Follow-up Automatically vs. As-Needed Comparison (FAAN-C) Trial

NCT ID: NCT05471908

Last Updated: 2025-12-10

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

RECRUITING

Clinical Phase

NA

Total Enrollment

2674 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-22

Study Completion Date

2028-02-28

Brief Summary

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Compare the effectiveness of automatic vs as-needed (PRN) post-hospitalization follow-up for children who are hospitalized for common infections.

Detailed Description

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BACKGROUND:

Automatic post-hospitalization follow-up visits are commonly recommended by hospital-based pediatricians. The intuitive appeal of automatic follow-up visits is that they might decrease hospital readmissions and promote continuity of care. However, automatic follow-up visits result in missed work for parents, missed school for children, and expenses like co-pays and transportation costs. The principal alternative strategy to automatic follow-up is PRN (pro re nata, "as-needed") follow-up, a patient and family-centered approach that empowers parents to monitor their child's symptoms and decide if a follow-up visit is necessary.

OBJECTIVE:

Compare the effectiveness of automatic vs as-needed (PRN) post-hospitalization follow-up for children who are hospitalized for common infections.

DESIGN:

The Follow-up Automatically vs As-Needed Comparison (FAAN-C, or "fancy") trial is a multicenter randomized controlled trial

POPULATION:

Children hospitalized for pneumonia, skin and soft tissue infection, acute gastroenteritis, or urinary tract infection will be eligible for enrollment.

EXPERIMENTAL INTERVENTION:

Randomization to a recommendation for PRN post-hospitalization follow-up

CONTROL INTERVENTION:

Randomization to a recommendation for automatic post-hospitalization follow-up

OUTCOMES:

The primary outcome is hospital readmission within 14 days of discharge. Secondary outcomes are medical interventions and child health-related quality of life. Exploratory outcomes are cost burden, child time, parent time, symptom duration, total additional ambulatory visits, non-primary care ambulatory visits, parent self-efficacy, parent anxiety, satisfaction with care, telephone and electronic communications with medical providers, well-child visits, immunizations, usual place of medical care, and medical interventions related to the index infection. Safety outcomes are medical errors and hospital readmissions related to the index infection.

TRIAL SIZE:

A total of 2,674 patients (1,337 patients in each group) will be randomized, providing 90% power to demonstrate non-inferiority of a recommendation for PRN follow-up compared to a recommendation for automatic follow-up.

Conditions

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Pneumonia Urinary Tract Infections Soft Tissue Infections Gastroenteritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors
Owing to the nature of the comparators, blinding of participants and their medical providers is not possible. However, outcomes that require adjudication will be adjudicated by persons blinded to the subject's randomized group. Outcomes requiring adjudication in FAAN-C are the safety outcomes (hospital readmissions related to the index infection and medical errors). Specifically, a clinician will determine if the readmission was related to the index infection and a separate clinician will score parent-reported medical errors in terms of severity (as described in the Safety Reporting section of the protocol). The clinicians performing adjudication of these outcomes will be blinded to the subject's randomized group.

Study Groups

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As-needed (PRN) post-hospitalization follow-up

At hospital discharge, participant receives a recommendation for PRN follow-up. Recommendation informs participant that scheduling a follow-up visit is not needed at discharge and suggests that participant follow symptoms after discharge to decide if a visit is ultimately needed or not.

Group Type EXPERIMENTAL

As-needed follow up

Intervention Type BEHAVIORAL

At hospital discharge, participant receives a recommendation for PRN follow-up. Recommendation informs participant that scheduling a follow-up visit is not needed at discharge and suggests that participant follow symptoms after discharge to decide if a visit is ultimately needed or not.

Automatic post-hospitalization follow-up

At hospital discharge, participant receives a recommendation for automatic follow-up. Recommendation instructs participant to schedule a follow-up visit and attend the visit even if symptoms get better.

Group Type ACTIVE_COMPARATOR

Automatic follow-up

Intervention Type BEHAVIORAL

At hospital discharge, participant receives a recommendation for automatic follow-up. Recommendation instructs participant to schedule a follow-up visit and attend the visit even if symptoms get better.

