Boosting Resources for Tracheostomy Care at Home

NCT ID: NCT06283953

Last Updated: 2025-10-14

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

ENROLLING_BY_INVITATION

Clinical Phase

NA

Total Enrollment

480 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-05-16

Study Completion Date

2027-10-01

Brief Summary

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The goal of this trial is to advance the understanding of how to best support caregivers of children with tracheostomies who are caring for their child at home. The main questions it aims to answer are:

* What are the best ways to support caregivers post-discharge with both medical and nonmedical decisions about resuming life, work, and family activities, while safely caring for their child with a tracheostomy at home?
* How can the investigators leverage existing technology to facilitate communication between inpatient and outpatient care teams to better support needs of pediatric patients and caregivers post-discharge?

Caregiver participants will be randomly assigned to receive Trach Me Home (gold standard discharge program) or Trach Me Home with additional components. Caregiver participants will complete three surveys over the course of 6 months. Researchers will see if caregivers in the Trach Me Home with additional components report lower caregiver burden at 4 weeks post discharge (primary outcome) and fewer hospital readmissions at 6 months than those in Trach Me Home arm.

Detailed Description

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The study is focused on a rare and medically complex population of children with tracheostomies. The study is a Type I hybrid effectiveness-implementation study using a pragmatic randomized trial at six participating sites. The goal of this trial is to advance the understanding of how to best support caregivers of children with tracheostomies who are caring for their child at home. The main question\[s\] it aims to answer are:

* What are the best ways to support caregivers post-discharge with both medical and nonmedical decisions about resuming life, work, and family activities, while safely caring for their child with a tracheostomy at home?
* How can the investigators leverage existing technology to facilitate communication between inpatient and outpatient care teams to better support needs of pediatric patients and caregivers post-discharge?

Caregiver participants will randomly assigned to the Comparator arm (gold standard discharge program) or to the Intervention arm (gold standard program with other components). Caregiver participants will complete three surveys over the course of 6 months. The investigators will test two main hypotheses: the Intervention arm will have (1) significantly lower caregiver burden at 4 weeks post discharge (primary outcome) and (2) significantly lower readmissions or emergency room visits at 6 months post discharge than the Comparator arm.

The investigators will also survey pediatricians of participating patients at 6 months post discharge and examine whether intervention arm pediatricians have higher satisfaction with discharge communication than those in comparator arm.

Conditions

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Tracheostomy Caregiver Burden

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors
Blinding of care team delivering the interventions and of caregiver participants receiving the interventions is not possible for this study.

The outcome assessors collecting the readmission data and statistician conducting analyses will be blinded to the assignment.

Study Groups

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Active Comparator Caregivers

TrachMeHome program delivered in the hospital including education, skills training and case management for caregivers

Group Type ACTIVE_COMPARATOR

Trach Me Home

Intervention Type BEHAVIORAL

The Trach Me Home discharge program includes caregiver education, skills training and case management.

Intervention Caregivers

Trach Me Home and Trach Plus with additional education, outpatient care team communication and social support for caregivers.

Group Type EXPERIMENTAL

Trach Plus

Intervention Type BEHAVIORAL

The Trach Plus program includes education, social support, and outreach to outpatient care team.

Trach Me Home

Intervention Type BEHAVIORAL

The Trach Me Home discharge program includes caregiver education, skills training and case management.

Active Comparator Physicians

Primary care physicians' of the enrolled participant's child receiving discharge communication

Group Type ACTIVE_COMPARATOR

Trach Me Home

Intervention Type BEHAVIORAL

The Trach Me Home discharge program includes caregiver education, skills training and case management.

Intervention Physicians

Primary care physicians' of the enrolled participant's child receiving outpatient care team communication prior to discharge

Group Type EXPERIMENTAL

Trach Plus

Intervention Type BEHAVIORAL

The Trach Plus program includes education, social support, and outreach to outpatient care team.

Trach Me Home

Intervention Type BEHAVIORAL

The Trach Me Home discharge program includes caregiver education, skills training and case management.

Interventions

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Trach Plus

The Trach Plus program includes education, social support, and outreach to outpatient care team.

Intervention Type BEHAVIORAL

Trach Me Home

The Trach Me Home discharge program includes caregiver education, skills training and case management.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Lead or primary adult caregiver (18 or older) of infants or children (0-17 years old) with tracheostomy who are planning for discharge to home, including children who are dependent on ventilator

Exclusion Criteria

* Patients transferred to other hospital or facility (and/or not discharged to home during study period)
* Primary caregiver unable to read or write in English, Spanish, Mandarin, or Arabic
* Not residing in the U.S. for at least 12 months after discharge
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Children's Hospital Medical Center, Cincinnati

OTHER

Sponsor Role collaborator

Children's Hospital of Philadelphia

OTHER

Sponsor Role collaborator

Children's Hospitals and Clinics of Minnesota

OTHER

Sponsor Role collaborator

Children's National Research Institute

OTHER

Sponsor Role collaborator

Rady Children's Hospital, San Diego

OTHER

Sponsor Role collaborator

Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

Massachusetts General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Karen Sepucha

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Karen Sepucha, PhD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts General Hospital

Christopher Hartnick, MD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts Eye and Ear Infirmary / Massachusetts General Hospital

Locations

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University of San Diego Rady Children's Hospital

La Jolla, California, United States

Site Status

Children's National Medical Center, Children's Research Institute

Silver Spring, Maryland, United States

Site Status

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Children's Hospitals and Clinics of Minnesota

Minneapolis, Minnesota, United States

Site Status

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States

Site Status

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

References

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Sepucha K, Callans K, Leavitt L, Chang Y, Vo H, Brigger M, Broughton S, Cahill J, Chinnadurai S, Germann J, Giordano T, Greenlick-Michals H, Javia L, Jayawardena ADL, Osthimer J, Patel RC, Redmann A, Roumiantsev S, Simmons L, Smith M, Tate M, Warren M, Whalen K, Yager P, Zalzal H, Hartnick C. Boosting REsources And caregiver empowerment for Tracheostomy care at HomE (BREATHE) Study: study protocol for a stratified randomization trial. Trials. 2024 Oct 28;25(1):722. doi: 10.1186/s13063-024-08522-x.

Reference Type DERIVED
PMID: 39468582 (View on PubMed)

Other Identifiers

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IHS-2022C1-26100

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2023P001695

Identifier Type: -

Identifier Source: org_study_id

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