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Showing 25–48 of 24 matching trials from the live ClinicalTrials.gov search.
Local D1 index available.
Filters: Condition: Transitions of Care Clear all
Completed No phase listed Observational

Enhancing Timely Access to Medication Changes: The Role of Pharmacists in Overcoming Transitions of Care Challenges

NCT07018232
View directory record Official record
Conditions
Transitional Care
Interventions
Unplanned healthcare encounter
Behavioral
Lead sponsor
The Guthrie Clinic
Other
Eligibility
18 Years and older
Enrollment
104 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2024 – 2025
U.S. locations
1
States / cities
Sayre, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Jun 14, 2025 · Synced Jul 23, 2026, 8:10 AM 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 Jul 23, 2026, 8:10 AM EDT
Completed Not applicable Interventional

Stroke Transitions of Care to Reduce Hospital Length of Stay

NCT04434638
View directory record Official record
Conditions
Stroke
Interventions
Transitions of Care Coordinator, Usual Care
Other
Lead sponsor
Georgetown University
Other
Eligibility
18 Years and older
Enrollment
40 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2018 – 2019
U.S. locations
1
States / cities
Washington D.C., District of Columbia
Source: ClinicalTrials.gov public record
Updated Jun 16, 2020 · Synced Jul 23, 2026, 8:10 AM 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 15, 2026 · Synced Jul 23, 2026, 8:10 AM EDT
Not yet recruiting Not applicable Interventional

ED PLWD/Care Partner Text Messaging

NCT07423871
View directory record Official record
Conditions
Dementia, Caregiver, Emergency Department, Mobile Health Technology (mHealth)
Interventions
CAPTURE Text Message Care Transition Support
Behavioral
Lead sponsor
Yale University
Other
Eligibility
18 Years and older
Enrollment
80 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2027 – 2030
U.S. locations
1
States / cities
New Haven, Connecticut
Source: ClinicalTrials.gov public record
Updated Feb 22, 2026 · Synced Jul 23, 2026, 8:10 AM EDT
Completed Not applicable Interventional Results available

Nudge to Drive Transitions of Care

NCT04660032
View directory record Official record
Conditions
Preeclampsia, Preeclampsia Severe, Gestational Hypertension, Hypertensive Disorder of Pregnancy, Superimposed Pre-Eclampsia
Interventions
Nudge
Behavioral
Lead sponsor
University of Pennsylvania
Other
Eligibility
18 Years and older · Female only
Enrollment
224 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2021 – 2023
U.S. locations
1
States / cities
Philadelphia, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Aug 4, 2024 · Synced Jul 23, 2026, 8:10 AM EDT
Completed No phase listed Observational Results available

Achieving Patient-Centered Care and Optimized Health In Care Transitions by Evaluating the Value of Evidence

NCT02354482
View directory record Official record
Conditions
Care Transitions
Interventions
Patient Communication and Care Management, Home-Based Trust, Plain Language, and Coordination, Hospital-Based Trust, Plain Language, and Coordination, Patient/Caregiver Assessment and Provider Information Exchange, Assessment and Teach Back, Standard of Care (Reference)
Behavioral · Other
Lead sponsor
Mark Williams
Other
Eligibility
18 Years and older
Enrollment
7,939 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2015 – 2019
U.S. locations
1
States / cities
Lexington, Kentucky
Source: ClinicalTrials.gov public record
Updated Nov 25, 2019 · Synced Jul 23, 2026, 8:10 AM EDT
Completed Not applicable Interventional

Putting Patients at the Center of Kidney Care Transitions (PREPARE NOW)

NCT02722382
View directory record Official record
Conditions
Chronic Kidney Disease
Interventions
Patient-Centered Kidney Transitions Care
Other
Lead sponsor
Duke University
Other
Eligibility
18 Years and older
Enrollment
1,572 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2017 – 2020
U.S. locations
1
States / cities
Baltimore, Maryland
Source: ClinicalTrials.gov public record
Updated Mar 24, 2024 · Synced Jul 23, 2026, 8:10 AM EDT
Not yet recruiting Not applicable Interventional

MEDBRIDGE-Guided NCM/CHW Post-Discharge Support for High-Risk T2D Patients

NCT07599852
View directory record Official record
Conditions
Type 2 Diabetes, Medication Adherence, Care Transition, Medication Discrepancy
Interventions
MEDBRIDGE-Guided NCM/CHW Post-Discharge Support Intervention
Behavioral
Lead sponsor
University of Alabama at Birmingham
Other
Eligibility
18 Years and older
Enrollment
45 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2029 – 2031
U.S. locations
2
States / cities
Birmingham, Alabama
Source: ClinicalTrials.gov public record
Updated May 19, 2026 · Synced Jul 23, 2026, 8:10 AM EDT
Completed Not applicable Interventional

The Care Transitions Intervention

NCT00244491
View directory record Official record
Conditions
Continuity of Patient Care
Interventions
Care Transitions Intervention
Behavioral
Lead sponsor
University of Colorado, Denver
Other
Eligibility
65 Years and older
Enrollment
1,400 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2002 – 2003
U.S. locations
1
States / cities
Denver, Colorado
Source: ClinicalTrials.gov public record
Updated Aug 12, 2015 · Synced Jul 23, 2026, 8:10 AM EDT
Completed Not applicable Interventional

MORE-PC: A 30-day Automated SMS Program to Support Post-discharge Transitions of Care

