N/A
N=1,979
Paramedic Coached ED Care Transitions to Help Older Adults Maintain Their Health
Emergencies · Aging
Bottom Line
View on ClinicalTrials.gov: NCT02520661 ↗Enrolled (actual)
1,979
Serious AEs
5.1%
Results posted
Jul 2022
Primary outcome: Primary: Number of Participants Returning to the ED Within 30 Days of the Original ED Visit — 84; 69; 51; 113 Participants
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Care Transitions Intervention (Behavioral)
- Age
- Adult, Older Adult · 60+ yrs
- Sex
- All
- Sponsor
- University of Wisconsin, Madison
- Primary completion
- Jul 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants Returning to the ED Within 30 Days of the Original ED Visit |
84; 69; 51; 113; 103; 81 | — |
| PRIMARY Time to Any Follow up (in Person or Phone) With PCP, Specialists, or Urgent Care |
657; 664; 561; 773; 775; 653 | — |
| PRIMARY Number of Participants With Urgent Care or Unplanned Hospitalizations Within 30 Days of ED Discharge |
24; 24; 23; 46; 45; 30 | — |
| SECONDARY Number of Participants With Medication Changes Implemented |
78; 73; 65 | — |
| SECONDARY Number of Participants Who Could Recall Any Specific Red Flag |
225; 225; 215 | — |
| SECONDARY Level of Participant Activation as Measured by the Perceived Health Competence Survey |
30.54; 31.12; 31.25 | — |
| SECONDARY Median Cost of Healthcare Services Within 30 Days of the Original ED Visit |
— | — |
Summary
The emergency department (ED) is a common source of acute illness care for older adults. Many older adults who are discharged home from the ED return within 30 days due to numerous challenges faced during the ED-to-home transition. Unless programs to improve the ED-to-home transition are identified, the health and financial costs will only increase as the older adult population doubles by 2040. This study will apply Coleman's Care Transitions Intervention to the ED-to-home transition by adapting the program to account for the unique aspects of the ED setting. The research will evaluate the process, ED use, and cost outcomes of a community-based, paramedic-coordinated Care Transitions Intervention. Upon completion, this study will provide empiric evidence regarding this innovative approach to help the rapidly growing older adult population remain healthy and independent after an ED visit.
Eligibility Criteria
Inclusion Criteria
- Age≥60 years
- English speaking
- Monroe County, New York or Dane County, Wisconsin resident
- University of Wisconsin or University of Rochester affiliated primary care physician
- Community dwelling (no prisoners, nursing home, assisted living residents)
- Discharge home from the ED
Exclusion Criteria
- Previous study participation
- Discharged to hospice
- Homelessness
- Followed by transition care team (e.g., from recent hospitalization)
- Followed by intensive case management program
- Emergency Severity Index 1 patients (highest acuity, as assigned by ED triage staff)
- Unable to obtain consent from patient or proxy
Data sourced from ClinicalTrials.gov (NCT02520661). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.