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Improving How Older Adults at Risk for Cardiovascular Outcomes Are Selected for Care Coordination

NCT05820295 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 400

Last updated 2025-09-04

Study results available
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Summary

This pragmatic clinical trial embedded in an accountable care organization will determine the comparative effectiveness of two approaches for assigning care coordinators to older adults at risk for cardiovascular outcomes. The hypothesis is that assigning care coordinators to older adults based on perceived need will be more effective at preventing emergency department visits and hospitalizations compared to usual care.

Conditions

Interventions

BEHAVIORAL

Care coordination delivered based on perceived need

If patients in intervention group report on the survey that they experience difficulty coordinating care among their providers, the patient will be selected for care management services. Those services will attempt to address the problems with care coordination that the proxy reported.

BEHAVIORAL

Care coordination delivered based on usual care (e.g. discharge from hospital)

If a patient is discharged from a hospital, the patient will be selected for care management services.

Sponsors & Collaborators

  • Agency for Healthcare Research and Quality (AHRQ)

    collaborator FED

  • Weill Medical College of Cornell University

    lead OTHER

Principal Investigators

  • Lisa M Kern, MD, MPH · Weill Medical College of Cornell University

Study Design

Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Model
PARALLEL

Eligibility

Min Age
65 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2023-05-17
Primary Completion
2024-05-31
Completion
2024-07-11

Countries

  • United States

Study Locations

More Related Trials

Entities

Diseases

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 NCT05820295 on ClinicalTrials.gov