Active — Not RecruitingNot Applicable

The Impact of Nurse Practitioner-Led Multidisciplinary Team Intervention on the Implementation of Guideline-Directed Medical Therapy and Clinical Outcomes in Adults With Multimorbidity

Taiwan178 participantsStarted 2025-09-02

Plain-language summary

The goal of this clinical trial is to evaluate whether a nurse practitioner-led multidisciplinary team (NP-led MDT) intervention can improve the use of guideline-directed medical therapy (GDMT) and short-term clinical outcomes in hospitalized adults with multimorbidity in a multidisciplinary medicine ward. The main questions it aims to answer are: Does NP-led MDT intervention increase the proportion of patients achieving GDMT at hospital discharge? Does NP-led MDT intervention reduce 30-, 60-, and 90-day readmission, emergency department visits, and mortality? Researchers will compare the NP-led MDT intervention group with the usual care group to see if the intervention improves GDMT implementation and clinical outcomes. Participants will: Be randomly assigned to NP-led MDT care or usual care. Have their medications reviewed according to the latest guidelines (intervention group only). Be followed for 90 days after discharge to collect outcomes through medical record review and telephone follow-up.

Who can participate

Age range18 Years

SexALL

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Inclusion criteria

✓. Age: 18 years or older
✓. Admitted to the multidisciplinary ward through the emergency department for inpatient care
✓. Diagnosed with at least one of the following six chronic conditions and concurrently having one or more additional chronic diseases:

Exclusion criteria

✕. 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.
✕. 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.
✕. Unwilling to participate.
✕. Patients under the care of the study team physician on the day of hospitalization.
✕. Patients known to be economically or educationally disadvantaged

What they're measuring

GDMT Implementation Rate at Hospital Discharge

Timeframe: On the day of hospital discharge

Trial details

NCT IDNCT07138183

SponsorNational Taiwan University Hospital

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2025-11-24

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