Interventions

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As-needed follow up

At hospital discharge, participant receives a recommendation for PRN follow-up. Recommendation informs participant that scheduling a follow-up visit is not needed at discharge and suggests that participant follow symptoms after discharge to decide if a visit is ultimately needed or not.

Intervention Type BEHAVIORAL

Automatic follow-up

At hospital discharge, participant receives a recommendation for automatic follow-up. Recommendation instructs participant to schedule a follow-up visit and attend the visit even if symptoms get better.

Intervention Type BEHAVIORAL

Other Intervention Names

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PRN (pro re nata)

Eligibility Criteria

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Inclusion Criteria

* Age \<18 years at the time of randomization
* Hospitalization due to a primary diagnosis of pneumonia, skin and soft tissue infection, acute gastroenteritis, or urinary tract infection.
* Parent speaks English or Spanish.

Exclusion Criteria

* Presence of a comorbid disease that is both chronic and complex
* Principal disease required surgical intervention (beyond superficial incision and drainage)
* Immunodeficiency
* A well-child check-up or post-hospitalization follow-up visit is already scheduled within 7 days of hospital discharge
* Parent or participant strongly prefers PRN or automatic follow-up
* A medical provider feels strongly that a post-hospitalization follow-up visit is needed within 7 days of hospital discharge
* Sibling concurrently hospitalized
* Unable to identify a clinic where the participant would receive any needed post-hospitalization follow-up
* Diagnosis of pneumonia complicated by:

o Receiving a chest tube
* Diagnosis of urinary tract infection complicated by:

* History of neurogenic bladder or urologic surgery
* Renal imaging anticipated within 7 days of hospital discharge
* Renal abscess
* Diagnosis of skin and soft tissue infection complicated by:

* Chronic wound
* Postoperative infection
* Predisposition to poor wound healing
* Discharging with a drain in place
* Complicated by necrotizing fasciitis or toxic shock syndrome
* Diagnosis of gastroenteritis complicated by:

* Hemolytic uremic syndrome
Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

University of Utah

OTHER

Sponsor Role lead

Responsible Party

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Eric Coon

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Eric Coon, MD

Role: PRINCIPAL_INVESTIGATOR

University of Utah

Locations

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Phoenix Children's Hospital

Phoenix, Arizona, United States

Site Status RECRUITING

Packard at El Camino Hospital

Mountain View, California, United States

Site Status RECRUITING

Lucile Packard Children's Hospital

Palo Alto, California, United States

Site Status RECRUITING

St. Louis Children's Hospital

St Louis, Missouri, United States

Site Status RECRUITING

Penn Medicine Princeton Medical Center

Plainsboro, New Jersey, United States

Site Status RECRUITING

Cincinnati Children's Hospital Medical Center - Main Campus

Cincinnati, Ohio, United States

Site Status RECRUITING

Cincinnati Children's Hospital Medical Center - Liberty Campus

Liberty Township, Ohio, United States

Site Status RECRUITING

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Texas Children's Main

Houston, Texas, United States

Site Status RECRUITING

Texas Children's West

Houston, Texas, United States

Site Status RECRUITING

Intermountain Primary Children's Hospital Larry H. and Gail Miller Family Campus

Lehi, Utah, United States

Site Status RECRUITING

Riverton Hospital

Riverton, Utah, United States

Site Status COMPLETED

Primary Children's Hospital

Salt Lake City, Utah, United States

Site Status RECRUITING

Seattle Children's Hospital

Seattle, Washington, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Eric Coon, MD, MS

Role: CONTACT

801-587-2160

Liz Rodriquez

Role: CONTACT

Facility Contacts

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Brittany Wold, MD

Role: primary

Lauren Destino, MD

Role: primary

Alan Schroeder, MD

Role: primary

Sarah Bram, MD

Role: primary

Julianne Prasto, MD

Role: primary

Patrick Brady, MD

Role: primary

Patrick Brady, MD

Role: primary

Chris Bonafide, MD

Role: primary

Sowdhamini Wallace, MD

Role: primary

Katie Ban, MD

Role: primary

Kristina McKinley, MD

Role: primary

Kristina McKinley

Role: primary

Eric Coon, MD, MS

Role: primary

Provided Documents

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Document Type: Study Protocol

View Document

Other Identifiers

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IHS-2021C1-22388

Identifier Type: -

Identifier Source: org_study_id

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