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ClinicalTrials.gov public records Last synced May 21, 2026, 11:54 PM EDT

Data is sourced from official ClinicalTrials.gov public API records. Always review the official ClinicalTrials.gov record for the latest information.

Showing 1–24 of 48 matching trials from the live ClinicalTrials.gov search.
Local D1 index available.
Filters: Condition: Transitional Care Planning Clear all
Completed No phase listed Observational
View directory record Official record
Conditions
Dementia, Dementia, Vascular, Alzheimer Disease, Delirium, Dementia, Amnestic, Cognitive Disorders, Lewy Body Disease, Mild Cognitive Impairment
Interventions
Augmented Standard Care (ASC), Resource Nurse Care (RNC), Advanced Practice Nurse Care (APNC)
Behavioral
Lead sponsor
University of Pennsylvania
Other
Eligibility
65 Years and older
Enrollment
814 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2006 – 2012
U.S. locations
3
States / cities
Philadelphia, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Feb 4, 2019 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional Accepts healthy volunteers
View directory record Official record
Conditions
Patient Admission, Patient Discharge
Interventions
Combined Social Worker and Pharmacist Program, No Intervention: Usual Care
Behavioral
Lead sponsor
Rush University Medical Center
Other
Eligibility
18 Years and older
Enrollment
100 participants
Healthy volunteers
Accepts healthy volunteers
Timeline
2011
U.S. locations
1
States / cities
Chicago, Illinois
Source: ClinicalTrials.gov public record
Updated May 30, 2013 · Synced May 21, 2026, 11:54 PM EDT
Recruiting Not applicable Interventional
View directory record Official record
Conditions
Stroke, Ischemic
Interventions
Transitional Care Program
Other
Lead sponsor
Syntrillo, Inc
Other
Eligibility
30 Years and older
Enrollment
224 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2024 – 2025
U.S. locations
1
States / cities
Winchester, Virginia
Source: ClinicalTrials.gov public record
Updated Jun 2, 2025 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional Results available
View directory record Official record
Conditions
Type 2 Diabetes Mellitus, Cardiometabolic Conditions, Behavioral Health Concerns
Interventions
Volunteer Peer Mentor+Behavioral Health Nurse
Behavioral
Lead sponsor
Scripps Whittier Diabetes Institute
Other
Eligibility
18 Years and older
Enrollment
536 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2016 – 2020
U.S. locations
1
States / cities
Chula Vista, California
Source: ClinicalTrials.gov public record
Updated Feb 27, 2023 · Synced May 21, 2026, 11:54 PM EDT
Suspended Not applicable Interventional
View directory record Official record
Conditions
Intensive Care Unit Syndrome, Disabilities Multiple, Critical Illness, Caregiver Burden
Interventions
Post Intensive Care Transitions Rehabilitation and Family Support (PIC-TRFS), Enhanced Usual Care Control
Other
Lead sponsor
University of Pittsburgh
Other
Eligibility
50 Years and older
Enrollment
320 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2025 – 2029
U.S. locations
1
States / cities
Pittsburgh, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Jan 13, 2026 · Synced May 21, 2026, 11:54 PM EDT
Recruiting Not applicable Interventional
View directory record Official record
Conditions
Chronic Opioid Use
Interventions
Transitional Pain Service
Behavioral
Lead sponsor
VA Office of Research and Development
Federal
Eligibility
18 Years and older
Enrollment
400 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2024 – 2027
U.S. locations
1
States / cities
Salt Lake City, Utah
Source: ClinicalTrials.gov public record
Updated May 5, 2026 · Synced May 21, 2026, 11:54 PM EDT
Recruiting Not applicable Interventional
View directory record Official record
Conditions
Health Care, Pediatrics, Transitional Care, Comparative Effectiveness, Family Engagement
Interventions
Focused Dose Hospital-to-Home Transitional Care Interventions, Extended Dose Hospital-to-Home Transitional Care Interventions
Behavioral
Lead sponsor
Duke University
Other
Eligibility
Up to 18 Years
Enrollment
480 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2025 – 2029
U.S. locations
2
States / cities
Chapel Hill, North Carolina • Durham, North Carolina
Source: ClinicalTrials.gov public record
Updated Sep 10, 2025 · Synced May 21, 2026, 11:54 PM EDT
