Post-Hospital Case Management to Improve Clinical Outcomes in Individuals Requiring Mechanical Ventilation

NCT ID: NCT00149513

Last Updated: 2017-12-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-09-30

Study Completion Date

2009-02-28

Brief Summary

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King County Lung Injury Project: Survivor Outcome Study (KCLIP:SOS) is a randomized trial for individuals who have survived prolonged mechanical ventilation (5 days or more). The objective is to enroll individuals who are likely to have impaired health status resulting from prolonged critical illness but whose long term prognosis is good. Such individuals are most likely to benefit from the study intervention of case management targeted at post intensive care complications.

KCLIP:SOS will test whether an outpatient intervention based on a nurse using a targeted case management tool can reduce patient morbidity and improve quality of life in the 6 months following hospital discharge. This intervention will be compared to usual post-hospital care.

Detailed Description

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BACKGROUND:

The purpose of this study is to understand individuals' physical and emotional conditions and concerns after being ventilated in the hospital. Modern hospital care helps many people survive even if they are on ventilators for long periods of time. Some individuals who leave the hospital after this kind of intensive care suffer from depression, post-traumatic stress disorder, muscle weakness, tiredness or breathing difficulties that may decrease their quality of life. Doctors know little about finding and treating these problems in survivors of mechanical ventilation.

DESIGN NARRATIVE:

Participants will be randomly assigned in blocks of 10 (5 participants to usual care and 5 participants to case management) for home or skilled nursing facility discharges. The Outcome Assessors (the interviewers collecting outcomes data) will be blinded to group assignment.

Primary outcome: All participants will have a baseline interview soon after hospital discharge and a final interview at the end of the 6-month intervention period (outcome assessments). All subjects will be asked to keep a diary/journal of their medical appointments, health services, and medications. Participants will be called once a month to collect this information.

Key secondary outcomes: Case management participants will be contacted by the nurse case manager who will provide follow-up care for 6 months. At the end of the study, interview results will be sent to the personal physician of the usual care participants so that appropriate care can follow.

Conditions

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Acute Respiratory Distress Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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1

Targeted nurse case management

Group Type EXPERIMENTAL

Targeted Case Management

Intervention Type BEHAVIORAL

A nurse case manager will assess and follow intervention arm subjects for six months. Nurse case manager will help subjects acquire needed community health services.

2

Usual Care

Group Type ACTIVE_COMPARATOR

Usual care

Intervention Type BEHAVIORAL

Participants will receive usual care.

Interventions

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Targeted Case Management

A nurse case manager will assess and follow intervention arm subjects for six months. Nurse case manager will help subjects acquire needed community health services.

Intervention Type BEHAVIORAL

Usual care

Participants will receive usual care.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* On a ventilator for 5 or more days
* Expected to survive the 6 months post-hospital discharge period
* Lives in the SOS zip code area (King, Pierce and Snohomish counties)

Exclusion Criteria

* Severe pre-hospital health conditions
* Lack of availability for follow-up (e.g. homeless, chronic substance abuse)
* Non-English speakers
* Severe psychiatric issues
* Need for special rehabilitation services not available in the intervention
* Predicted survival of less than 6 months
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Elizabeth Parsons

Assistant Professor, SOM: Department of Medicine: Pulmonary, Critical Care and Sleep Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gordon Rubenfeld, MD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Locations

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University of Washington

Seattle, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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P50HL073996

Identifier Type: NIH

Identifier Source: secondary_id

View Link

25934

Identifier Type: -

Identifier Source: org_study_id