Comparative Effectiveness of Readmission Reduction Interventions for Individuals with Sepsis or Pneumonia
ACCOMPLISH
1 other identifier
interventional
1,288
1 country
1
Brief Summary
An adaptive platform trial to compare effectiveness of different care models to prevent readmissions for patients hospitalized with sepsis or lower respiratory tract infection. The primary outcome is number of days spent at home within 90 days after hospital discharge.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable sepsis
Started Mar 2021
Longer than P75 for not_applicable sepsis
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
March 26, 2021
CompletedStudy Start
First participant enrolled
March 30, 2021
CompletedFirst Posted
Study publicly available on registry
April 2, 2021
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 15, 2024
CompletedStudy Completion
Last participant's last visit for all outcomes
December 15, 2024
CompletedJanuary 16, 2025
January 1, 2025
3.7 years
March 26, 2021
January 14, 2025
Conditions
Outcome Measures
Primary Outcomes (1)
Post-discharge home days
days alive and at home
90 days after discharge to home
Secondary Outcomes (8)
Functional Status (measured by PROMIS Physical Function-for Mobility Aid Users-SF)
baseline, 90 days
Health-related Quality of Life (measured by Quality of Life Enjoyment and Satisfaction Questionnaire-SF)
baseline, 90 days
Transition to Hospice
measured at 90 days after discharge to home
Emergent outpatient utilization
measured at 90 days after discharge to home
Hospital readmissions
measured at 7 days
- +3 more secondary outcomes
Study Arms (5)
Structured Telephone Support (STS)
ACTIVE COMPARATORPost-discharge assessment, education, and medication reconciliation delivered telephonically by a health plan case manager, home care as needed, and follow-up with the primary care provider (PCP) within seven days post-discharge.
Low-intensity Remote Patient Monitoring (RPM) + Standard Response Team (RPM-Low, Standard Team)
ACTIVE COMPARATORQuestions are pushed to members patients times per week for up to 90 days post-discharge. Questions are limited to those checking vital signs that indicate worsening of infection. Patient answers to RPM questions trigger High or Medium alerts, which trigger a response by members of the intervention care team. RPM alerts are screened by a nurse-staffed call center. Nurses determine whether emergency care is needed. If not, nurses contact the patient and/or the patients' primary care provider (PCP) or specialist to coordinate care and ensure timely follow-up.
High-intensity Remote Patient Monitoring (RPM) plus the Standard Team (RPM-High, Standard Team)
ACTIVE COMPARATORQuestions are pushed to patients multiple times per week for up to 90 days post-discharge. Questions include monitoring vital signs for worsening infection but also ask about factors that would indicate worsening of underlying heart or lung conditions, such as weight gain or shortness of breath. Patient answers to RPM questions trigger High or Medium alerts, which trigger a response by members of the intervention care team. RPM alerts are screened by a nurse-staffed call center. Nurses determine whether emergency care is needed. If not, nurses contact the patient and/or the patients' primary care provider (PCP) or specialist to coordinate care and ensure timely follow-up.
Low-intensity Remote Patient Monitoring (RPM) + Enhanced Team (RPM-Low, Enhanced Team)
ACTIVE COMPARATORQuestions are pushed to patients multiple times per week for up to 90 days post-discharge. Questions are limited to those checking vital signs that indicate worsening of infection. Patient answers to RPM questions trigger High or Medium alerts, which trigger a response by members of the intervention care team. RPM alerts are screened by a nurse-staffed call center. Nurses determine whether emergency care is needed. If not, the call center alerts a multidisciplinary care team that is led by a certified registered nurse practitioner (CRNP). CRNPs, who operate in a palliative care role, have prescribing authority and can modify care plans. In addition to reacting to RPM triggers, team members (e.g., CRNP, social workers, nurses) meet with the patient in-person or virtually in the week after discharge and at least twice more in the next 90 days, conduct assessments and a pharmacy review, develop care plans, and discuss advance directives).