Completed Phase 3 Interventional
View directory record Official record
Conditions
Medication Reconciliation
Interventions
Electronic medication reconciliation
Other
Lead sponsor
Indiana University
Other
Eligibility
18 Years and older
Enrollment
4,818 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2010 – 2012
U.S. locations
1
States / cities
Indianapolis, Indiana
Source: ClinicalTrials.gov public record
Updated Mar 4, 2014 · Synced May 21, 2026, 11:54 PM EDT
Enrolling by invitation Not applicable Interventional
View directory record Official record
Conditions
Traumatic Brain Injury
Interventions
BETTER (Brain Injury, Education, Training, and Therapy to Enhance Recovery), Usual Care
Behavioral · Other
Lead sponsor
Duke University
Other
Eligibility
18 Years and older
Enrollment
500 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2024 – 2027
U.S. locations
1
States / cities
Durham, North Carolina
Source: ClinicalTrials.gov public record
Updated Apr 14, 2026 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional
View directory record Official record
Conditions
Ovarian Cancer, Transitional Care Planning
Interventions
telephone-based intervention, counseling intervention, educational intervention, medical chart review, questionnaire administration, psychosocial assessment and care, quality-of-life assessment
Behavioral · Other · Procedure
Lead sponsor
City of Hope Medical Center
Other
Eligibility
18 Years and older · Female only
Enrollment
110 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2008 – 2010
U.S. locations
1
States / cities
Duarte, California
Source: ClinicalTrials.gov public record
Updated Aug 10, 2010 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional Accepts healthy volunteers
View directory record Official record
Conditions
Transitional Care, Frail Elderly, Home Health Care
Interventions
Transition Intervention
Behavioral
Lead sponsor
Johns Hopkins University
Other
Eligibility
65 Years and older
Enrollment
761 participants
Healthy volunteers
Accepts healthy volunteers
Timeline
2022 – 2023
U.S. locations
1
States / cities
Baltimore, Maryland
Source: ClinicalTrials.gov public record
Updated Aug 22, 2023 · Synced May 21, 2026, 11:54 PM EDT
Terminated Not applicable Interventional
View directory record Official record
Conditions
Positive Thinking, Psychology, Positive, Resilience, Psychological
Interventions
Three Good Things (3GT) Positive Psychology journaling activity
Behavioral
Lead sponsor
Mayo Clinic
Other
Eligibility
18 Years and older
Enrollment
25 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2021 – 2023
U.S. locations
1
States / cities
Bloomer, Wisconsin
Source: ClinicalTrials.gov public record
Updated Apr 9, 2024 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional
View directory record Official record
Conditions
Type 1 Diabetes Mellitus
Interventions
Transition Empowerment Program, Transition Empowerment Program (TEP) + Diabetes Wellness Council (DWC), Online Transition Empowement Program Access
Behavioral
Lead sponsor
University of Southern California
Other
Eligibility
19 Years to 25 Years
Enrollment
104 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2009 – 2020
U.S. locations
1
States / cities
Los Angeles, California
Source: ClinicalTrials.gov public record
Updated Nov 18, 2020 · Synced May 21, 2026, 11:54 PM EDT
Withdrawn No phase listed Observational
View directory record Official record
Conditions
Transitional Care Coordination, Home Visits
Interventions
Collaborative visit with provider and pharmacist
Other
Lead sponsor
Ohio State University
Other
Eligibility
18 Years and older
Healthy volunteers
Healthy volunteers not accepted
Timeline
2013 – 2014
U.S. locations
1
States / cities
Columbus, Ohio
Source: ClinicalTrials.gov public record
Updated Sep 29, 2022 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional Results available
View directory record Official record
Conditions
Pathologic Processes
Interventions
Connect-Home Plus
Behavioral
Lead sponsor
University of North Carolina, Chapel Hill
Other
Eligibility
18 Years and older
Enrollment
38 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2021 – 2022
U.S. locations
1
States / cities
Chapel Hill, North Carolina
Source: ClinicalTrials.gov public record
Updated Jul 20, 2023 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional
View directory record Official record
Conditions
