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Nurse-Led teams may cut hospital returns for patients with multiple illnesses

NCT ID NCT07138183

Disease control Sponsor: National Taiwan University Hospital Source: ClinicalTrials.gov ↗

What the study statuses mean

This study's is highlighted.

Recruitment status, easiest to join first

Recruiting now
This trial is taking on new participants right now.
Not yet recruiting
Registered, but not yet taking participants.
By invitation only
Not open to general applications. Only people the study team invites can take part.
Paused
Paused for now. It may or may not start again.
Ongoing This study
Running, but no longer taking on new participants.
Completed
The trial has finished. Results may not be published yet.
Stopped early
Stopped early, before it reached the end. That can be for many reasons, including safety.
Cancelled
Cancelled before anyone took part.

Expanded access (not trials)

Expanded access
Not a trial. This treatment can be requested outside a study, case by case, for people who qualify.
Expanded access (paused)
Not a trial. The treatment can normally be requested outside a study, but is unavailable right now.
Expanded access (ended)
Not a trial. The treatment could once be requested outside a study, but no longer can.
Approved
The treatment has been approved, so it is available normally rather than through this programme.

When the status isn't known

Details not published
The full record has not been published yet, so there is little to show here.
Status unknown
This status has not been confirmed recently, so it may be out of date.

First seen Jun 27, 2026 · Last updated Jun 27, 2026

Summary

This study tests whether a nurse practitioner-led team can improve care for adults with two or more chronic conditions like heart failure, diabetes, or kidney disease. Participants are randomly assigned to either the nurse-led team or usual care. The team reviews medications to ensure they follow guidelines and tracks hospital readmissions and emergency visits for 90 days after discharge.

What this could mean

Our plain-language read of the trial. This is informational only, not medical advice or a prediction.

Active substance
nurse practitioner-led multidisciplinary team intervention
What this could lead to
If successful, this approach could improve how hospitals manage patients with multiple chronic conditions, leading to better use of recommended medications and fewer return visits to the hospital.
What could go wrong
This is a small, single-center trial with 178 participants, so results may not apply to all hospitals or patients. The intervention is behavioral, so its impact may be limited by how well it is implemented.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Not a phased trial

Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.

Participants

About 178 people

The number the study aims to enrol. It can still change while the study runs.

Started

Sep 2025

Expected to finish

Apr 2026

An estimate. End dates often move.

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Age: 18 years or older 2. Admitted to the multidisciplinary ward through the emergency department for inpatient care 3. Diagnosed with at least one of the following six chronic conditions and concurrently having one or more additional chronic diseases: * Congestive Heart Failure (CHF) * Diabetes Mellitus (DM) * Hypertension (HTN) * Dyslipidemia (DLP) * Atrial Fibrillation (AF) * Chronic Kidney Disease (CKD) Exclusion Criteria: 1. End-of-life (EOL) patients: Refers to patients receiving palliative care or those assessed by the medical team as unlikely to survive to discharge during the current hospitalization. 2. Patients expected to be transferred to other departments: For example, patients anticipated to be transferred to oncology, intensive care unit (ICU), surgery, or other departments where full MDT intervention cannot be implemented. 3. Unwilling to participate. 4. Patients under the care of the study team physician on the day of hospitalization. 5. Patients known to be economically or educationally disadvantaged

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Conditions

The condition(s) this trial relates to.

atrial fibrillation chronic kidney disease congestive heart failure diabetes mellitus hypertensive disorder inherited lipid metabolism disorder

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Multimorbidity

Contacts and locations

Locations

  • National Taiwan University Hospital

    Taipei, 100, Taiwan

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