ClinicalTrials.gg
CompletedNCT03342495TNTUpdated Jun 12, 2023

Evaluating Innovations in Transition From Pediatric to Adult Care - The Transition Navigator Trial

An interventional study of Patient Navigator and Usual Care in Diabetes, Endocrine System Diseases and Gastro-Intestinal Disorder, sponsored by University of Calgary. Completed at 3 sites in Canada. Open to participants aged 16 Years to 21 Years. Per ClinicalTrials.gov, last updated 2023-06-12.

Sponsored by University of Calgary · Not applicable, Interventional, and Health services research

Phase
Not applicable
Study type
Interventional
Enrollment
337
Allocation
Randomized
Ages
16 Years to 21 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 13 studies in Diabetes Mellitus by University of Calgary — 3 open to participants now, 3 under way, none of them phase 3. Diabetes Mellitus · University of Calgary.

Started
2018
the only one that year
No phase
6 of 13
1 open now
Registered
9th of 13
by date

Among the 13 studies in Diabetes Mellitus by University of Calgary, this one is the only one that started in 2018, is one of 6 with no phase, and was the 9th registered.

Diabetes Mellitus

8,290 studies on the registry are indexed under Diabetes Mellitus; 1,077 are open to participants now.

Browse Diabetes Mellitus studies →

Open to participants now

3 of the 13 studies in Diabetes Mellitus by University of Calgary are open now, in 1 country. Recruiting first, the newest first:

By country, each count listing its studies:

All 3 open studies →

Where they have run

Who these studies take

Of the 651 Diabetes Mellitus studies recruiting now, 357 (55%) set no upper age limit and 198 (30%) stop at 75 or younger; 87 take children under 18; 183 take healthy volunteers.

This study: 16 Years to 21 Years · all sexes · no healthy volunteers.

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This tab as a report to print or save as PDF → With an account.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 13 studies in Diabetes Mellitus by University of Calgary, or all of them as a file.
02

Study summary

The Transition Navigator Trial (TNT) is a pragmatic randomized controlled trial evaluating the effectiveness of usual care plus a patient navigator service versus usual care plus newsletters and other educational materials, to improve transition outcomes among adolescents aged 16-21 who have chronic health conditions requiring transfer to adult specialty care.

The study will provide urgently needed data to guide health care providers and policy makers regarding the provision of coordinated transition care. These results have the potential to:

  1. Change care delivery
  2. Improve health outcomes
  3. Improve the experiences of young adult transition to adult care
Read the detailed description

Transition is the purposeful, planned movement of adolescent and young adults with chronic health conditions from child-centered to adult-oriented health systems. Transition includes, but is not limited to transfer to adult care. Transfer of care, which occurs during a vulnerable developmental period around age 18 introduces gaps in continuity of care that can lead to detrimental health outcomes in young adults. Therefore, provision of coordinated and developmentally appropriate care during the transition period is necessary to maintain health and to sustain investments made in pediatric health care.

Clinical practice guidelines for transition to adult care recommend the use of patient navigators to coordinate the entry of patients into a complex and unfamiliar adult health care system. Patient navigators provide individualized supports to facilitate medical follow-up and adherence. A limited number of studies have shown that access to a patient navigator during transition decreases drop-out from medical care and disease specific adverse events. No study to date has evaluated the benefits of a patient navigator to improve patient and or health system outcomes, when implemented across multiple chronic disease settings.

Objectives/Methods

  1. to evaluate the impact of a patient navigator intervention compared to treatment as usual for 16 to 21 year olds living with chronic health conditions who are transferring to adult care with respect to healthcare utilization and patient reported outcomes
  2. to obtain perceptions of stakeholders regarding the role of patient navigators in reducing barriers to adult-oriented ambulatory care
  3. to determine the net health care cost impact attributable to the navigator intervention

A qualitative study sampling participants randomized into the intervention arm at the beginning and end of the trial will also be undertaken to understand the patient experience.

03

Conditions studied

  • Diabetes
  • Endocrine System Diseases
  • Gastro-Intestinal Disorder
  • Neuro-Degenerative Disease
  • Epilepsy
  • Autoimmune Diseases
  • Renal Disease
  • Cardiac Disease
  • Metabolic Disease
  • Genetic Diseases, Inborn
  • Respiratory Disease
  • Hematologic Diseases
  • Autism Spectrum Disorder
  • Fetal Alcohol Spectrum Disorders
  • Traumatic Brain Injury
  • Stroke

Keywords

  • transition, young adults, transfer
04

Who can participate

Ages eligible
16 Years to 21 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • has a chronic medical condition (defined as conditions which are >3 months in duration and/or lifelong with multiple morbidities and/or multi-organ/system manifestations or condition with typically affect a single organ/system), who are expected to be transferred to adult specialty follow-up
  • Last planned pediatric visit within up to 12 months after assessment of eligibility

