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Social Work Intervention Focused on Transitions (SWIFT)

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ClinicalTrials.gov Identifier: NCT02232126
Recruitment Status : Completed
First Posted : September 5, 2014
Results First Posted : February 10, 2017
Last Update Posted : February 10, 2017
Sponsor:
Collaborators:
Huntington Hospital
National Institute on Aging (NIA)
Information provided by (Responsible Party):
Susan Enguidanos, University of Southern California

Study Type Interventional
Study Design Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Triple (Participant, Investigator, Outcomes Assessor);   Primary Purpose: Health Services Research
Conditions Study Focus: 30-day Rehospitalizations Among At-risk Older Adults Randomized to a Social Work-driven Care Transitions Intervention
Heart Disease
Diabetes
Hypertension
Cancer
Depression
Asthma
Chronic Heart Failure
Chronic Obstructive Pulmonary Disease
Stroke
Intervention Other: SWIFT home intervention
Enrollment 181
Recruitment Details  
Pre-assignment Details  
Arm/Group Title Usual Care Intervention
Hide Arm/Group Description [Not Specified] SWIFT home intervention: 1 in-home assessment performed by study social worker, another in-home visit performed if needed. Up to 4 telephone contacts performed by study social worker. A maximum of 6 contacts
Period Title: Overall Study
Started 91 90
Completed 91 90
Not Completed 0 0
Arm/Group Title Usual Care Intervention Total
Hide Arm/Group Description Usual care consisted of the usual course of care provided to older adults transitioning home from a hospital stay at Huntington Memorial Hospital SWIFT home intervention: 1 in-home assessment performed by study social worker, another in-home visit performed if needed. Up to 4 telephone contacts performed by study social worker. A maximum of 6 contacts Total of all reporting groups
Overall Number of Baseline Participants 91 90 181
Hide Baseline Analysis Population Description
[Not Specified]
Age, Categorical  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
<=18 years
0
   0.0%
0
   0.0%
0
   0.0%
Between 18 and 65 years
0
   0.0%
0
   0.0%
0
   0.0%
>=65 years
91
 100.0%
90
 100.0%
181
 100.0%
Age, Continuous  
Mean (Standard Deviation)
Unit of measure:  Years
Number Analyzed 91 participants 90 participants 181 participants
79.2  (8.8) 78.4  (7.8) 78.8  (8.3)
Gender  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
Female
49
  53.8%
39
  43.3%
88
  48.6%
Male
42
  46.2%
51
  56.7%
93
  51.4%
Race/Ethnicity, Customized  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
African American 23 14 37
Caucasian 52 57 109
Latino 7 9 16
Native American 1 1 2
Asian/Pacific Islander 4 2 6
Other 3 6 9
Declined to provide response 1 1 2
Region of Enrollment  
Measure Type: Number
Unit of measure:  Participants
United States Number Analyzed 91 participants 90 participants 181 participants
91 90 181
Marital status  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
Married 35 45 80
Single 11 16 27
Divorced 10 7 17
Widowed 35 19 54
Declined to provide response 0 3 3
Current living situation  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
Own house/apartment 82 78 160
Living in family member's home 7 6 13
Other 2 3 5
Declined to provide response 0 3 3
Who do you live with?  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
Alone 35 20 55
Spouse/partner 31 43 74
Child 14 13 27
Paid caregiver 2 1 3
Other 9 8 17
Declined to provide response 0 5 5
Who is your primary caregiver?  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
No one/self 43 33 76
Spouse 19 24 43
Significant other 0 4 4
Child 11 11 22
Paid caregiver 9 6 15
Other 9 8 17
Declined to provide response 0 4 4
Current annual income  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
Under $10,000 15 9 24
$10,000-$19,000 9 10 19
$20,000-$29,000 9 5 14
$30,000-$39,000 3 1 4
$40,000-$49,000 0 1 1
$50,000 or more 11 11 22
Refused to respond 44 53 97
Highest grade completed in school  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
8th grade or less 1 5 6
9th-11th grade 4 5 9
High school graduate 17 13 30
Some college 27 20 47
College graduate 17 19 36
Graduate degree 10 14 24
Doctoral degree 7 4 11
Declined to provide response 8 10 18
Chronic condition inventory   [1] 
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
Cancer 24 20 44
Cardiac disease 58 55 113
Dementia/Alzheimer's disease 3 4 7
Depression 14 32 46
Diabetes 18 23 41
Hypertension 57 54 111
Respiratory disease 30 29 59
Stroke 7 10 17
[1]
Measure Description: Measure NOT mutually exclusive. Inventory of conditions
Patient Health Questionnaire 9-item (PHQ-9)   [1] 
Mean (Standard Deviation)
Unit of measure:  Units on a scale
Number Analyzed 91 participants 90 participants 181 participants
4.33  (3.9) 6.15  (5.1) 5.24  (4.5)
[1]
Measure Description:

The Patient Health Questionnaire, 9-item uses nine questions to asses for depression and has been widely and successfully used in health care research since the early 1990's, particularly in investigations among older adults aged 65 years or more.

A total score is reported at the end of the questionnaire and scores can range from 0-27 with a higher value indicating more severe or worse depression. Total scores correspond to the following: 0 no depression, 1-4 minimal depression, 5-9 mild depression, 10-14 moderate depression, 15-19 moderate severe depression, and 20-27 severe depression.

