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ClinicalTrials.gov public records Last synced Jul 22, 2026, 10:45 AM EDT

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Showing 1–24 of 82 matching trials from the live ClinicalTrials.gov search.
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Filters: Condition: Transitions of Care Clear all
Not yet recruiting Not applicable Interventional

Feasibility of an Interdisciplinary Intervention to Improve Care Transitions for Hospitalized Patients With Substance Use Disorders

NCT07575373
View directory record Official record
Conditions
Substance Use Disorders
Interventions
IntACT, Usual Care
Behavioral
Lead sponsor
Michael Incze
Other
Eligibility
18 Years and older
Enrollment
75 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2026 – 2027
U.S. locations
1
States / cities
Salt Lake City, Utah
Source: ClinicalTrials.gov public record
Updated May 10, 2026 · Synced Jul 22, 2026, 10:45 AM EDT
Completed No phase listed Observational

Linking Former Inmates to Primary Care

NCT01863290
View directory record Official record
Conditions
Hypertension, Substance Abuse, Asthma, Depression
Interventions
Primary care redesign
Other
Lead sponsor
Yale University
Other
Eligibility
18 Years and older
Enrollment
816 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2013 – 2016
U.S. locations
10
States / cities
Birmingham, Alabama • Martinez, California • San Francisco, California + 6 more
Source: ClinicalTrials.gov public record
Updated Oct 24, 2017 · Synced Jul 22, 2026, 10:45 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 22, 2026, 10:45 AM EDT
Terminated Phase 4 Interventional

Anchoring Sequential Intermittent Long Acting Antimicrobials With Medication for Opioid Use Disorder (MOUD) for Invasive Infections Related to Opioid Use

NCT05521880
View directory record Official record
Conditions
Substance Use Disorders, Infection, Soft Tissue, Bacteremia, Osteomyelitis Acute, Septic Arthritis
Interventions
Oritavancin
Drug
Lead sponsor
University of Maryland, Baltimore
Other
Eligibility
18 Years to 88 Years
Enrollment
2 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2024 – 2025
U.S. locations
1
States / cities
Baltimore, Maryland
Source: ClinicalTrials.gov public record
Updated May 28, 2025 · Synced Jul 22, 2026, 10:45 AM EDT
Completed Not applicable Interventional Results available

Hospital to Home Outcomes

NCT02081846
View directory record Official record
Conditions
Focus: Hospitalized Patients
Interventions
Nurse Home Visit, Standard of Care
Other
Lead sponsor
Children's Hospital Medical Center, Cincinnati
Other
Eligibility
Up to 18 Years
Enrollment
1,500 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2015 – 2017
U.S. locations
1
States / cities
Cincinnati, Ohio
Source: ClinicalTrials.gov public record
Updated Apr 15, 2019 · Synced Jul 22, 2026, 10:45 AM EDT
Completed Not applicable Interventional

The Impact of a Personalized Care Intervention on 90-day Post-Discharge Care

NCT06146582
View directory record Official record
Conditions
Cardiovascular Diseases
Interventions
Laguna Coach and App Intervention Group
Behavioral
Lead sponsor
Laguna Health, Inc
Industry
Eligibility
18 Years and older
Enrollment
187 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2021 – 2023
U.S. locations
1
States / cities
Rochester, Minnesota
Source: ClinicalTrials.gov public record
Updated Mar 19, 2024 · Synced Jul 22, 2026, 10:45 AM EDT
Completed Not applicable Interventional Results available

Improving Coordination and Transitions of Care in Stroke Patients

NCT02642744
View directory record Official record
Conditions
Stroke, Transient Ischemic Attack
Interventions
Nursing care model
Other
Lead sponsor
University of Pennsylvania
Other
Eligibility
18 Years and older
Enrollment
670 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2015 – 2023
U.S. locations
1
States / cities
Philadelphia, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Feb 22, 2024 · Synced Jul 22, 2026, 10:45 AM EDT
Completed Not applicable Interventional Results available

LCI-HEM-SCD-ST3P-UP-001: The Sickle Cell Trevor Thompson Transition Project (ST3P-UP Study)

NCT03593395
View directory record Official record
Conditions
Sickle Cell Disease
Interventions
Peer Mentoring [PM], Structured Education Based Transition Program STE
Other
Lead sponsor
Wake Forest University Health Sciences
Other
Eligibility
16 Years and older
Enrollment
291 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2019 – 2023
U.S. locations
14
States / cities
Birmingham, Alabama • Mobile, Alabama • Miami, Florida + 10 more
Source: ClinicalTrials.gov public record
Updated Sep 2, 2024 · Synced Jul 22, 2026, 10:45 AM EDT
Completed Not applicable Interventional

Electronic Medication Adherence Reporting and Feedback During Care Transitions

NCT03475030
View directory record Official record
Conditions
Medication Adherence
Interventions
pre-filled medication trays, automated medication reminders
Other
Lead sponsor
Brigham and Women's Hospital
Other
Eligibility
18 Years and older
Enrollment
207 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2016 – 2018
U.S. locations
1
States / cities
Boston, Massachusetts
Source: ClinicalTrials.gov public record
Updated Feb 18, 2019 · Synced Jul 22, 2026, 10:45 AM EDT
Active, not recruiting Not applicable Interventional