Exclusion criteria

Exclusion Criteria:

  • cannot consent in English
  • moving out of province within 24 months
  • enrolled in another transition navigator study
05

Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
337 participants (actual)

Study arms

  • Experimental
    Patient Navigator Arm

    Patient Navigator (Social Worker) will assist youth adapt and attach to adult delivered healthcare for up to 24 months. Participants will receive 5 issues of a provincial generic newsletter on topics around transition. Participants will be asked to complete a health questionnaire at baseline and 4 more times during 24 months. Participants will be asked to complete a transition readiness questionnaire at baseline and 4 more times during 24 months. Participants will be provided the opportunity to journal online about their experiences. Up to 100 participants will be provided the opportunity to be interviewed at baseline and end of study about their transition experience.

    Other: Patient Navigator

  • Other
    Usual Care Arm

    Youth will receive usual care from their pediatric clinics in preparation and transfer to adult care. Participants will receive 5 issues of a provincial generic newsletter on topics around transition. Participants will be asked to complete a health questionnaire at baseline and 4 more times during 24 months. Participants will be asked to complete a transition readiness questionnaire at baseline and 4 more times during 24 months. Participants will be provided the opportunity to journal online about their experiences.

    Other: Usual Care

Interventions

  • OtherPatient Navigator

    Social worker/Patient Navigator will be assigned to follow youth in adult care for up to 24 months to assist youth adapt and attach to adult delivered healthcare

  • OtherUsual Care

    Whatever processes are in place in a variety of clinics to support transfer from pediatric to adult care in the pediatric clinics

06

What researchers measure

Primary outcomes

  1. Health services utilization

    verification of health services utilized by up to 600 participants collected via personal health numbers (e.g. National Ambulatory Care Reporting System; Alberta Ambulatory Care Reporting System; Discharge Abstract Database; Physician Claims)

    Time frame: 12 to 24 months

Secondary outcomes

  1. cost analysis

    did the intervention save high cost service provision

    Time frame: up to 24 months

  2. Variation in TRAQ (Transition Readiness Questionnaire) scores

    Variation in TRAQ scores; comparing intervention and non-intervention arm

    Time frame: Enrollment and 3 subsequent times in 24 months

  3. Variation in SF-12 Scores

    Participant reported mental and physical health

    Time frame: Enrollment and 3 subsequent times in 24 months

Other outcomes

  1. Youth/Caregiver Satisfaction

    Qualitative Interviews with sampling of participants from patient navigator intervention arm

    Time frame: after 12 to 24 months

07

Study locations

3 sites
  • Alberta Children's Hospital
    Calgary, Alberta T3B 6A8, Canada
  • Glenrose Rehabilitation Hospital
    Edmonton, Alberta, Canada
  • Stollery Childrens Hospital
    Edmonton, Alberta, Canada
08

References and documents

Publications

  • Samuel S, Dimitropoulos G, Schraeder K, Klarenbach S, Nettel-Aguirre A, Guilcher G, Pacaud D, Pinzon J, Lang E, Andrew G, Zwaigenbaum L, Scott S, McBrien K, Hamiwka L, Mackie A. Pragmatic trial evaluating the effectiveness of a patient navigator to decrease emergency room utilisation in transition age youth with chronic conditions: the Transition Navigator Trial protocol. BMJ Open. 2019 Dec 10;9(12):e034309. doi: 10.1136/bmjopen-2019-034309. PubMed 31826899 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Feb 2018 to primary completion in Aug 2021, 42 months.

Of 1,583 non-industry interventional studies with no phase under Diabetes Mellitus, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 10 and three quarters within 43. This study's 42 months is above that.

Counting every sponsor, half of 1,743 studies reached it within 21 months; a quarter within 9 and three quarters within 42.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 3, 2017
First posted
Nov 17, 2017
StartActual
Feb 6, 2018
Primary completionActual
Aug 31, 2021
CompletionActual
Sep 7, 2021
Last update
Jun 12, 2023
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 12, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03342495
Collaborators
Alberta Health services, University of Alberta
Responsible party
Sponsor
First posted
Nov 17, 2017
Start date
Feb 6, 2018
Primary completion
Aug 31, 2021
Completion
Sep 7, 2021
Last update
Jun 12, 2023

Study contacts

Susan Samuel, MD, MSc
principal investigator · University of Calgary
Gina Dimitropoulos, PhD
principal investigator · University of Calgary
Andrew Mackie, MD
principal investigator · University of Alberta

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jun 2023. You cannot join it, but the record below documents what was studied.

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Discussion

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