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Home Visits for Patients at Risk for Appointment No-shows (SNAP HOME)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT04376736
Recruitment Status : Suspended (Covid-19)
First Posted : May 6, 2020
Last Update Posted : May 6, 2020
Information provided by (Responsible Party):
Johns Hopkins University

Brief Summary:
Unused clinic visits due to patient no-shows continue to plague American healthcare as a large source of waste and avoidable constraint on access. The average no-show rate across 105 studies was 23% though with wide variation (4% to 79%). No-show behavior has adverse effects on patients, providers, and healthcare organizations' operational and financial outcomes. Patients that miss clinic visits are more likely to need acute care and suffer poor health outcomes. There have been increasingly sophisticated efforts focused on predicting which patients are likely to no-show. This can allow for tactful over-booking and/or patient outreach. At Hopkins, investigators have implemented a novel machine learning based approach for identifying those patients at high-risk for no-show. Offering home visits for patients who are most likely to no-show is an appealing strategy to connect medical providers with patients who need care but are otherwise unlikely to receive it. Yet, it is unclear if this would be helpful to engage patients in their care, and encourage subsequent attendance, or if it would encourage future missed appointments, fostering a reliance on possible ongoing home visits. This study would link existing efforts with no-show prediction to home visits by internal medicine residents and evaluate its clinical impact. Patients at high-risk for no-show will be randomized into the control arm where patients will be called to remind patients of their visits. Those randomized into the intervention arm will be offered a one time home visit in lieu of their in-person visit to help understand barriers to in-person care and build rapport. Outcomes evaluated include future in-person show rates and healthcare cost/utilization

Condition or disease Intervention/treatment Phase
Utilization, Health Care Engagement, Patient No-Show Patients Other: Home visit Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 400 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Other
Official Title: SNAP HOME: Smart No-show Analytics Paired With Home-based Outpatient Medical Engagement
Actual Study Start Date : September 1, 2019
Estimated Primary Completion Date : July 1, 2021
Estimated Study Completion Date : July 1, 2022

Arm Intervention/treatment
No Intervention: Control arm
Patients are reminded about their appointments
Experimental: Intervention arm
Patients are offered a one-time home visit by providers in lieu of their upcoming in-person visit
Other: Home visit
Home visit by medical provider

Primary Outcome Measures :
  1. Engagement [ Time Frame: 1 year post enrollment ]
    Subsequent show up rate for medical clinic appointments, that is, number of actual visits per total number of expected visits

Secondary Outcome Measures :
  1. Healthcare utilization as assessed by number of hospitalizations [ Time Frame: 1 year post enrollment ]
    This will be assessed based on the Number of ER visits and hospitalizations

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • One or more poorly controlled chronic medical illness
  • More than one chronic illness, regardless of its level of control
  • Acute illness

Exclusion Criteria:

  • No documented medical illnesses (acute or chronic)
  • Single well controlled chronic illness

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT04376736

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United States, Maryland
Johns Hopkins Outpatient Center
Baltimore, Maryland, United States, 21287
Sponsors and Collaborators
Johns Hopkins University
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Responsible Party: Johns Hopkins University Identifier: NCT04376736    
Other Study ID Numbers: IRB00196142
First Posted: May 6, 2020    Key Record Dates
Last Update Posted: May 6, 2020
Last Verified: May 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No