Home Hospital for Bariatric Sleeve Gastrectomy
Acute Care at Home for Adults Undergoing Bariatric Sleeve Gastrectomy: A Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: David Levine, MD
- Phone Number: 6177327063
- Email: dmlevine@bwh.harvard.edu
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02130
- Brigham and Women's Hospital
-
Boston, Massachusetts, United States, 02130
- Brigham and Women's Faulkner Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- All existing home hospital criteria apply, with the following taking precedent for this specific condition
- 21-55 years old
- Indication for bariatric laparoscopic sleeve gastrectomy per surgeon
- Caregiver capable of communicating with the home hospital team and able to stay in the same home as the patient the first night the patient is home
Exclusion Criteria:
- All existing home hospital criteria apply, with the following taking precedent for this specific condition
Comorbidities
- Body mass index>55
- Chronic kidney disease
- Heart failure
History of
- Chronic pain (with or without opioid use)
- Substance use disorder
- Venous thromboembolism
- Stroke
- Chronic headache
Medications
- Anticoagulants and anti-platelets: aspirin, clopidogrel, warfarin, and direct oral anticoagulants
- Beta blockade
- Immunosuppressive
- Supplemental oxygen
- Allergy to ketorolac
- Prolonged QTc
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Control, Care in the Hospital
After bariatric sleeve gastrectomy, patients receive their care in the hospital, as usual.
|
|
|
Experimental: Intervention, Care in the Home
After bariatric sleeve gastrectomy, patients receive their care in the home.
|
Acute care provided at home, including nurse/paramedic visits, physician visits, laboratory testing, imaging, continuous monitoring, 24/7 urgent visits, and specialty consultation.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Length of Stay
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
Days spent hospitalized
|
From day of admission to day of discharge, assessed up to 10 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Motion
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
Percent of the day lying down
|
From day of admission to day of discharge, assessed up to 10 months
|
|
Cost, direct
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
Presented as a percentage
|
From day of admission to day of discharge, assessed up to 10 months
|
|
Opioid use
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
Morphine milligram equivalents used
|
From day of admission to day of discharge, assessed up to 10 months
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of emergency department presentation
Time Frame: From day of discharge to 30 days later, assessed up to 10 months
|
Emergency department presentation without admission
|
From day of discharge to 30 days later, assessed up to 10 months
|
|
Rate of readmission
Time Frame: From day of discharge to 30 days later, assessed up to 10 months
|
Readmission to the hospital
|
From day of discharge to 30 days later, assessed up to 10 months
|
|
BodyQ Score
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
Sum of the following three transformed scales (total of 300 points): Satisfaction with information (100 points) + Satisfaction with doctor/surgeon (100 points) + Satisfaction with medical team (100 points)
|
From day of admission to day of discharge, assessed up to 10 months
|
|
Picker experience questionnaire - 15
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
0-15 points, more points better
|
From day of admission to day of discharge, assessed up to 10 months
|
|
Global experience score
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
0-10 points, more points better
|
From day of admission to day of discharge, assessed up to 10 months
|
|
Pain score
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
Pain score on scale of 0-10, fewer points better
|
From day of admission to day of discharge, assessed up to 10 months
|
|
Number of complications
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
Sum of the complications included in the metabolic and bariatric surgery accreditation and quality improvement program
|
From day of admission to day of discharge, assessed up to 10 months
|
|
Bed-days saved
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
Acute care bed days not required due to the intervention
|
From day of admission to day of discharge, assessed up to 10 months
|
|
Stage 2 diet
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
Time to resumption of stage 2 diet, measured in hours
|
From day of admission to day of discharge, assessed up to 10 months
|
|
400mL intake
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
Time to intake of 400mL, measured in hours
|
From day of admission to day of discharge, assessed up to 10 months
|
|
6 hours out of bed on post operative day 1
Time Frame: From day of admission to day of discharge, assessed up to 10 months
|
Time to 6 hours out of bed on post operative day 1, measured in hours
|
From day of admission to day of discharge, assessed up to 10 months
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Leff B, Burton L, Mader SL, Naughton B, Burl J, Inouye SK, Greenough WB 3rd, Guido S, Langston C, Frick KD, Steinwachs D, Burton JR. Hospital at home: feasibility and outcomes of a program to provide hospital-level care at home for acutely ill older patients. Ann Intern Med. 2005 Dec 6;143(11):798-808. doi: 10.7326/0003-4819-143-11-200512060-00008.
- Levine DM, Pian J, Mahendrakumar K, Patel A, Saenz A, Schnipper JL. Hospital-Level Care at Home for Acutely Ill Adults: a Qualitative Evaluation of a Randomized Controlled Trial. J Gen Intern Med. 2021 Jul;36(7):1965-1973. doi: 10.1007/s11606-020-06416-7. Epub 2021 Jan 21.
- Bryan AF, Levine DM, Tsai TC. Home Hospital for Surgery. JAMA Surg. 2021 Jul 1;156(7):679-680. doi: 10.1001/jamasurg.2021.0597. No abstract available.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- 2017P002583e
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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