Clinical trial NCT02114515: PATient Navigator to rEduce Readmissions
Official title: PATient Navigator to rEduce Readmissions
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Chronic Obstructive Pulmonary Disease
Heart Failure
Sickle Cell Disease
Myocardial Infarction
Pneumonia
Keywords: Patient Navigators
Readmissions
Peer Coaching
Lead sponsor: University of Illinois at Chicago
Sponsor class: OTHER
Collaborators: name: Patient-Centered Outcomes Research Institute
name: Society of Hospital Medicine
name: COPD Foundation
name: University of Kentucky
name: Mended Hearts
name: American Heart Association
name: Sickle Cell Disease Association of Illinois
name: AcademyHealth
name: The National Association of Social Workers Foundation
name: Respiratory Health Association
name: University of Illinois Sickle Cell Patient Council
name: National Jewish Health
name: Baystate Medical Center
First posted: 2014-04-15
Enrollment: 1029
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Staying out of the hospital is valued by patients and their caregivers. Their interests converge with those of hospitals now that high 30-day readmission rates for some conditions place hospitals at risk for financial penalties from the Centers for Medicare and Medicaid Services. This study focuses on developing and testing a program that combines a community health worker (lay patient advocate, acting as a "Patient Navigator") and a peer-led telephone support line to improve patient experience during hospital to home transition.


Eligibility criteria: Inclusion Criteria:

1. Age 18 years or older on date of hospital admission
2. Hospitalized at the University of Illinois Hospital, Chicago
3. Admission diagnosis, per treating physician, of pneumonia, COPD, sickle cell disease, heart failure, or myocardial infarction
4. Receive medical care on an inpatient medical service

Exclusion Criteria:

1. Unable to understand and speak English
2. Unable/decline to give informed consent
3. Previous participant in PArTNER
4. Planned transfer to another acute care facility
5. Planned discharge to facility other than home (e.g. long term care facility)
6. Currently on hospice or plans to discharge home to hospice
7. Current plans to leave against medical advice

Primary outcomes:
measure: PROMIS Emotional Distress-Anxiety (v1.0, SF4a)
timeFrame: 30 days post discharge
measure: PROMIS Informational Support (v2.0, SF4a)
timeFrame: 30 days post discharge
Secondary outcomes:
measure: PROMIS Emotional Support (v2.0, SF4a)
timeFrame: 30 days post discharge
measure: PROMIS Instrumental Support (v2.0, SF4a)
timeFrame: 30 days post discharge
measure: PROMIS Global Health, Physical (v1.1, SF)
timeFrame: 30 days post discharge
measure: PROMIS Global Health, Mental (v1.1, SF)
timeFrame: 30 days post discharge
measure: PROMIS Emotional Distress-Anxiety (v1.0, SF4a)
timeFrame: 60 days post discharge
measure: PROMIS Informational Support (v2.0, SF4a)
timeFrame: 60 days post discharge
measure: PROMIS Emotional Support (v2.0, SF4a)
timeFrame: 60 days post discharge
measure: PROMIS Instrumental Support (v2.0, SF4a)
timeFrame: 60 days post discharge
measure: PROMIS Global Health, Physical (v1.1, SF)
timeFrame: 60 days post discharge
measure: PROMIS Global Health, Mental (v1.1, SF)
timeFrame: 60 days post discharge
measure: Death
timeFrame: 30 days post discharge
measure: Death
timeFrame: 60 days post discharge
measure: Re-hospitalization or Death
timeFrame: 30 days post discharge
measure: Re-hospitalization or Death
timeFrame: 60 days post discharge
measure: ED Visit, Re-hospitalization, or Death
timeFrame: 30 days post discharge
measure: ED Visit, Re-hospitalization, or Death
timeFrame: 60 days post discharge
measure: Outpatient Healthcare Visit
timeFrame: 14 days post discharge
measure: Outpatient Healthcare Visit
timeFrame: 14 days post discharge
Other outcomes:
Locations:
city: Chicago
country: United States
facility: University of Illinois Hospital
state: Illinois
Study officials:
affiliation: University of Illinois at Chicago
name: Jerry A Krishnan, MD, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Arizona
name: Elizabeth Calhoun, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Kentucky
name: Mark V. Williams, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: LaBedz SL, Prieto-Centurion V, Mutso A, Basu S, Bracken NE, Calhoun EA, DiDomenico RJ, Joo M, Pickard AS, Pittendrigh B, Williams MV, Illendula S, Krishnan JA. Pragmatic Clinical Trial to Improve Patient Experience Among Adults During Transitions from Hospital to Home: the PArTNER study. J Gen Intern Med. 2022 Dec;37(16):4103-4111. doi: 10.1007/s11606-022-07461-0. Epub 2022 Mar 8.