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Showing 25–48 of 24 matching trials from the live ClinicalTrials.gov search.
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Filters: Condition: Care Transitions Clear all
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 Jun 10, 2026, 9:22 PM EDT
Completed Not applicable Interventional

Care Transitions for Complex Patient - Cycle 1 and Cycle 2

NCT01039324
View directory record Official record
Conditions
Asthma, Coronary Artery Disease, Diabetes, Hypertension, Congestive Heart Failure
Interventions
Reports, Reports and Notices, Usual care
Other
Lead sponsor
Duke University
Other
Eligibility
Not listed
Enrollment
8,422 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2009 – 2012
U.S. locations
1
States / cities
Durham, North Carolina
Source: ClinicalTrials.gov public record
Updated May 14, 2014 · Synced Jun 10, 2026, 9:22 PM EDT
Completed Not applicable Interventional Results available

Criminal Justice Coordinated Transitional Care

NCT05376371
View directory record Official record
Conditions
HIV, Hepatitis C, Substance Use Disorders
Interventions
CJC-TraC
Other
Lead sponsor
University of Wisconsin, Madison
Other
Eligibility
18 Years and older
Enrollment
219 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2022 – 2025
U.S. locations
2
States / cities
Oregon, Wisconsin • Union Grove, Wisconsin
Source: ClinicalTrials.gov public record
Updated Nov 16, 2025 · Synced Jun 10, 2026, 9:22 PM EDT
Completed Not applicable Interventional Results available

Nurse-Led Heart Failure Care Transition Intervention for African Americans: The Navigator Program

NCT01141907
View directory record Official record
Conditions
Heart Failure
Interventions
Heart Failure Self Care Support, Usual heart failure care
Behavioral · Other
Lead sponsor
Johns Hopkins University
Other
Eligibility
21 Years and older
Enrollment
11 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2010 – 2011
U.S. locations
1
States / cities
Baltimore, Maryland
Source: ClinicalTrials.gov public record
Updated Feb 18, 2019 · Synced Jun 10, 2026, 9:22 PM EDT
Completed Not applicable Interventional

SWEET: Postpartum Navigation After GDM

NCT04583839
View directory record Official record
Conditions
Gestational Diabetes, Preventive Care / Anticipatory Guidance, Retention in Care, Postpartum Health, Lifestyle Modification
Interventions
Patient Navigation Program
Behavioral
Lead sponsor
Northwestern University
Other
Eligibility
16 Years and older · Female only
Enrollment
40 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2020 – 2024
U.S. locations
1
States / cities
Chicago, Illinois
Source: ClinicalTrials.gov public record
Updated Jun 5, 2024 · Synced Jun 10, 2026, 9:22 PM 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 Jun 10, 2026, 9:22 PM EDT
Withdrawn No phase listed Observational

Utility of Remote Lung Auscultation in Transitions of Care After Pulmonary Exacerbations of COPD

NCT05661435
View directory record Official record
Conditions
Chronic Obstructive Pulmonary Disease (COPD)
Interventions
RESP Biosensor
Device
Lead sponsor
Strados Labs, Inc.
Industry
Eligibility
35 Years to 75 Years
Healthy volunteers
Healthy volunteers not accepted
Timeline
2023
U.S. locations
2
States / cities
Philadelphia, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Mar 15, 2023 · Synced Jun 10, 2026, 9:22 PM EDT
Not listed No phase listed Observational

Care Transitions in Renal Disease Patients

NCT01842776
View directory record Official record
Conditions
Renal Disease
Interventions
Not listed
Lead sponsor
Fresenius Medical Care North America
Industry
Eligibility
18 Years and older
Enrollment
3,300 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2013 – 2014
U.S. locations
1
States / cities
Franklin, Tennessee
Source: ClinicalTrials.gov public record
Updated Apr 29, 2013 · Synced Jun 10, 2026, 9:22 PM EDT
Recruiting Not applicable Interventional

Transitions of Care Clinic (TOCC)

NCT06937827
View directory record Official record
Conditions
Heart Failure With Preserved Ejection Fraction
Interventions
HF Kit and Follow-ups
Behavioral
Lead sponsor
Hackensack Meridian Health
Other
Eligibility
18 Years to 90 Years
Enrollment
150 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2025 – 2027
U.S. locations
1
States / cities
Brick, New Jersey
Source: ClinicalTrials.gov public record
Updated Feb 10, 2026 · Synced Jun 10, 2026, 9:22 PM EDT
Enrolling by invitation Not applicable Interventional

