Home Hospital care for Asthma

Phase-Based Progress Estimates
1
Effectiveness
1
Safety
Asthma+10 MoreHome Hospital care - Other
Eligibility
18+
All Sexes
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Study Summary

This trial sought to improve care for rural patients by providing hospital-level care in their homes.

Eligible Conditions
  • Gout Flare
  • Asthma
  • Infections
  • Diabetes
  • Blood Thinners
  • Heart Failure
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Atrial Fibrillation
  • High Blood Pressure Emergency
  • End of Life/Palliative Care
  • Chronic Kidney Disease

Treatment Effectiveness

Study Objectives

1 Primary · 4 Secondary · Reporting Duration: Day of discharge to 30 days, assessed up to 2 months

Month 2
Activities of daily living, score
EuroQol-5D-5L, visual analogue scale, 0-100, where 100 is the best imaginable health today
Instrumental activities of daily living, score
PROMIS Emotional Support Short Form 4a, score
Patient health questionnaire-2, score
SF-1
Day 10
Total cost, hospitalization
Month 2
Caregiver burden (Zarit), 0-48, where 48 indicates the worst possible caregiver burden
Month 2
Acute kidney injury, y/n
Consultant sessions, # of notes
DVT/PE, y/n
Daily steps
Delirium, y/n
Documentation error
Duration of subsequent RN visit, in-person
Duration of subsequent RN visit, virtual
Equipment malfunction
Failed connectivity, %
Fall, y/n
Frequency of disposition, routine, SNF, home health, other
Hospital-acquired Clostridium difficile infection, y/n
Hospital-acquired catheter-associated urinary tract infection, y/n
Hospital-acquired methicillin resistant staphylococcus aureus infection, y/n
Hours of activity per day
Hours of activity per night
Hours of sitting upright per day
Hours of sitting upright per night
Hours of sleep per day
Hours of sleep per night
Hypokalemia, y/n
IV medication, days
Imaging, %
Insufficient handoff
Intravenous antibiotics, days
Intravenous diuretics, days
Intravenous fluids, days
Lab orders, #
Length of stay, days
Loss of consciousness, y/n
MD sessions, # of notes
Medication error, y/n
Nebulizer treatment, days
New arrhythmia, y/n
New pressure ulcer, y/n
Number of "on call" MD interactions (video or phone)
Number of RN visits, in-person
Number of RN visits, total
Number of RN visits, virtual
Other metrics captured on the clinician process survey and nursing visit form
Oxygen requirement, days
Occupational therapy regime
Pain management, mean pain score on a scale from 0-10 where 10 is the worst pain imaginable
Percent of day lying down
RN travel time
Thrombophlebitis at peripheral IV site, y/n
Transfer back to hospital, y/n
Unanticipated mortality, y/n
Unplanned mortality during admission
Use of Foley catheter, y/n
Use of inappropriate medications in the elderly, y/n
Use of restraints, y/n
Month 2
Admission source
Admitting diagnosis
Age
BMI
BRIEF health literacy screening tool
COVID case count on day of admission
Comorbidities, type and #
DNR/I code status
Degree of rurality
Duration of 1st RN visit
ED visits in the previous 6 months, #
Education
Eight-item Interview to Differentiate Aging and Dementia
Elective and urgent admissions in the previous year, #
Employment
Gender
Health insurance states, public/private/none
Home health aide prior to admission
Interqual disease-specific leveling
Lives alone
Medications used as outpatient, #
PRISMA-7
Partner status
Primary language
Race/ethnicity
Smoking status
Would you be surprised if this patient died in the next year?
Zip code
Month 2
Qualitative interview
Day 30
Days at home
Total cost, discharge to 30-days post discharge
Unplanned readmission within 30-days of discharge
Month 2
[intervention arm only] Perceived acceptability of RHH care
Month 2
[intervention arm only] Perceived safety, quality of care, caregiver burden
Month 2
Unplanned 30-day mortality
Month 2
Readmission risk score on discharge (HOSPITAL)
Month 4
Qualitative interviews
Month 2
[intervention arm only] RHH admission, daily care, and discharge processes accomplished
Month 2
ED observation stay(s), # and y/n + date
ED visit(s), # and y/n + date
Follow up with patient's PCP within 14 days, y/n
Home health utilization, days
SNF utilization, days
Unplanned readmission(s) after index, # and y/n + date
Month 2
Global satisfaction with care, score, 0-10, where 10 is the best global satisfaction
Global satisfaction with care, score, 0-10, where 10 is the best global satistfaction
Picker Experience Questionnaire -15, score, measured 0-15, where 15 is the best patient experience
Recommend care, score, 0-10, where 10 is the best recommendation possible

Trial Safety

Trial Design

2 Treatment Groups

Traditional Hospital care
1 of 2
Home Hospital care
1 of 2

Active Control

Experimental Treatment

150 Total Participants · 2 Treatment Groups

Primary Treatment: Home Hospital care · No Placebo Group · N/A

Home Hospital care
Other
Experimental Group · 1 Intervention: Home Hospital care · Intervention Types: Other
Traditional Hospital care
Other
ActiveComparator Group · 1 Intervention: Traditional Hospital care · Intervention Types: Other

Trial Logistics

Trial Timeline

Screening: ~3 weeks
Treatment: Varies
Reporting: day of discharge to 30 days, assessed up to 2 months

Who is running the clinical trial?

Brigham and Women's HospitalLead Sponsor
1,480 Previous Clinical Trials
9,735,631 Total Patients Enrolled
40 Trials studying Asthma
215,746 Patients Enrolled for Asthma
The Thompson Family Foundation IncUNKNOWN

Eligibility Criteria

Age 18+ · All Participants · 10 Total Inclusion Criteria

Mark “Yes” if the following statements are true for you:
You have any of the following: pneumonia, diverticulitis, cellulitis, complicated urinary tract infection.
You have atrial fibrillation with rapid ventricular response.
References