Pain (Number Rating Scale)   [1] 
Mean (Standard Deviation)
Unit of measure:  Units on a scale
Number Analyzed 91 participants 90 participants 181 participants
3.54  (3.4) 9.18  (1.1) 6.36  (2.25)
[1]
Measure Description: The Number Rating Scale is a self-reported measure for pain level that is widely used in US hospitals. Patients are asked to rate their level of pain felt over the last 24-hours on a scale ranging from 0-10, where zero indicates no pain, and 10 is the worst pain imaginable.
Physical Functioning Index (abbreviated Short Form-12)   [1] 
Mean (Standard Deviation)
Unit of measure:  Units on a scale
Number Analyzed 91 participants 90 participants 181 participants
7.67  (5.12) 7.18  (5.08) 7.43  (5.1)
[1]
Measure Description: The Short-Form, 12-item is a survey tool to measure physical health and functional level and an abbreviated version of this tool was used in the present study which constituted eight of the 12-items that focused on physical functioning. Response options ranged from 'not limited at all,' to 'limited a lot' and after assigning numerical values to response options, total scores ranged from 0-16 with a higher score corresponding to greater physical limitations.
Cognition (SPMSQ score)   [1] 
Mean (Standard Deviation)
Unit of measure:  Units on a scale
Number Analyzed 91 participants 90 participants 181 participants
9.08  (1.2) 9.18  (1.1) 9.13  (1.15)
[1]
Measure Description: The Short Portable Mental Health Questionnaire (SPMSQ) is widely used tool to screen for cognitive impairment. This questionnaire consists of 10 questions and a total score is derived at the end. Scores can range from 0-10 where a low score indicates high cognitive impairment and a high score indicates higher cognitive functioning. The scale has an established cut-off score of 5 where those scoring 5 or higher are cognitively intact to participate in research, understand the study and associated activities, and provide consent. Those scoring below 5 are deemed ineligible.
Number of health conditions  
Mean (Standard Deviation)
Unit of measure:  Health conditions
Number Analyzed 91 participants 90 participants 181 participants
6.35  (4.1) 5.88  (2.9) 6.17  (3.5)
Number of daily medications  
Mean (Standard Deviation)
Unit of measure:  Medications
Number Analyzed 91 participants 90 participants 181 participants
7.61  (3.8) 8.00  (3.8) 7.81  (3.8)
Discharged home under self-care  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
Yes 61 67 128
No 30 23 53
Had inpatient stay or emergency department visit in previous 6 months  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
Yes 35 32 67
No 56 58 114
Has Advance Directive  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 91 participants 90 participants 181 participants
Yes 50 46 96
No 41 44 85
1.Primary Outcome
Title 30-day Hospital Readmission
Hide Description The outcome measure is the number of readmissions experienced by participants in the Usual Care and Intervention groups within 30-days of their index discharge.
Time Frame 30-days post hospitalization
Hide Outcome Measure Data
Hide Analysis Population Description
[Not Specified]
Arm/Group Title Usual Care Intervention
Hide Arm/Group Description:
Usual Care in the present study constitutes usual care that is delivered to older adults transitioning from the hospital to home from Huntington Memorial Hospital.
SWIFT home intervention: 1 in-home assessment performed by study social worker, another in-home visit performed if needed. Up to 4 telephone contacts performed by study social worker. A maximum of 6 contacts
Overall Number of Participants Analyzed 91 90
Measure Type: Number
Unit of Measure: 30-day hospital readmissions
11 9
2.Secondary Outcome
Title 30-day Readmission Among Intervention Participants
Hide Description The outcome measure is the rate of 30-day readmissions among Intervention group participants that declined to receive the in-home social work intervention versus those Intervention group participants that received the in-home social work intervention.
Time Frame 30-days
Hide Outcome Measure Data
Hide Analysis Population Description
Analysis among Intervention group ONLY for this outcome
Arm/Group Title Intervention Group: Received Intervention Intervention Group: Opt-outs
Hide Arm/Group Description:
Patients randomized to the intervention group and received the intervention. SWIFT home intervention: 1 in-home assessment performed by study social worker, another in-home visit performed if needed. Up to 4 telephone contacts performed by study social worker. A maximum of 6 contacts
Patients randomized to the intervention group that refused the intervention.
Overall Number of Participants Analyzed 63 27
Measure Type: Number
Unit of Measure: 30-day hospital readmissions
4 5
Time Frame [Not Specified]
Adverse Event Reporting Description [Not Specified]
 
Arm/Group Title Usual Care Intervention
Hide Arm/Group Description Usual care for the present study constituted the usual course of care provided to older adults transitioning from hospital to home from Huntington Memorial Hospital. SWIFT home intervention: 1 in-home assessment performed by study social worker, another in-home visit performed if needed. Up to 4 telephone contacts performed by study social worker. A maximum of 6 contacts
All-Cause Mortality
Usual Care Intervention
Affected / at Risk (%) Affected / at Risk (%)
Total   --/--   --/-- 
Show Serious Adverse Events Hide Serious Adverse Events
Usual Care Intervention
Affected / at Risk (%) Affected / at Risk (%)
Total   0/91 (0.00%)   0/90 (0.00%) 
Show Other (Not Including Serious) Adverse Events Hide Other (Not Including Serious) Adverse Events
Frequency Threshold for Reporting Other Adverse Events 0%
Usual Care Intervention
Affected / at Risk (%) Affected / at Risk (%)
Total   0/91 (0.00%)   0/90 (0.00%) 
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
Name/Title: Dr. Susan Enguidanos
Organization: University of Southern California
Phone: 213-740-9822
Responsible Party: Susan Enguidanos, University of Southern California
ClinicalTrials.gov Identifier: NCT02232126     History of Changes
Other Study ID Numbers: UP-10-00372
5R21AG034557-02 ( U.S. NIH Grant/Contract )
First Submitted: August 25, 2014
First Posted: September 5, 2014
Results First Submitted: December 4, 2014
Results First Posted: February 10, 2017
Last Update Posted: February 10, 2017