N/A N=344 Multiple Chronic Conditions for Older Adults
Chronic Disease
Primary: PROMIS Global Health Measure Score — 46.27; 46.21; 44.92; 46.38 T-score
Clinical Trial Search
Completed trials with posted results — search by concept, filter by the parameters that matter at the bedside.
N/A N=1,400 Integrated Care (IC) Models for Patient-Centered Outcomes
Diabetes · Asthma · Chronic Obstructive Pulmonary Disease
Primary: Patient Activation — 61.87; 63.73; 63.82; 63.15 score on a scale — p=0.0211
N/A N=25 Living With Multimorbidity: CO-ORDINATE Program
Multimorbidity · Quality of Life · Symptom Management
Primary: Symptom Burden Assessed by Edmonton Symptom Assessment System (ESAS) Score - Pain — 5; 4; 5 score on a scale
N/A N=264 Patient Priority Care for Older Adults With Multiple Chronic Conditions
Multiple Chronic Conditions
Primary: Treatment Burden — 11.9; 11.6; 12.7; 17.9 score on a scale
N/A N=268 ElderTree Smart System for Older Adults
Chronic Pain
Primary: Change in Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form v2.1 - Pain Interference Score — 58.44; 59.57; 59.19; 57.94 score on a scale
N/A N=3 Caregiver Support in the Context of Multiple Chronic Conditions
Caregiver Burnout
Primary: Quality of Life as Assessed by the Short Form Health Survey — 72.3; 74.1; 70.4; 76.1 units on a scale
N/A N=21 Patient Priorities Care for Hispanics With Dementia
Multiple Chronic Conditions · Dementia
Primary: Self-reported Perceived Value of Patient Priorities Care (PPC) Approach — 75; 85.7 percentage of participants
N/A N=18,268 Improving Chronic Disease Management With Pieces
Chronic Kidney Disease · Diabetes · Hypertension
Primary: All Cause Hospitalizations for Patients With a Triad of Chronic Kidney Disease, Diabetes and Hypertension — 20.7; 21.12 percentage of participants hospitalized
N/A N=331 Improving Care for Children With Complex Needs
Medically Complex Children · Care Coordination · Case Manager
Primary: Cost of Care — 71692; 70618; 37,677; 56702 US Dollars
N/A N=168,477 Consumer Health IT Tools: Impact on Experience, Access, and Outcomes for Patients With Complex Chronic Conditions
Chronic Disease · Patient Outcome Assessment · Electronic Health Records
Primary: Number of Ambulatory Care Sensitive Conditions (ACSC) Hospitalizations. Portal Users vs Those Who Are Not Portal Users — 6.2; 7.0 hospitalizations/1000 participants/month
N/A N=263 Home Based Care Transitions Tailored by Cognition and Patient Activation
Chronic Disease
Primary: Health Care Utilization — 7; 8; 4; 3 events
N/A N=312 Clinical Trials for Elderly Patients With Multiple Disease
Chronic Obstructive Pulmonary Disease (COPD) · Congestive Heart Failure (CHF) · Sleep Disordered Breathing (SDB)
Primary: Time to First Hospitalization — 255; 224 days — p=0.342
N/A N=44 Cirrhosis Medical Home
Cirrhosis, Liver
Primary: Enrollment Rate — 20; 20 Participants
N/A N=25,507 Minnesota Care Coordination Effectiveness Study
Chronic Disease · Multi-morbidity · Care Coordination
Primary: Change in Composite Measure of Care Quality — 7.0; 4.5; 5.9; 5.9 Change in percent — p=0.19
N/A N=33 Improving Medical Training for the Care of Chronic Conditions
Diabetes Mellitus
Primary: Change in Confidence in Ability to Perform Teamwork — 1.40; -0.12 units of a scale — p=0.04
N/A N=238 Implementing Health Plan-Level Care Management for Solo & Small Practices
Bipolar Disorder · Depression
Primary: Health-related Quality of Life, as Measured by the Mental Health Component Score — 38.2; 43.2 score on a scale
N/A N=5,421 Medication Adherence Clinical Decision Support
Hyperlipidemia · Hypertension · Diabetes
Primary: Blood Pressure Medication Adherence — 396; 470 Participants — p=0.0103
N/A N=4,322 Care Coordination for Complex Cancer Survivors in an Integrated Safety Net System
Breast Cancer · Colorectal Cancer
Primary: Proportion of Complex Cancer Survivors Meeting Quality of Care Guidelines for Chronic Conditions and Follow-up Cancer Surveillance
N/A N=592 A Multi-center Trial of IMPaCT CHW Support for Chronically-ill Patients
Hypertension · Diabetes · Obesity
Primary: Short Form Health Survey (SF-12) Physical Component Score (PCS) — 2.3; 0.6 score on a scale — p=0.30
N/A N=23 Medication Adherence With Polyglot Meducation
Hypertension · Diabetes · Hypercholesterolemia
Primary: Medication Possession Ratio at Baseline — 65.0 percentage of medication possession
N/A N=50 Self-management Intervention for Children With Chronic Medical Complexity: Pilot Feasibility Trial
Children With Medical Complexity
Primary: Patient Quality of Life (QOL) — 62.7; 54.4; 59.8; 51.9 score on a scale, range from 20 to 100 — p=>0.05
Phase 4 N=2,199 A Chronic Care Model Based Quality Improvement (QI) Program to Improve the Care of Patients With Chronic Kidney Disease (CKD)
Chronic Kidney Disease
Primary: Systolic Blood Pressure (SBP) — 135.1; 134.4 mmHg — p=0.57
N/A N=300 Collaborative Connected Health (CCH) for PCORI
Psoriasis
Primary: Improvement in Self-Administered Psoriasis Area and Severity Index (SA-PASI) — -0.82; -1.37 Score on a Scale
N/A N=512 My Diabetes, My Community
Type 2 Diabetes
Primary: Mean Change in Percent of Hemoglobin A1C — -1.1; -0.8; -0.8 percentage of hemoglobin A1C — p=0.8
N/A N=162 Brief COVID-19 Intervention for People With Serious Mental Illness and Co-Morbid Medical Conditions
Mental Illness · Chronic Disease
Primary: Number of Participants Who Received COVID-19 Vaccine — 56; 50 Participants
N/A N=360 Bridging the Gap From Postpartum to Primary Care
Hypertension · Hypertension in Pregnancy · Diabetes Mellitus
Primary: Rate of Primary Care Provider Visit Attendance — 38; 72 Participants — p=<0.001
N/A N=148 Depression and Congestive Heart Failure in Outpatients.
Heart Failure · Depression
Primary: Beck Depression Inventory II — 9.3; 9.2; 9.0; 8.6 units on a scale — p=0.90
N/A N=136 Integrating Mindfulness Into the Patient-Centered Medical Home (Phase 2)
Depression · Anxiety · Stress Related Disorder
Primary: Action Plan Initiation Survey (APIS-5) — 53; 14 Participants — p=0.006
N/A N=828 Multiple Areas of Pain (MAP)
Chronic Pain
Primary: Multi-site Pain Index — 0.52 units on a scale
N/A N=414 Preparing Older Veterans With Serious and Chronic Illness for Decision Making
Aging
Primary: New Advance Care Planning Documentation in the Medical Record at 9 Months — 35; 25 percentage of participants