The Transitions Project: Efficacy Trial

NCT05087251
View directory record Official record
Conditions
Lung Cancer
Interventions
Five Psycho-educational Session(s), One Psycho-educational Session(s)
Behavioral
Lead sponsor
Massachusetts General Hospital
Other
Eligibility
21 Years and older
Enrollment
100 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2021 – 2026
U.S. locations
2
States / cities
Boston, Massachusetts
Source: ClinicalTrials.gov public record
Updated Mar 29, 2026 · Synced Jul 22, 2026, 10:45 AM EDT
Completed Not applicable Interventional Results available

Supplement to Hospital to Home Outcomes

NCT03224130
View directory record Official record
Conditions
Hospitalized Patients
Interventions
Nurse Phone Call, Standard of Care
Other
Lead sponsor
Children's Hospital Medical Center, Cincinnati
Other
Eligibility
Up to 18 Years
Enrollment
966 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2016 – 2017
U.S. locations
1
States / cities
Cincinnati, Ohio
Source: ClinicalTrials.gov public record
Updated Apr 15, 2019 · Synced Jul 22, 2026, 10:45 AM EDT
Completed Phase 4 Interventional

DHFS for Medication Adherence Support During Hospital Admissions for Person Living With HIV

NCT04418037
View directory record Official record
Conditions
HIV/AIDS
Interventions
Digital Health Feedback System(DHFS)
Device
Lead sponsor
University of California, San Diego
Other
Eligibility
18 Years and older
Enrollment
16 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2019 – 2021
U.S. locations
1
States / cities
San Diego, California
Source: ClinicalTrials.gov public record
Updated Dec 15, 2024 · Synced Jul 22, 2026, 10:45 AM EDT
Active, not recruiting Not applicable Interventional Accepts healthy volunteers

Enhancing the Care Transitions Intervention With Peer Support to Reduce Disparities

NCT04981977
View directory record Official record
Conditions
Hospital Readmissions
Interventions
Care Transitions Intervention, Care Transitions Intervention and Peer Support, Usual Care
Behavioral · Other
Lead sponsor
University of South Florida
Other
Eligibility
60 Years and older
Enrollment
483 participants
Healthy volunteers
Accepts healthy volunteers
Timeline
2022 – 2025
U.S. locations
1
States / cities
Tampa, Florida
Source: ClinicalTrials.gov public record
Updated Feb 6, 2025 · Synced Jul 22, 2026, 10:45 AM EDT
Completed Not applicable Interventional

Care Transitions Innovation (C-TraIn)

NCT01906645
View directory record Official record
Conditions
Hospitalization
Interventions
Care Transitions Innovation (C-TraIn)
Other
Lead sponsor
Oregon Health and Science University
Other
Eligibility
18 Years and older
Enrollment
382 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
Started 2010
U.S. locations
1
States / cities
Portland, Oregon
Source: ClinicalTrials.gov public record
Updated Jul 23, 2013 · Synced Jul 22, 2026, 10:45 AM 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 Jul 22, 2026, 10:45 AM EDT
Completed Not applicable Interventional Results available

CAPABLE Transitions: A Home Health-Based Intervention for the Hospital or Post-Acute Care Facility-to-Home Transition

NCT04460742
View directory record Official record
Conditions
Care Transitions, Dementia
Interventions
CAPABLE Transitions, Home Health Agency Care
Behavioral
Lead sponsor
University of Rochester
Other
Eligibility
65 Years and older
Enrollment
31 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2021 – 2023
U.S. locations
1
States / cities
Rochester, New York
Source: ClinicalTrials.gov public record
Updated Jul 31, 2023 · Synced Jul 22, 2026, 10:45 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 22, 2026, 10:45 AM 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 Jul 22, 2026, 10:45 AM EDT
Completed Not applicable Interventional

GAPcare: The Geriatric Acute & Post-acute Care Coordination Program for Fall Prevention in the Emergency Department

NCT03360305
View directory record Official record
Conditions
Falls (Accidents) in Old Age
Interventions
GAPcare intervention
Behavioral
Lead sponsor
Rhode Island Hospital
Other
Eligibility
65 Years and older
Enrollment
110 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2018 – 2019
U.S. locations
2
States / cities
Providence, Rhode Island
Source: ClinicalTrials.gov public record
Updated Jul 8, 2020 · Synced Jul 22, 2026, 10:45 AM EDT
Completed Not applicable Interventional Results available

A Study of Acute Kidney Injury in Care Transitions

NCT05184894
View directory record Official record
Conditions
Acute Kidney Injury
Interventions
AKI in Care Transitions (ACT) program
Behavioral
Lead sponsor
Mayo Clinic
Other
Eligibility
18 Years and older
Enrollment
50 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2022 – 2023
U.S. locations
1
States / cities
Rochester, Minnesota
Source: ClinicalTrials.gov public record
Updated Dec 17, 2024 · Synced Jul 22, 2026, 10:45 AM EDT
Completed Not applicable Interventional Results available

Improving Patient Prioritization During Hospital-homecare Transition

NCT04136951
View directory record Official record
Conditions
Diabetes Mellitus, Type 2, Congestive Heart Failure, Obstructive Pulmonary Disease, Dyspnea, Renal Failure
Interventions
PREVENT clinical decision support
Other
Lead sponsor
Columbia University
Other
Eligibility
18 Years and older
Enrollment
1,915 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2023 – 2024
U.S. locations
2
States / cities
New York, New York
Source: ClinicalTrials.gov public record
Updated Oct 7, 2025 · Synced Jul 22, 2026, 10:45 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 22, 2026, 10:45 AM 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 Jul 22, 2026, 10:45 AM EDT