Effectiveness of care transition intervention” plan in the older

Not Applicable

Recruiting

• Conditions: Condition 1: Congestive Heart Failure. Condition 2: Coronary Artery Disease. Condition 3: Hypertension. Condition 4: Cardiac Arrhythmia. Condition 5: Chronic Obstructive Pulmonary Disease. Condition 6: Diabetes. Condition 7: Peripheral Vascular Disease.; Chronic combined systolic (congestive) and diastolic (congestive) heart failure; Chronic obstructive pulmonary disease, unspecified; Atherosclerotic heart disease of native coronary artery; Chronic venous hypertension (idiopathic); Diabetes mellitus due to underlying condition; Cardiac arrhythmia, unspecified; Peripheral vascular disease, unspecified; I50.42; I25.1

• Registration Number: IRCT20180930041185N3
• Lead Sponsor: Faculty of Medical Sciences, Tarbiat Modares University

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Last Update Posted: 21 November 2022

Recruitment & Eligibility

• Status: Recruiting
• Sex: All
• Target Recruitment: 90

Inclusion Criteria

Age 60 years and older
Alertness and ability to communicate
Having a normal cognitive status based on the Abbreviated Mental Test (score 7 and above)
Having at least two chronic condition (Congestive Heart Failure, Coronary Artery Disease, Hypertension, Cardiac Arrhythmia, Chronic Obstructive Pulmonary Disease, Diabetes, Peripheral Vascular Disease)
Having a telephone
Being transported home after hospital discharge
Family caregivers must be at least Be 18 years old
Willingness to continue participating in the study

Exclusion Criteria

Evidence of mental illness and dementia

Study & Design

• Study Type: interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Rehospitalization. Timepoint: The beginning of the study (Before intervention), 30, 90 and 180 days after discharge. Method of measurement: Questionnaire.

Secondary Outcome Measures

Name	Time	Method
Quality of Life. Timepoint: The beginning of the study (Before intervention), 30, 90 and 180 days after discharge. Method of measurement: World Health Organization Quality of Life Questionnaire, older adults Edition.;Activity of Daily Living. Timepoint: The beginning of the study (Before intervention), 30, 90 and 180 days after discharge. Method of measurement: Activities of Daily Living Questionnaire.;Instrumental Activity of Daily Living. Timepoint: The beginning of the study (Before intervention), 30, 90 and 180 days after discharge. Method of measurement: Instrumental Activity of Daily Living Questionnaire.;Depression. Timepoint: The beginning of the study (Before intervention), 30, 90 and 180 days after discharge. Method of measurement: Geriatric Depression Scale.