patient medication review
- Where
- United States
- Sponsor
- The University of Texas Health Science Center, Houston
Community Hospital Patients Discharging to the Community
Enhancing Patient Wellbeing Through Integration of Social Prescribing, Transitional Care, and Place-based Care in Community Hospitals Settings
The study aims to find out whether placed-based care (PBC), helps patients receive better support when they return home after leaving the community hospital, compared with the usual care provided.
- Trial name
- NCT07856030
- Testing
- SingHealth Community Hospitals Place-based Care
- Where
- 2 sites in Singapore
- Volunteers
- 720 people
- Sponsor
- SingHealth Community Hospitals
Asthma in Children
The Effect of Health Care Transition Based Education Given to Adolescents With Asthma
Aim: The purpose of this study was to examine the effect of health care transition-based education on transition readiness and self-efficacy in adolescents (14-18 years) with asthma through a randomized controlled experimental…
- Trial name
- NCT05550922
- Testing
- Healthcare Transition-Based Education
- Where
- Turkey (Türkiye)
- Volunteers
- 52 people, healthy volunteers welcome
- Sponsor
- Saglik Bilimleri Universitesi
Traumatic Brain Injury
BETTER (Brain Injury Education, Training, and Therapy to Enhance Recovery)
Despite poor outcomes for adults with traumatic brain injury (TBI), there are no U.S. standards for TBI transitional care for patients discharged home from acute hospital care.
- Trial name
- NCT05929833
- Testing
- BETTER (Brain Injury, Education, Training, and Therapy to Enhance Recovery), Usual Care
- Where
- United States
- Volunteers
- 500 people
- Sponsor
- Duke University
Stroke
Transitional Care Model for Patients With Stroke
Patients with stroke benefitted from superior improvements in physical function, particularly when performing activities of daily living, fewer visits to the emergency room, less depression symptoms, and improved health-related…
- Trial name
- NCT06280599
- Testing
- Transitional care model
- Where
- Indonesia
- Volunteers
- 80 people
- Sponsor
- Kaohsiung Medical University
Transitional Care, Multimorbidity
AdvantAGE: Implementation and Evaluation of an Interprofessional Tranistional Care Model for Frail Older Adults
This clinical trial at the University Department of Geriatric Medicine FELIX Platter in Basel, Switzerland, is designed to evaluate a new transitional care model aimed at helping frail older adults after they get discharged from…
- Conditions
- Transitional Care, Multimorbidity, Geriatric Care
- Trial name
- AdvantAGE (NCT06190288)
- Testing
- Transitional care model
- Where
- Switzerland
- Volunteers
- 250 people
- Sponsor
- Thekla Brunkert
Neoplasms, Frailty
Ready for Safe Cancer Treatment (RESET): A Comprehensive Perioperative Program for Surgical Oncology
The goal of this randomized controlled clinical trial is to evaluate whether the Ready for Safe Cancer Treatment (RESET) program improves perioperative care and supports safe hospital discharge in two surgical populations: adult…
- Conditions
- Neoplasms, Frailty, Surgical Procedures, Operative
- Trial name
- RESET (NCT07727876)
- Testing
- RESET multimodal perioperative care pathway, Standard perioperative care
- Where
- 2 sites in Poland
- Volunteers
- 12,800 people
- Sponsor
- Regional Specialist Hospital in Wroclaw
Frail Elderly Syndrome, Transitional Care
Models of Care in the Transition From the Secondary to the Primary Sector Among the Frailest Elderly
In most Western countries the elderly population increases rapidly. In Denmark, the population of elderly aged 75 years or older may amount to nearly 15 % of the entire population in 2050 compared to 9 % today (2017).
- Conditions
- Frail Elderly Syndrome, Transitional Care, Frailty, Readmission
- Trial name
- NCT03796923
- Testing
- Early follow-up visit after discharge, Comprehensive geriatric assessment (CGA), Continued geriatric care
- Where
- Denmark
- Volunteers
- 3,340 people
- Sponsor
- University of Aarhus
Hypertension, Blood Pressure Monitoring
Monitoring Blood Pressure at Home and Pharmacy Telehealth Among People Living With HIV
The overall goal of this project is to determine if measuring blood pressure at home and staying in contact with a team of pharmacists and physicians to manage participants' blood pressure is useful.