Implementation and Evaluation of A Health Innovation to Support Medicaid-Insured Individuals Following Hospitalization

NCT05714605
View directory record Official record
Conditions
Care Transitions
Interventions
THRIVE Intervention
Behavioral
Lead sponsor
University of Pennsylvania
Other
Eligibility
18 Years to 99 Years
Enrollment
267 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2023 – 2026
U.S. locations
1
States / cities
Philadelphia, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Jul 2, 2025 · Synced Jun 10, 2026, 9:22 PM EDT
Enrolling by invitation Not applicable Interventional

Effectiveness of mHealth Post-discharge Intervention for Patients With Severe Mental Illness

NCT05703412
View directory record Official record
Conditions
Bipolar Disorder, Major Depression, Schizophrenia
Interventions
Transition-FOCUS mHealth Intervention, Check-In
Behavioral
Lead sponsor
Butler Hospital
Other
Eligibility
18 Years and older
Enrollment
180 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2023 – 2027
U.S. locations
1
States / cities
Providence, Rhode Island
Source: ClinicalTrials.gov public record
Updated Jun 5, 2025 · Synced Jun 10, 2026, 9:22 PM 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 Jun 10, 2026, 9:22 PM EDT
Completed Not applicable Interventional

Preventing Medication-Related Problems in Care Transitions to Skilled Nursing Facilities

NCT05241951
View directory record Official record
Conditions
Care Transition
Interventions
Structured hand-off, Medication reconciliation during transitional period, Transitional medication monitoring, Teleconsultation
Other
Lead sponsor
University of Washington
Other
Eligibility
18 Years and older
Enrollment
1,052 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2022 – 2025
U.S. locations
1
States / cities
Seattle, Washington
Source: ClinicalTrials.gov public record
Updated Nov 23, 2025 · Synced Jun 10, 2026, 9:22 PM EDT
Not yet recruiting Not applicable Interventional Accepts healthy volunteers

Designing Care Management for Hospice Transitions for Persons Living With Advanced Dementia

NCT07182357
View directory record Official record
Conditions
Alzheimer Disease and Related Dementias
Interventions
Dementia Care Management Checklist for Hospice Transitions
Behavioral
Lead sponsor
New York University
Other
Eligibility
18 Years and older
Enrollment
96 participants
Healthy volunteers
Accepts healthy volunteers
Timeline
2025 – 2028
U.S. locations
1
States / cities
New York, New York
Source: ClinicalTrials.gov public record
Updated Sep 18, 2025 · Synced Jun 10, 2026, 9:22 PM EDT
Completed Not applicable Interventional

Testing the Efficacy of a Post-discharge Call Program on the Rate of Readmission

NCT03683797
View directory record Official record
Conditions
Care Transitions
Interventions
Post-discharge call
Other
Lead sponsor
NYU Langone Health
Other
Eligibility
Not listed
Enrollment
3,267 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2018 – 2019
U.S. locations
1
States / cities
New York, New York
Source: ClinicalTrials.gov public record
Updated Jul 19, 2021 · Synced Jun 10, 2026, 9:22 PM EDT
Terminated Not applicable Interventional

Behavioral Coaching Intervention (Laguna Health) for Patients With Cancer

NCT06004141
View directory record Official record
Conditions
Cancer
Interventions
Laguna Health
Behavioral
Lead sponsor
Massachusetts General Hospital
Other
Eligibility
18 Years and older
Enrollment
18 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2023 – 2024
U.S. locations
1
States / cities
Boston, Massachusetts
Source: ClinicalTrials.gov public record
Updated Feb 1, 2024 · Synced Jun 10, 2026, 9:22 PM EDT
Recruiting Not applicable Interventional

Calls and Coordination for Transitions of Care at Re-entry

NCT06794983
View directory record Official record
Conditions
Prisoners, Substance Use History, Chronic Medical Conditions, Psychiatric Condition, Substance Use Disorder (SUD)
Interventions
In-person visit with study team member, In-person visit with NCM, Phone calls and texts, Phone calls and texts - NCM
Other
Lead sponsor
University of Wisconsin, Madison
Other
Eligibility
18 Years and older
Enrollment
488 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2025 – 2029
U.S. locations
1
States / cities
Madison, Wisconsin
Source: ClinicalTrials.gov public record
Updated Mar 12, 2026 · Synced Jun 10, 2026, 9:22 PM EDT
Completed Not applicable Interventional Accepts healthy volunteers