High-intensity Remote Patient Monitoring (RPM) plus the Enhanced Team (RPM-High, Enhanced Team)
ACTIVE COMPARATORQuestions are pushed to patients multiple times per week for up to 90 days post-discharge. Questions include monitoring vital signs for worsening infection but also ask about factors that would indicate worsening of underlying heart or lung conditions, such as weight gain or shortness of breath. Patient answers to RPM questions trigger High or Medium alerts, which trigger a response by members of the intervention care team. RPM alerts are screened by a nurse-staffed call center. Nurses determine whether emergency care is needed. If not, the call center alerts a multidisciplinary care team that is led by a certified registered nurse practitioner (CRNP). CRNPs, who operate in a palliative care role, have prescribing authority and can modify care plans.Team members (e.g., CRNP, social workers, nurses) address RPM triggers, meet with the patient three times, pharmacy review, develop care plans, and discuss advance directives).
Interventions
Structured telephone support (STS) consists of post-discharge assessment, education, and medication reconciliation delivered telephonically by a health plan case manager, home care as needed, and follow-up with the primary care within seven days post-discharge.
Questions are pushed to members multiple times per week for up to 90 days post-discharge. Questions are limited to those checking vital signs that indicate worsening of infection. Patient answers to RPM questions trigger High or Medium alerts, which trigger a response by members of the intervention care team.
Questions are pushed to members multiple times per week for up to 90 days post-discharge. Questions include monitoring vital signs for worsening infection but also ask about factors that would indicate worsening of underlying heart or lung conditions, such as weight gain or shortness of breath. Patient answers to RPM questions trigger High or Medium alerts, which trigger a response by members of the intervention care team.
RPM alerts are screened by a nurse-staffed call center. Nurses determine whether emergency care is needed. If not, nurses contact the patient and/or the patients' PCP or specialist to coordinate care and ensure timely follow-up.
RPM alerts are screened by a nurse-staffed call center. Nurses determine whether emergency care is needed. If not, the call center alerts a multidisciplinary care team that is led by a certified registered nurse practitioner (CRNP). CRNPs, who operate in a palliative care role, have prescribing authority and can modify care plans. In addition to reacting to RPM triggers, team members (e.g., CRNP, social workers, nurses) meet with the patient in-person or virtually in the week after discharge and at least twice more in the next 90 days, conduct assessments and a pharmacy review, develop care plans, and discuss advance directives.
Eligibility Criteria
You may qualify if:
- UPMC Health Plan members
- Medicare Fee-for-Service enrollees
- Age 21+ -Hospitalized with a primary diagnosis of sepsis or lower respiratory tract infection, --
- Discharged to home, independent living facility, or skilled nursing facility
- Readmission risk is moderate or high
You may not qualify if:
- Admitted from hospice;
- Discharged to hospice, inpatient rehabilitation, or a long term acute care facility;
- Known to be pregnant;
- Current enrollment in another remote patient monitoring program;
- Failure of the Callahan 6 item cognitive screen and do not have a proxy to consent;
- No access to a technological device required to participate in remote patient monitoring program;
- Current enrollment in UPMC Advanced Illness Care program;
- Severe, persistent cognitive impairment;
- No documented PCP;
- PCP disapproves of the patient being enrolled in remote patient monitoring;
- Discharged from hospital to skilled nursing facility and stay at the skilled nursing facility for greater than 28 days
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
UPMC Presbyterian
Pittsburgh, Pennsylvania, 15213, United States
Related Publications (1)
Mayes K, Talisa VB, Malito A, Mayr FB, Williams K, Char K, Wadas R, Lorenzi E, Viele K, Awdish R, Angus DC, Chang CH, Yende S. Design and methods of an adaptive trial to test comparative effectiveness of readmission reduction approaches following infection and sepsis hospitalizations (ACCOMPLISH). Contemp Clin Trials Commun. 2025 Jun 19;46:101504. doi: 10.1016/j.conctc.2025.101504. eCollection 2025 Aug.
PMID: 40642111DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Kalpana Char, MD
UPMC Health Plan
- PRINCIPAL INVESTIGATOR
Sachin Yende, MD
University of Pittsburgh
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- DOUBLE
- Who Masked
- INVESTIGATOR, OUTCOMES ASSESSOR
- Purpose
- HEALTH SERVICES RESEARCH
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Associate Vice President
Study Record Dates
First Submitted
March 26, 2021
First Posted
April 2, 2021
Study Start
March 30, 2021
Primary Completion
December 15, 2024
Study Completion
December 15, 2024
Last Updated
January 16, 2025
Record last verified: 2025-01
Data Sharing
- IPD Sharing
- Will not share