Home-Based Integrated Care Nudge for Heart Failure
(AHCAH Trial)

Recruiting in Palo Alto (17 mi)

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: University of Pennsylvania

No Placebo Group

Trial Summary

What is the purpose of this trial?

This trial tests if encouraging doctors to sign up very sick heart failure patients for a special home care program can reduce hospital visits and costs. The program combines heart treatment with comfort care, aiming to improve patient quality of life.

Research Team

Eligibility Criteria

This trial is for adults over 18 with heart failure who live in a specific area and have had a related health care visit within the last year. They must be hospitalized during the study period, not pregnant, incarcerated, homeless, or without a primary physician.

Inclusion Criteria

I am 18 years old or older.

Your Palliative Connect score is higher than 0.3.

I was diagnosed with heart failure in the last year.

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Exclusion Criteria

You live outside the area where Caring Way can provide services.

Patients without an identifiable primary physician for AHCAH staff to communicate with as determined by the AHCAH liaison via EPIC

Prior hospitalization during study period

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Treatment Details

Interventions

Clinician nudge or opt out approach for AHCAH liaison visit (Behavioural Intervention)

Trial OverviewThe trial tests if 'nudging' clinicians to discuss and enroll seriously ill heart failure patients into an at-home care program can reduce healthcare use and costs while improving end-of-life care compared to usual practices.

Participant Groups

2Treatment groups

Experimental Treatment

Active Control

Group I: AHCAH NudgeExperimental Treatment1 Intervention

The investigators have developed methods for sending "nudges" to clinicians via secure text messages to primary teams to alert them that their patient was identified as high-risk for 6-month mortality and that an AHCAH liaison would visit their patient to discuss the AHCAH program and to facilitate enrollment if the patient was amenable. The investigators propose that these secure text messages would be sent to the teams of patients randomized to the intervention by the AHCAH liaison within 72 hours of eligibility identification (to allow for the liaison not being available over the weekend). The investigator team will track all aspects of messaging and timing. Clinicians can choose to opt out a patient from the liaison visit and AHCAH enrollment within a two-hour timeframe.

Group II: ControlActive Control1 Intervention

Usual Care

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Who Is Running the Clinical Trial?

University of Pennsylvania

Lead Sponsor

Trials

2,118

Recruited

45,270,000+

Dr. Joan Lau

University of Pennsylvania

Chief Executive Officer since 2020

PhD in Neuroscience from the University of Cincinnati College of Medicine, MBA from the Wharton School of Business, BS in Bioengineering from the University of Pennsylvania