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Showing 1–24 of 170 matching trials from the live ClinicalTrials.gov search.
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Filters: Condition: Care Transitions Clear all
Completed Not applicable Interventional Accepts healthy volunteers

Using Health Information Technology (HIT) to Improve Transitions of Complex Elderly Patients From Skilled Nursing Facility (SNF) to Home

NCT01004328
View directory record Official record
Conditions
Adverse Outcomes
Interventions
Intervention 1: Electronic medical record (EMR)-based transitional care intervention
Other
Lead sponsor
University of Massachusetts, Worcester
Other
Eligibility
65 Years and older
Enrollment
626 participants
Healthy volunteers
Accepts healthy volunteers
Timeline
2011 – 2013
U.S. locations
1
States / cities
Worcester, Massachusetts
Source: ClinicalTrials.gov public record
Updated Apr 23, 2014 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional

A Pharmacist-led Transitions of Care Program

NCT04556786
View directory record Official record
Conditions
Chronic Disease
Interventions
Transitions of care
Behavioral
Lead sponsor
Auburn University
Other
Eligibility
18 Years and older
Enrollment
88 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2018 – 2019
U.S. locations
1
States / cities
Auburn, Alabama
Source: ClinicalTrials.gov public record
Updated Sep 20, 2020 · Synced Jul 21, 2026, 11:30 AM EDT
Terminated Phase 4 Interventional Results available

Nebulizer Versus Dry Powdered Inhalers for Chronic Obstructive Pulmonary Disease (COPD)

NCT03219866
View directory record Official record
Conditions
COPD, COPD Exacerbation
Interventions
Nebulizers, Dry Powder Inhaler, Brovana, Pulmicort, Atrovent, Advair Diskus, Spiriva HandiHaler
Device · Drug
Lead sponsor
Wake Forest University Health Sciences
Other
Eligibility
40 Years and older
Enrollment
40 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2017 – 2020
U.S. locations
1
States / cities
Winston-Salem, North Carolina
Source: ClinicalTrials.gov public record
Updated Jun 21, 2021 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional Results available

Feasibility Testing of Patient Reported Outcomes - Informed Symptom Management System (PRISMS)

NCT04492007
View directory record Official record
Conditions
Colorectal Cancer, Bladder Cancer, Ovarian Cancer, Cervical Cancer, Uterine Cancer
Interventions
Patient-Reported Outcomes-Informed Symptom Management System (PRISMS)
Behavioral
Lead sponsor
UNC Lineberger Comprehensive Cancer Center
Other
Eligibility
18 Years to 99 Years
Enrollment
46 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2020 – 2021
U.S. locations
1
States / cities
Chapel Hill, North Carolina
Source: ClinicalTrials.gov public record
Updated Feb 2, 2025 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Phase 2Phase 3 Interventional

Improving Medication Adherence Through a Transitional Care Pharmacy Practice Model

NCT02047448
View directory record Official record
Conditions
Pulmonary Disease, Chronic Obstructive, Heart Failure
Interventions
Pharmacist Counseling
Procedure
Lead sponsor
Wilkes University
Other
Eligibility
18 Years and older
Enrollment
180 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2014 – 2017
U.S. locations
1
States / cities
Scranton, Pennsylvania
Source: ClinicalTrials.gov public record
Updated May 1, 2017 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional Results available

A Technology Assisted Care Transition Intervention for Veterans With CHF or COPD

NCT02632552
View directory record Official record
Conditions
CHF, COPD
Interventions
Technology-assisted care transition intervention, Active attention control
Behavioral
Lead sponsor
VA Office of Research and Development
Federal
Eligibility
18 Years and older
Enrollment
140 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2018 – 2021
U.S. locations
5
States / cities
Palo Alto, California • Hines, Illinois • Iowa City, Iowa + 2 more
Source: ClinicalTrials.gov public record
Updated Jul 26, 2023 · Synced Jul 21, 2026, 11:30 AM EDT
Recruiting Not applicable Interventional

Adapted Hospital Discharge Intervention: the CONNECT Pilot

NCT07032818
View directory record Official record
Conditions
Communication Research
Interventions
Additional post discharge phone call
Other
Lead sponsor
Boston Medical Center
Other
Eligibility
18 Years and older
Enrollment
60 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2026 – 2027
U.S. locations
1
States / cities
Boston, Massachusetts
Source: ClinicalTrials.gov public record
Updated Jan 19, 2026 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional

System-Wide Improvement for Transitions After Surgery: The SWIFT Post op Program

NCT02543190
View directory record Official record
Conditions
Colectomy, Colorectal Surgery, Ileostomy
Interventions
compliance surveillance and improvement strategy
Behavioral
Lead sponsor
University of Minnesota
Other
Eligibility
18 Years and older
Enrollment
100 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2014 – 2016
U.S. locations
2
States / cities
Minneapolis, Minnesota • Saint Paul, Minnesota
Source: ClinicalTrials.gov public record
Updated Dec 28, 2017 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional Accepts healthy volunteers

