Trial results for a care coordination strategy aimed at older adults at risk for cardiovascular outcomes, including Atrial Fibrillation, were posted on ClinicalTrials.gov on 2025-09-04. The intervention group experienced 0.25 events per 100 person-days alive for emergency department visits or hospital admissions, compared to 0.21 events per 100 person-days alive in the control group.
Background
Cardiovascular diseases, including conditions like Atrial Fibrillation, Myocardial Infarction, Diabetes Mellitus, and Heart Failure, pose significant health risks, particularly for older adults. These conditions often lead to complex care needs, increasing the likelihood of emergency department visits and hospitalizations. Care coordination strategies are frequently implemented to manage these complex needs, aiming to improve patient outcomes and reduce acute care utilization. The goal is to ensure that older adults receive appropriate and timely care, thereby preventing adverse events and improving overall health management.
Trial design
This pragmatic clinical trial, which completed enrollment of 400 participants, investigated the comparative effectiveness of two approaches for assigning care coordinators to older adults at risk for cardiovascular outcomes. The study was conducted without a specified phase (Phase NA) and focused on individuals with conditions such as Cardiovascular Diseases, Myocardial Infarction, Atrial Fibrillation, Diabetes Mellitus, and Heart Failure. The primary objective was to determine if assigning care coordinators based on perceived need would be more effective at preventing emergency department visits and hospitalizations compared to usual care. Participants were randomized into an intervention group, where care coordinators were assigned based on perceived need, and a control group receiving usual care.
Key results
The trial results compared the outcomes between the intervention and control groups:
- For the "Number of Emergency Department Visits or Hospital Admissions", the intervention group recorded 0.25 events per 100 person-days alive, while the control group recorded 0.21 events per 100 person-days alive.
- Regarding "Acceptability", there were 13 Participants in the intervention group and 17 Participants in the control group.
- For "Appropriateness", the intervention group had 13 Participants, and the control group had 17 Participants.
- In terms of "Fidelity", the intervention group reported 13 Participants, compared to 17 Participants in the control group.
- For "Efficiency", the intervention group had 52 Encounters, and the control group had 45 Encounters.
What this means
The posted trial results indicate that the care coordination strategy, which assigned coordinators based on perceived need for older adults at risk for cardiovascular outcomes, did not demonstrate a reduction in emergency department visits or hospital admissions. The intervention group experienced a slightly higher rate of these events (0.25 events per 100 person-days alive) compared to the usual care control group (0.21 events per 100 person-days alive). This suggests that this specific approach to care coordination, as implemented in this trial, may not be more effective than usual care in preventing acute care utilization for this patient population. Further analysis would be needed to understand the factors contributing to these outcomes and to refine care coordination models for older adults with complex cardiovascular needs.
Source
The information regarding these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for the study NCT05820295, titled "Improving How Older Adults at Risk for Cardiovascular Outcomes Are Selected for Care Coordination", were posted on 2025-09-04 on clinicaltrials.gov.