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New Care Pathways for Supporting TRANSitional CARE From Hospital to Home Using AI and Personalized Digital Assistance

NCT07731126 · Status: RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 210

Last updated 2026-07-28

No results posted yet for this study

Summary

The objective of the TRANSCARE study is to evaluate the use of a digital remote monitoring system to reduce the risk of 30-day readmission in multimorbid elderly patients. The pilot study is multicenter, and the trial will be conducted across 3 sites: Italy, Romania, and Norway. The overall goal of the TRANSCARE project is to create a digital monitoring ecosystem capable of identifying and preventing the risk of readmission. Two hundred and ten older adults aged over 65, who meet the inclusion and exclusion criteria, will be enrolled in the study. They will be randomized into two groups and allocated to an intervention group or a control group.

Conditions

  • Transitional Care
  • Remote Patient Monitoring (RPM)
  • Geriatric Multimorbidity

Interventions

OTHER

TRANSCARE Digital Remote Monitoring Ecosystem

A digital remote monitoring suite comprising connected home medical devices for physiological parameter measurement, a wearable activity tracker, and an integrated telemonitoring software platform designed for patient self-management and clinical risk detection.

Sponsors & Collaborators

  • Technical University of Cluj-Napoca, Romania

    collaborator UNKNOWN

  • INSTITUTUL INIMII "NICOLAE STANCIOIU" CLUJ-NAPOCA, Romania

    collaborator UNKNOWN

  • Tellu AS, Norway

    collaborator UNKNOWN

  • Farsund Kommune, Norway

    collaborator UNKNOWN

  • Karde AS, Norway

    collaborator UNKNOWN

  • Istituto Nazionale di Ricovero e Cura per Anziani

    lead OTHER

Principal Investigators

  • Ionut Anghel, Prof. Dr. · Technical University of Cluj-Napoca, Romania

  • Roberta Bevilacqua, Ph.D. · IRCCS INRCA, Ancona, Italy

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
2025-12-12
Primary Completion
2027-02-28
Completion
2027-02-28

Countries

  • Italy
  • Norway
  • Romania

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 NCT07731126 on ClinicalTrials.gov