The Residential Care Transition Module

NCT02915939
View directory record Official record
Conditions
Alzheimer Disease, Dementia
Interventions
The Residential Care Transition Module
Behavioral
Lead sponsor
University of Minnesota
Other
Eligibility
21 Years and older
Enrollment
240 participants
Healthy volunteers
Accepts healthy volunteers
Timeline
2016 – 2021
U.S. locations
1
States / cities
Minneapolis, Minnesota
Source: ClinicalTrials.gov public record
Updated Aug 2, 2022 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional

Use of a Brief Phone Call After ED Discharge

NCT01893931
View directory record Official record
Conditions
Discharge Planning, Emergency Medicine, Geriatrics, Patient Readmission
Interventions
ED Discharge & Medication Call, Placebo Comparator
Behavioral
Lead sponsor
University of North Carolina, Chapel Hill
Other
Eligibility
65 Years and older
Enrollment
2,003 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2013 – 2016
U.S. locations
1
States / cities
Chapel Hill, North Carolina
Source: ClinicalTrials.gov public record
Updated Jul 10, 2016 · Synced Jul 21, 2026, 11:30 AM EDT
Recruiting Not applicable Interventional

Cardiac Rehabilitation of Stroke Survivors (SRP-CROSS)

NCT05651945
View directory record Official record
Conditions
Stroke, Cerebrovascular Accident
Interventions
Cardiac rehabilitation program
Other
Lead sponsor
Hackensack Meridian Health
Other
Eligibility
18 Years and older
Enrollment
150 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2023 – 2031
U.S. locations
1
States / cities
Edison, New Jersey
Source: ClinicalTrials.gov public record
Updated Feb 4, 2026 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional Results available

Suicide Prevention in Rural Veterans During High-risk Care Transition Scenarios

NCT04054947
View directory record Official record
Conditions
Suicidal and Self-injurious Behavior
Interventions
Suicide Prevention Program
Behavioral
Lead sponsor
White River Junction Veterans Affairs Medical Center
Federal
Eligibility
18 Years and older
Enrollment
60 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2019 – 2022
U.S. locations
1
States / cities
White River Junction, Vermont
Source: ClinicalTrials.gov public record
Updated Jun 25, 2024 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional

Suicide Prevention Among Recipients of Care

NCT04893447
View directory record Official record
Conditions
Suicide, Suicide, Attempted, Suicidal Ideation, Social Support, Secondary Prevention, Patient Care Planning, Outpatients, Outpatient Clinics, Hospital, Mental Health Services, Mental Health, Mental Disorder, Loneliness, Emergency Service, Hospital, Depressive Disorder, Depression, Continuity of Patient Care, Ambulatory Care, Adolescent, Adult, Crisis Intervention
Interventions
SPI+, SP+CC (Caring Contacts)
Behavioral
Lead sponsor
St. Luke's Health System, Boise, Idaho
Other
Eligibility
12 Years and older
Enrollment
1,520 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2021 – 2024
U.S. locations
1
States / cities
Boise, Idaho
Source: ClinicalTrials.gov public record
Updated Nov 11, 2024 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional

Pharmacist-led Transitions of Care in the Outpatient Oncology Infusion Center for Patients With Solid Tumor

NCT04122118
View directory record Official record
Conditions
Malignant Solid Neoplasm
Interventions
Medical Chart Review, Educational Intervention, Survey Administration
Other
Lead sponsor
Thomas Jefferson University
Other
Eligibility
18 Years to 85 Years
Enrollment
26 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2019 – 2021
U.S. locations
1
States / cities
Philadelphia, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Apr 28, 2025 · Synced Jul 21, 2026, 11:30 AM EDT
Recruiting Not applicable Interventional

Transition to Cardiac Rehabilitation (T2CR) to Address Barriers of Multimorbidity and Frailty

NCT06244199
View directory record Official record
Conditions
Cardiovascular Diseases, Cardiac Rehabilitation, Transition of Care
Interventions
T2CR Intervention, Usual Care
Behavioral · Other
Lead sponsor
VA Office of Research and Development
Federal
Eligibility
18 Years and older
Enrollment
250 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2024 – 2027
U.S. locations
2
States / cities
Boston, Massachusetts • Pittsburgh, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Oct 21, 2025 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional

Adapting a Sepsis Transition and Recovery Program for Optimal Scale Up

NCT05997420
View directory record Official record
Conditions
Sepsis
Interventions
STAR Program, Usual Care
Behavioral
Lead sponsor
Wake Forest University Health Sciences
Other
Eligibility
18 Years and older
Enrollment
1,820 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2024 – 2025
U.S. locations
1
States / cities
Charlotte, North Carolina
Source: ClinicalTrials.gov public record
Updated Jan 28, 2026 · Synced Jul 21, 2026, 11:30 AM EDT
Recruiting Not applicable Interventional Accepts healthy volunteers

Improving Care Transitions for Medicaid Insured Individuals With Co-occurring Serious Mental Illness