- Trial name
- REMAP-BP-HIV (NCT07849595)
- Testing
- Remote Blood Pressure Monitoring + Telehealth
- Volunteers
- 572 people
- Sponsor
- University of Alabama at Birmingham
Transitional Care, Frail Elderly
Making Health Care Safer for Older Adults Receiving Skilled Home Health Care Services After Hospital Discharge
Care transitions are the movement of a person from one healthcare setting to another. Older adults who require skilled home health care ("home health") services (e.g., home-based nursing) after hospital discharge are at high risk…
- Conditions
- Transitional Care, Frail Elderly, Home Health Care
- Trial name
- NCT05182060
- Testing
- Transition Intervention
- Where
- United States
- Volunteers
- 761 people, healthy volunteers welcome
- Sponsor
- Johns Hopkins University
Follow-up Study, Medical In-patients
Impact of Medical Follow-up Discharge Package
The post discharge time is a vulnerable time for general medical in-patients, with high rates of adverse events that may cause unnecessary readmissions and even death.
- Trial name
- RECALL-CT (NCT01916876)
- Testing
- Integrated medical follow-up package
- Where
- 2 sites in South Africa
- Sponsor
- University of Cape Town
Cirrhosis, Liver
Transitional Care Program for Fluid Overload in Cirrhosis
The goal of this clinical trial is to learn about an intensive monitoring plan (transitional care program) in patients with cirrhosis and excessive swelling that are going to be discharged from the hospital.
- Trial name
- NCT06174272
- Testing
- Transitional Care Program
- Where
- United States
- Volunteers
- 20 people
- Sponsor
- Milton S. Hershey Medical Center
Nonadherence, Patient, Polypharmacy
Pharmacist Intervention to Reduce Post-Hospitalization Utilization
This is a randomized trial testing a peri- and post-discharge pharmacist-led medication management intervention on post-discharge utilization, including both readmissions and emergency department visits within 30 days of…
- Conditions
- Nonadherence, Patient, Polypharmacy, Readmission
- Trial name
- NCT04071951
- Testing
- Pharmacist-led Hospital Discharge Care Intervention
- Where
- 2 sites in United States
- Volunteers
- 6,478 people
- Sponsor
- Cedars-Sinai Medical Center
Congenital Heart Disease in Adolescence, Transitional Care
Evaluation of Transition With a Heart, a Transition Program for Adolescents With Congenital Heart Disease and Parents
The department of Congenital Heart Disease of the Ghent University Hospital (Belgium) developed a transition program dedicated to adolescents with congenital heart disease (CHD): 'Transition With a Heart´ (TWAH).
- Trial name
- NCT05479630
- Testing
- Transition With a Heart (TWAH)
- Where
- Belgium
- Volunteers
- 81 people
- Sponsor
- University Hospital, Ghent
LTC-to-hospital Transfer Decision-making
Evaluation of the STEP Intervention for Long-Term Care Residents Facing Hospital Transfer Decisions
This trial will evaluate whether the Supporting Transitions and Empowering Preferences (STEP) toolkit can improve decision-making about hospital transfers in long-term care residents and their substitute decision-makers and…
- Trial name
- STEP (NCT07153341)
- Testing
- STEP Decision Support Toolkit
- Where
- 2 sites in Canada
- Volunteers
- 200 people
- Sponsor
- Bruyère Health Research Institute.
Inflammatory Bowel Diseases, Crohn's Disease
The Effect of Joint Transition Visits on Quality of Life in Inflammatory Bowel Diseases (TRANS-IBD)
Inflammatory bowel diseases (IBD) are among the most common chronic illnesses diagnosed in childhood. Moving from the pediatric to the adult health care is a crucial phase, which can greatly affect adolescents' quality of life.
- Conditions
- Inflammatory Bowel Diseases, Crohn's Disease, Ulcerative Colitis
- Trial name
- TRANS-IBD (NCT04290156)
- Testing
- joint visits
- Volunteers
- 160 people
- Sponsor
- University of Pecs
Ovarian Cancer, Transitional Care Planning
Effects of a Teaching Intervention With an Advanced Practice Nurse on Quality of Life and Psychosocial and Symptom Distress in Patients With Ovarian Cancer
RATIONALE: A teaching intervention with an advanced practice nurse may help reduce psychosocial and symptom distress and improve the well-being and quality of life of patients with ovarian cancer.
- Trial name
- NCT00900679
- Testing
- telephone-based intervention, counseling intervention, educational intervention
- Where
- United States
- Volunteers
- 110 people
- Sponsor
- City of Hope Medical Center