NCT05245773
View directory record Official record
Conditions
Care Transitions
Interventions
Automated SMS program to support post-discharge transitions of care
Other
Lead sponsor
University of Pennsylvania
Other
Eligibility
18 Years and older
Enrollment
5,000 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2022 – 2023
U.S. locations
1
States / cities
Philadelphia, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Feb 26, 2023 · Synced Jul 23, 2026, 8:10 AM EDT
Completed Not applicable Interventional Accepts healthy volunteers

Transport PLUS Intervention

NCT03046771
View directory record Official record
Conditions
Fall, Accidental, Fall, Hospital Readmission, Emergency Medical Services
Interventions
Transport PLUS group
Behavioral
Lead sponsor
Icahn School of Medicine at Mount Sinai
Other
Eligibility
18 Years and older
Enrollment
58 participants
Healthy volunteers
Accepts healthy volunteers
Timeline
2017 – 2019
U.S. locations
1
States / cities
New York, New York
Source: ClinicalTrials.gov public record
Updated Feb 4, 2020 · Synced Jul 23, 2026, 8:10 AM EDT
Completed Not applicable Interventional Accepts healthy volunteers

Interactive Digital Health Tools to Improve Patient Safety in Acute Care

NCT03116074
View directory record Official record
Conditions
Transitions of Care, Patient Portals, General Medicine, Discharge Checklist, Patient-provider Communication, Adverse Event, Readmission
Interventions
Interactive Digital Health Tools
Behavioral
Lead sponsor
Brigham and Women's Hospital
Other
Eligibility
18 Years and older
Enrollment
750 participants
Healthy volunteers
Accepts healthy volunteers
Timeline
2017 – 2020
U.S. locations
1
States / cities
Boston, Massachusetts
Source: ClinicalTrials.gov public record
Updated Jul 24, 2022 · Synced Jul 23, 2026, 8:10 AM EDT
Completed Not applicable Interventional

Intensive Discharge Intervention in Diabetes

NCT02122926
View directory record Official record
Conditions
Type II Diabetes, Cardiovascular Disease
Interventions
Intensive discharge intervention
Other
Lead sponsor
Brigham and Women's Hospital
Other
Eligibility
18 Years and older
Enrollment
180 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2011 – 2013
U.S. locations
1
States / cities
Boston, Massachusetts
Source: ClinicalTrials.gov public record
Updated Apr 24, 2014 · Synced Jul 23, 2026, 8:10 AM EDT
Completed Not applicable Interventional

IMPaCT (Individualized Management Towards Patient-Centered Targets)

NCT01346462
View directory record Official record
Conditions
General Medical Inpatient Conditions
Interventions
Patient-Centered Transition Intervention
Behavioral
Lead sponsor
University of Pennsylvania
Other
Eligibility
18 Years to 65 Years
Enrollment
513 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2011 – 2012
U.S. locations
1
States / cities
Philadelphia, Pennsylvania
Source: ClinicalTrials.gov public record
Updated Apr 30, 2014 · Synced Jul 23, 2026, 8:10 AM 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 Jul 23, 2026, 8:10 AM EDT
Active, not recruiting Not applicable Interventional

Diabetes Toolkit at Discharge

NCT05663931
View directory record Official record
Conditions
Diabetes Mellitus, Type 2, Insulin Dependent Diabetes
Interventions
DM Discharge Toolkit
Other
Lead sponsor
Northwestern University
Other
Eligibility
18 Years to 90 Years
Enrollment
120 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2024 – 2026
U.S. locations
1
States / cities
Chicago, Illinois
Source: ClinicalTrials.gov public record
Updated Apr 2, 2026 · Synced Jul 23, 2026, 8:10 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 23, 2026, 8:10 AM EDT
Recruiting Early Phase 1 Interventional

Pilot of Mailing Buprenorphine

NCT07421102
View directory record Official record
Conditions
Opioid Use Disorder
Interventions
strategy of mailing buprenorphine
Other
Lead sponsor
Medical University of South Carolina
Other
Eligibility
18 Years and older
Enrollment
20 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2026 – 2027
U.S. locations
1
States / cities
Charleston, South Carolina
Source: ClinicalTrials.gov public record
Updated Apr 12, 2026 · Synced Jul 23, 2026, 8:10 AM 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 Jul 23, 2026, 8:10 AM EDT
Enrolling by invitation No phase listed Observational

Epilepsy Emergency Department High Utilizer Program

NCT07663240
View directory record Official record
Conditions
Epilepsy, Uncontrolled Seizures
Interventions
CHW-Led Transition-of-Care Intervention
Behavioral
Lead sponsor
Morehouse School of Medicine
Other
Eligibility
18 Years and older · Female only
Enrollment
15 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2026
U.S. locations
1
States / cities
Atlanta, Georgia
Source: ClinicalTrials.gov public record
Updated Jun 22, 2026 · Synced Jul 23, 2026, 8:10 AM EDT
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 23, 2026, 8:10 AM EDT
Completed Not applicable Interventional Results available

Relative Patient Benefits of a Hospital-PCMH Collaboration Within an ACO to Improve Care Transitions

NCT02130570
View directory record Official record
Conditions
Adverse Events, Readmissions, Patient Engagement
Interventions
Multi-Model Intensive Discharge Intervention
Other
Lead sponsor
Brigham and Women's Hospital
Other
Eligibility
18 Years and older
Enrollment
1,679 participants
Healthy volunteers
Healthy volunteers not accepted
Timeline
2013 – 2015
U.S. locations
2
States / cities
Boston, Massachusetts
Source: ClinicalTrials.gov public record
Updated Aug 19, 2019 · Synced Jul 23, 2026, 8:10 AM 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 Jul 23, 2026, 8:10 AM EDT