NCT06051058 Care Transitions App for Patients With Multiple Chronic Conditions
| NCT ID | NCT06051058 |
| Status | Recruiting |
| Phase | — |
| Sponsor | Brigham and Women's Hospital |
| Condition | Heart Failure |
| Study Type | INTERVENTIONAL |
| Enrollment | 798 participants |
| Start Date | 2024-10-08 |
| Primary Completion | 2026-06 |
Eligibility & Interventions
Eligibility Fast-Check
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What to Expect as a Participant
You will actively receive the study intervention — which may be a drug, biologic, device, or procedure.
This trial targets 798 participants in total. It began in 2024-10-08 with a primary completion date of 2026-06.
⚠ This information is for research awareness only. Always consult your physician before joining any clinical trial. Participation is voluntary and you may withdraw at any time.
Brief Summary
The objective of this study is to widely implement and evaluate the Care Transitions App in a randomized controlled trial. The app the investigators designed for patients with multiple chronic conditions has four envisioned modules: 1) falls-reduction content, 2) a digital post-discharge transitional care plan (e.g., after hospital care plan, including education, medications, follow-up appointments, warning signs to watch for, nutrition, and other care plan activities), 3) a new module for patients with MCC (diabetes, congestive heart failure, and chronic kidney disease) including condition-specific post-discharge care plans with relevant symptom management activities, 4) a new post-discharge report module which summarizes key care transition findings and allows for patients to enter notes and questions for their providers and their own goals for recovery.
Eligibility Criteria
Inclusion Criteria: * Adult patients (55+) with a Brigham PCP or appointment in one of the 15 locations discharging from a BWH general medicine unit * Discharging to home, home health care service or assisted living * Fluent in spoken English in patient or healthcare proxy * Patients with at least one of the conditions listed below + one additional chronic condition on the problem list. * Patient with heart failure on the problem list * Patient with type 2 diabetes on the problem list * Patient with chronic kidney disease on the problem list Exclusion Criteria: * Adult patients (55+) with Westwood, Pembroke, or Transition Clinic PCP admitted to ICU, OBGYN, Surgical, Cardiology, Oncology, Orthopedics, or other Specialty Unit * Pregnant * Prisoner, institutionalized individual or in police custody * Discharge planned within 3 hours of screening * Patient too ill to participate or with active psychosis/serious mental illness, delirium, or severe dementia * Not fluent in spoken English in patient and health proxy * Unlikely to be discharged to home * Lacks a device capable of accessing the app * Lack of a working telephone for 30-day follow-up
Contact & Investigator
Lipika Samal, MD, MPH
PRINCIPAL INVESTIGATOR
Brigham and Women's Hospital
Frequently Asked Questions
Who can join the NCT06051058 clinical trial?
This trial is open to participants of all sexes, aged 55 Years or older, studying Heart Failure. Full inclusion and exclusion criteria are listed in the Eligibility Criteria section. Always confirm your eligibility with the research team before applying.
Is NCT06051058 currently recruiting?
Yes, NCT06051058 is actively recruiting participants. Contact the research team at lsamal@bwh.harvard.edu for enrollment information.
Where is the NCT06051058 trial being conducted?
This trial is being conducted at Boston, United States.
Who is sponsoring the NCT06051058 clinical trial?
NCT06051058 is sponsored by Brigham and Women's Hospital. The principal investigator is Lipika Samal, MD, MPH at Brigham and Women's Hospital. The trial plans to enroll 798 participants.
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