Community program to support patients with heart and lung conditions after hospital discharge

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial aims to evaluate the effectiveness of the Reforça't program, an interdisciplinary, community-based intervention designed for patients aged 65 and older with chronic cardiorespiratory conditions. The program seeks to reduce 30-day hospital readmissions and improve functional outcomes by providing comprehensive care following hospital discharge. Participants will be randomly assigned to either the Reforça't program or standard care, with assessments conducted before and after the intervention to measure health outcomes, medication adherence, and quality of life. The study will compare the two groups to determine the program's impact on readmission rates and overall patient well-being.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Users admitted to the Polivalent Observation Units, Internal Medicine, or Hospital at home.
* Individuals aged 65 years or older.
* Hospital admission due to decompensation of a cardiac, respiratory, or mixed condition.
* Place of residence within the health coverage area of Sant Jaume de Calella Hospital - Corporació de Salut del Maresme i la Selva.
* Willingness to participate in the study as gathered by the signing of an informed consent document

Exclusion Criteria:

* Users institutionalized in a nursing home
* Users already enrolled in home care programs
* Users in the Advanced Chronic Care Model program with a limited life prognosis
* Users on the waiting list for organ transplantation
* Users with language barriers
* Users with a GDS (Global Deterioration Scale) score of 5 or higher
* Users who have already been included in the Reforça't program

Where it's running

• Hospital Comarcal de Calella - Corporació de Salut del Maresme i la Selva
  Calella, Barcelona, Spain Recruiting

Study contacts

• Study coordinator: Griselda Manzano Monfort
• Email: gmanzano@salutms.cat
• Phone: +34620215477

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Using Apple Watch data to predict heart failure outcomes

  This study is testing if data from Apple Watches can help predict heart failure problems and the chances of needing to go back to the hospital for patients with heart failure.

  Recruiting University Medical Center Goettingen · Goettigen, Lower Saxony · NCT06819618

• Comparing Aortix Device to Diuretics for Acute Heart Failure

  This study is testing whether the Aortix device can help people with acute heart failure who aren't responding to diuretics feel better compared to standard treatment.

  Recruiting at 33 sites Procyrion · Phoenix, Arizona and 49 other locations · NCT05677100

• Myocardial Energetics Across Cardiovascular Disease Spectrum Using 31P-MRS

  Researchers are testing whether phosphorus-31 magnetic resonance spectroscopy (31P-MRS) can map heart energy metabolism across healthy people and patients with various heart conditions.

  Recruiting Chinese Academy of Medical Sciences, Fuwai Hospital · Beijing · NCT07912086

• Tailored digital support to cut sedentary time in long-term cardiac rehab

  In adults in a long-term cardiac rehabilitation program, this study tests whether a personalized behavioural program with digital tools can reduce daily sitting time.

  Recruiting University of Lisbon · Lisbon, Lisbon District · NCT07910812

• NT-proBNP–guided heart failure screening for people 65+ in rural China

  This study tests whether using NT-proBNP blood tests to guide heart failure screening in adults 65 and older in rural China can find unrecognized heart problems more effectively than symptom-based screening.

  Recruiting Jiangsu Taizhou People's Hospital · Nanjing · NCT07885488

• Voice-based detection of heart failure deterioration using Noah Labs Vox

  This study tests whether a voice-analysis app can flag worsening heart failure in adults by comparing its alerts to standard weight-based monitoring.

  Recruiting Noah Labs · Boston, Massachusetts · NCT07870395

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.