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N/A N=140 Randomized Single-blind Health Services Research

A Technology Assisted Care Transition Intervention for Veterans With CHF or COPD

CHF · COPD

Enrolled (actual)
140
Serious AEs
0.0%
Results posted
Nov 2021
Primary outcome: Primary: Pre-post Change in Combined Emergency and Urgent Care Service Utilization — 1.06; 1.03; 0.92; 0.71 care utilization events — p=0.45

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Technology-assisted care transition intervention (Behavioral); Active attention control (Behavioral)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
VA Office of Research and Development
Primary completion
Jun 2020

Outcome Measures

OutcomeResultp-value
PRIMARY
Pre-post Change in Combined Emergency and Urgent Care Service Utilization
1.06; 1.03; 0.92; 0.71 0.45
SECONDARY
Care Transition Measure (CTM) Score Comparison
75.96; 77.00 0.05
SECONDARY
Adherence to Refills and Medications Scale (ARMS) Score Comparison
15.24; 16.91; 15.0; 15.0 0.03 sig
SECONDARY
Health Distress Score Comparison
3.48; 3.27; 2.90; 2.79 0.75
SECONDARY
Self Efficacy for Managing Chronic Disease Scale Comparison
6.23; 6.29; 6.34; 6.21 0.74
SECONDARY
Outcome Measure Title: Self-Care of Heart Failure Index Score Comparison
28.51; 27.20; 31.11; 30.71 0.63
SECONDARY
COPD Self-Management Scale Score Comparison
37.91; 36.95; 39.58; 35.71 0.23
SECONDARY
Self-Efficacy for Managing Symptoms (PROMIS)
17.87; 18.20; 18.87; 17.53 0.38
SECONDARY
Self-Efficacy for Managing Medications and Treatments (PROMIS)
18.89; 18.63; 19.08; 18.12 0.38

Summary

Transition from hospital to home places patients in jeopardy of adverse events and increases their risk for rehospitalization. CHF is the most prevalent chronic condition among U.S. adults and COPD is the third leading cause of death in the U.S. Both CHF and COPD represent significant burdens for the VHA healthcare system. Care transitions can be supported through multi-component interventions, but are costly to implement. Virtual nurses provide an effective medium for explaining health concepts to patients, and previous work indicates patients find virtual nurses acceptable. The investigators will implement and evaluate a virtual nurse intervention to provide automated, tailored, and timely support to Veterans transitioning from hospital to home. As effective care transition interventions incorporate both inpatient and outpatient components, the virtual nurse will first engage with patient onscreen during their inpatient stay and then via text message post-discharge. This project has the potential to improve the care transition experience for patients, caregivers and healthcare providers.

Eligibility Criteria

Inclusion Criteria

  • Veterans
  • Diagnosis of chronic heart failure or chronic obstructive pulmonary disease
  • Admission to a general medical service
  • Able and willing to engage with touchscreen technology
  • Have a text-enabled cellular phone to receive the post-discharge text messages

Exclusion Criteria

  • Not Veterans
  • Not diagnosed of chronic heart failure or chronic obstructive pulmonary disease
  • Not admitted to a general medical service
  • Not capable of using touchscreen technology
  • Do not have a text-enabled cellular phone
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02632552). 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.

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