NCT06203509
View directory record Official record
Conditions
Care Transitions
Interventions
Thrive Intervention
Behavioral
Lead sponsor
University of Pennsylvania
Other
Eligibility
18 Years and older
Enrollment
267 participants
Healthy volunteers
Accepts healthy volunteers
Timeline
2024 – 2026
U.S. locations
1
States / cities
Philadelphia, Pennsylvania
Source: ClinicalTrials.gov public record
Updated May 4, 2026 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional Accepts healthy volunteers

Improving Hospital-to-Home Care Transitions for High-risk Younger Adult Patients

NCT02532296
View directory record Official record
Conditions
Patient Discharge
Interventions
Transition Coach (TC), Control
Behavioral
Lead sponsor
Cambridge Health Alliance
Other
Eligibility
18 Years to 60 Years
Enrollment
201 participants
Healthy volunteers
Accepts healthy volunteers
Timeline
2015 – 2016
U.S. locations
1
States / cities
Cambridge, Massachusetts
Source: ClinicalTrials.gov public record
Updated Aug 4, 2016 · Synced Jul 21, 2026, 11:30 AM EDT
Recruiting Not applicable Interventional

Pharmacy-led Transitions of Care Intervention to Improve Medication Adherence

NCT06374277
View directory record Official record
Conditions
Diabetes, Hypertension, High Cholesterol/Hyperlipidemia, Coronary Artery Disease, Congestive Heart Failure, Chronic Lung Disease, Chronic Kidney Diseases, Arrythmia, Stroke, Depression, Anxiety, Pulmonary Embolism, Heart Attack
Interventions
Med AAAction intervention
Other
Lead sponsor
University of Tennessee
Other
Eligibility
18 Years and older
Enrollment
388 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2024 – 2028
U.S. locations
2
States / cities
Knoxville, Tennessee • Memphis, Tennessee
Source: ClinicalTrials.gov public record
Updated Jan 28, 2026 · Synced Jul 21, 2026, 11:30 AM EDT
Recruiting Not applicable Interventional

Health Care Transition Readiness Short-Form Video Intervention

NCT06842576
View directory record Official record
Conditions
Health Care Transition Readiness, Health Literacy, Self Efficacy, Emotional Wellbeing, Appointment Attendance
Interventions
Health Education Videos, GotTransition.org Website
Behavioral
Lead sponsor
Children's Hospital Los Angeles
Other
Eligibility
12 Years to 17 Years
Enrollment
44 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2025 – 2026
U.S. locations
1
States / cities
Los Angeles, California
Source: ClinicalTrials.gov public record
Updated May 11, 2026 · Synced Jul 21, 2026, 11:30 AM EDT
Recruiting Not applicable Interventional

OsteoPorotic fracTure preventION System (OPTIONS) Research Study

NCT06731608
View directory record Official record
Conditions
Osteoporosis, Lower Limb Fracture
Interventions
OPTIONS, Enhanced usual care
Behavioral
Lead sponsor
Brigham and Women's Hospital
Other
Eligibility
65 Years and older
Enrollment
1,344 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2026 – 2029
U.S. locations
2
States / cities
Baltimore, Maryland • Boston, Massachusetts
Source: ClinicalTrials.gov public record
Updated Jan 28, 2026 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional Results available

Mobile After-Care Support App: Pilot RCT

NCT03955250
View directory record Official record
Conditions
Psychotic Disorder
Interventions
Mobile After-Care Support (MACS) app, Mobile app attention control
Behavioral
Lead sponsor
Butler Hospital
Other
Eligibility
18 Years and older
Enrollment
42 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2019 – 2022
U.S. locations
1
States / cities
Providence, Rhode Island
Source: ClinicalTrials.gov public record
Updated Mar 18, 2024 · Synced Jul 21, 2026, 11:30 AM EDT
Completed Not applicable Interventional Results available

Home Based Care Transitions Tailored by Cognition and Patient Activation

NCT02045147
View directory record Official record
Conditions
Chronic Disease
Interventions
Grp 1a Low Cognition, Low Activation Intervention, Grp 2a Low Cognition, High Activation Intervention, Grp 3a Normal Cognition, Low Activation Intervention, Grp 4a Normal Cognition, High Activation Intervention
Behavioral
Lead sponsor
University of Nebraska
Other
Eligibility
19 Years and older
Enrollment
263 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2013 – 2014
U.S. locations
1
States / cities
Lincoln, Nebraska
Source: ClinicalTrials.gov public record
Updated Oct 7, 2024 · Synced Jul 21, 2026, 11:30 AM EDT
Recruiting Not applicable Interventional

Real-time Symptom Monitoring Using ePROs to Prevent Adverse Events During Care Transitions

NCT05282654
View directory record Official record
Conditions
Multiple Chronic Conditions, Adverse Event
Interventions
ePRO Application
Behavioral
Lead sponsor
Brigham and Women's Hospital
Other
Eligibility
18 Years and older
Enrollment
1,300 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2022 – 2026
U.S. locations
2
States / cities
Boston, Massachusetts
Source: ClinicalTrials.gov public record
Updated Apr 19, 2026 · Synced Jul 21, 2026, 11:30 AM EDT