PREventing Adverse Events Post-Discharge Through Proactive Identification, Multidisciplinary Communication, and Technology

NCT05232656
View directory record Official record
Conditions
Transitions of Care, General Medicine, Discharge Checklist, Adverse Event
Interventions
Pre-Discharge Checklist and Patient Safety Dashboard
Behavioral
Lead sponsor
Brigham and Women's Hospital
Other
Eligibility
18 Years and older
Enrollment
268 participants
Healthy volunteers
Accepts healthy volunteers
Timeline
2018 – 2020
U.S. locations
1
States / cities
Boston, Massachusetts
Source: ClinicalTrials.gov public record
Updated Feb 9, 2022 · Synced Jun 10, 2026, 9:22 PM EDT
Not yet recruiting Not applicable Interventional

Patient Navigation for Improving Transition Success Among Multiply Disadvantaged Young Adult Survivors of Childhood Cancer

NCT07630831
View directory record Official record
Conditions
Cancer Childhood
Interventions
Navigation, Control
Behavioral
Lead sponsor
Children's Hospital Los Angeles
Other
Eligibility
20 Years to 29 Years
Enrollment
190 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2026 – 2030
U.S. locations
1
States / cities
Los Angeles, California
Source: ClinicalTrials.gov public record
Updated Jun 4, 2026 · Synced Jun 10, 2026, 9:22 PM EDT
Completed Not applicable Interventional

Feasibility of Using the CGM During TOC From in Persons With T2D Using Insulin

NCT04533945
View directory record Official record
Conditions
Diabetes, Type 2 Diabetes
Interventions
FreeStyle Libre
Device
Lead sponsor
Northwell Health
Other
Eligibility
18 Years and older
Enrollment
40 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2020
U.S. locations
1
States / cities
Manhasset, New York
Source: ClinicalTrials.gov public record
Updated Jan 10, 2022 · Synced Jun 10, 2026, 9:22 PM EDT
Terminated Not applicable Interventional

An Electronic Multimedia Discharge Application

NCT02752321
View directory record Official record
Conditions
Hospital Inpatients
Interventions
eDischarge
Device
Lead sponsor
Northwell Health
Other
Eligibility
18 Years and older
Enrollment
117 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2016 – 2017
U.S. locations
1
States / cities
New York, New York
Source: ClinicalTrials.gov public record
Updated Jan 9, 2018 · Synced Jun 10, 2026, 9:22 PM EDT
Recruiting Not applicable Interventional

Optimizing Care Transition Process for Older Colorectal Surgery Patients

NCT06752031
View directory record Official record
Conditions
Colorectal Surgery, Care Transition, Older Adults (65 Years and Older)
Interventions
OSCAR-S Care Transition Model
Behavioral
Lead sponsor
Massachusetts General Hospital
Other
Eligibility
65 Years and older
Enrollment
30 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2025 – 2027
U.S. locations
1
States / cities
Salem, Massachusetts
Source: ClinicalTrials.gov public record
Updated May 12, 2026 · Synced Jun 10, 2026, 9:22 PM EDT
Completed Not applicable Interventional

Mobile Integrated Health in Heart Failure

NCT04662541
View directory record Official record
Conditions
Heart Failure
Interventions
Mobile Integrated Health (MIH), Transitions of care coordinator (TOCC)
Other
Lead sponsor
Columbia University
Other
Eligibility
18 Years and older
Enrollment
2,005 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2021 – 2024
U.S. locations
3
States / cities
New York, New York
Source: ClinicalTrials.gov public record
Updated Feb 18, 2026 · Synced Jun 10, 2026, 9:22 PM EDT
Completed Not applicable Interventional

An Automatic Notification System for Test Results Finalized After Discharge

NCT01153451
View directory record Official record
Conditions
Test Result Management
Interventions
Email Notification
Other
Lead sponsor
Brigham and Women's Hospital
Other
Eligibility
18 Years and older
Enrollment
441 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2010 – 2012
U.S. locations
1
States / cities
Boston, Massachusetts
Source: ClinicalTrials.gov public record
Updated Jun 4, 2013 · Synced Jun 10, 2026, 9:22 PM EDT