Post-intensive Care Syndrome, Transitional Care, Critical Care, Health Services
Interventions
PICTURE-THIS, Enhanced Usual Care, Run-In Phase
Other · Behavioral
Lead sponsor
University of Pittsburgh
Other
Eligibility
50 Years and older
Enrollment
42 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2023 – 2025
U.S. locations
1
States / cities
Pittsburgh, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Dec 17, 2025 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional
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 May 21, 2026, 11:54 PM EDT
Recruiting Not applicable Interventional
View directory record Official record
Conditions
Liver Diseases
Interventions
Transitional Liver Clinic (TLC)
Other
Lead sponsor
Indiana University
Other
Eligibility
18 Years and older
Enrollment
1,000 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2023 – 2028
U.S. locations
4
States / cities
Chicago, Illinois • Indianapolis, Indiana • Ann Arbor, Michigan + 1 more
Source: ClinicalTrials.gov public record
Updated Oct 23, 2025 · Synced May 21, 2026, 11:54 PM EDT
Completed Phase 2Phase 3 Interventional
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 May 21, 2026, 11:54 PM EDT
Withdrawn Not applicable Interventional
View directory record Official record
Conditions
Colorectal Cancer, Comprehensive Transitional Care Program
Interventions
Patient education: One-on-one visit, Discharge planning: Assessment of barriers to discharge, Medication reconciliation: Patient medication review, Appointment before discharge: Additional measure to ensure awareness of next clinic visit, Transition coach, Patient-centered discharge instructions: Enhanced, Provider continuity: Specific surgeons responsible for coordinating care with medical/radiation oncology, Timely follow-up: Barriers to clinic follow-up visits will be discussed, Timely PCP communication, Follow-up telephone call, Patient hotline: 24 hour follow-up following call to Ask My Nurse number
Other
Lead sponsor
The University of Texas Health Science Center, Houston
Other
Eligibility
18 Years and older
Healthy volunteers
Healthy volunteers not accepted
Timeline
Started 2015
U.S. locations
1
States / cities
Houston, Texas
Source: ClinicalTrials.gov public record
Updated Jun 13, 2016 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional Results available
View directory record Official record
Conditions
Transitional Care, Caregivers, Patient Discharge, Aging, Frailty
Interventions
Connect-Home
Behavioral
Lead sponsor
University of North Carolina, Chapel Hill
Other
Eligibility
18 Years and older
Enrollment
654 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2019 – 2021
U.S. locations
1
States / cities
Chapel Hill, North Carolina
Source: ClinicalTrials.gov public record
Updated Aug 22, 2022 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional Results available
View directory record Official record
Conditions
Stroke, Transient Ischemic Attack
Interventions
COMPASS Intervention
Other
Lead sponsor
Wake Forest University Health Sciences
Other
Eligibility
18 Years and older
Enrollment
6,024 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2016 – 2020
U.S. locations
40
States / cities
Albemarle, North Carolina • Asheville, North Carolina • Chapel Hill, North Carolina + 32 more
Source: ClinicalTrials.gov public record
Updated Jun 10, 2021 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional
View directory record Official record
Conditions
Patient Admission, Patient Discharge
Interventions
Enhanced Discharge Planning Program transitional care
Behavioral
Lead sponsor
Rush University Medical Center
Other
Eligibility
65 Years and older
Enrollment
740 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2009 – 2010
U.S. locations
1
States / cities
Chicago, Illinois
Source: ClinicalTrials.gov public record
Updated Sep 7, 2023 · Synced May 21, 2026, 11:54 PM EDT
Completed Not applicable Interventional
View directory record Official record
Conditions
Cardiac Failure, Congestive Heart Failure
Interventions
Heart Failure Disease Management Program, Heart Failure Usual Care
Other
Lead sponsor
University of Colorado, Denver
Other
Eligibility
Not listed
Enrollment
713 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2013 – 2019
U.S. locations
1
States / cities
Aurora, Colorado
Source: ClinicalTrials.gov public record
Updated Aug 6, 2019 · Synced May 21, 2026, 11:54 PM EDT