COORDINATE Program for Multi-morbidity
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores whether a special care program, the COORDINATE Program, can assist older adults with multiple chronic health issues. The researchers aim to determine if this program can improve quality of life and reduce emergency visits and hospital readmissions compared to regular care with additional support. Participants will either follow the COORDINATE Program, which includes guidance from a nurse, or receive enhanced usual care. The trial seeks individuals aged 50 and over who have at least two chronic conditions and are being discharged from intermediate care units. As an unphased trial, this study offers a unique opportunity to contribute to innovative care solutions that could enhance many lives.
Do I need to stop my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications. It seems focused on care coordination rather than medication changes.
What prior data suggests that the COORDINATE Program is safe for older adults with multiple chronic conditions?
Research shows that the COORDINATE Program aims to improve care for older adults with multiple long-term health issues. This program employs a nurse-led approach to manage patients' needs and track their progress after hospital discharge. Although new, the program builds on similar care coordination efforts that have been well-received in other studies.
Existing research has not indicated any major safety concerns for participants in programs like COORDINATE. These programs primarily aim to improve quality of life and reduce hospital visits, rather than introducing new medications or treatments that might have side effects.
Participants in the COORDINATE Program receive personalized support from trained nurses, which includes setting health goals and monitoring symptoms. This type of care coordination is generally considered safe and helpful, as it supports patients without introducing risks.12345Why are researchers excited about this trial?
Researchers are excited about the COORDINATE Program for managing multi-morbidity because it offers a fresh approach to transitional care. Unlike standard treatments that might focus on individual conditions separately, this nurse-led program provides a structured 6-week intervention that integrates care across multiple conditions. It includes comprehensive follow-up calls at 1, 4, and 6 weeks, ensuring ongoing support and coordination. This holistic approach is designed to improve patient outcomes by addressing the complex needs of patients with multiple chronic conditions in a more cohesive manner.
What evidence suggests that the COORDINATE Program is effective for improving care for older adults with multiple chronic conditions?
Research shows that care coordination programs, such as the COORDINATE Program, can greatly improve the quality of life for people with multiple health issues. Studies have found that well-organized, patient-focused care leads to fewer emergency room visits and hospital stays. A review of research found that collaboration with healthcare providers reduced the need for unexpected medical care. Early results suggest that programs offering personalized and ongoing support significantly help older adults manage their symptoms and improve their overall well-being.12678
Who Is on the Research Team?
Binu Koirala, PhD, MGS
Principal Investigator
Johns Hopkins School of Nursing
Are You a Good Fit for This Trial?
This trial is for older adults with multiple chronic conditions who are leaving Intermediate Care Units. They should be able to complete surveys and participate in follow-up calls. There's no specific list of exclusions provided, but typically those unable to consent or follow the program may not qualify.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive the COORDINATE Program or enhanced usual care, including follow-up calls and discharge planning
Follow-up
Participants are monitored for quality of life and healthcare utilization outcomes
What Are the Treatments Tested in This Trial?
Interventions
- COORDINATE Program
Find a Clinic Near You
Who Is Running the Clinical Trial?
Johns Hopkins University
Lead Sponsor