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Transition cAre inteRvention tarGeted to High-risk patiEnts To Reduce rEADmission

NCT03496896 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 1393

Last updated 2023-01-26

No results posted yet for this study

Summary

Hospital rehospitalizations within 30 days are frequent and represent a burden for the patients, but also for the entire health care system. This study evaluates the impact of an intervention targeted to high-risk medical patients in order to reduce their risk of rehospitalization. Half of the patients will receive a set of interventions before and after their hospital discharge, while the other half will receive usual care.

Conditions

  • Patient Readmission

Interventions

OTHER

TARGET

The pre-discharge component includes mainly patient information, medication reconciliation, patient education, planning of a first post-discharge primary care physician visit with a timely discharge summary sent to the primary care physician. Two follow-up phone calls are made by a nurse, at D3 and D14, and include the assessment of the general health condition, the verification of the follow-up care plan, a reinforcement of the patient education, and review with the patient of the medication list with assessment of potential adverse drug events.

Sponsors & Collaborators

  • Swiss National Science Foundation

    collaborator OTHER

  • University of Bern

    collaborator OTHER

  • Brigham and Women's Hospital

    collaborator OTHER

  • Insel Gruppe AG, University Hospital Bern

    lead OTHER

Principal Investigators

  • Jacques Donzé, MD, MSc · Bern University Hospital

Study Design

Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Model
PARALLEL

Eligibility

Min Age
18 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2018-04-03
Primary Completion
2020-02-15
Completion
2020-02-15

Countries

  • Switzerland

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT03496896 on ClinicalTrials.gov