PITTSBURGH — The UPMC Center for High-Value Health Care, a nonprofit research organization housed within UPMC Insurance Services, announced it has been approved for a $3.7 million funding award from the Patient-Centered Outcomes Research Institute (PCORI) to compare the effectiveness of different interventions to better manage care for sepsis survivors and people recovering from severe pneumonia.
Sepsis is a life-threatening condition in which the body injures its own tissues and organs in response to fighting off an out-of-control response to infection, and is responsible for one in five deaths worldwide. Those who survive sepsis are at higher risk for major health problems in the future and, according to previous research, one-third of sepsis survivors will die within the following year.
“This project has tremendous potential to improve overall outcomes for sepsis survivors not only by reducing readmissions in this population, but also by educating sepsis patients and their families about their readmission risks and providing them with resources to monitor their health post-sepsis,” said Thomas Heymann, executive director of Sepsis Alliance, the leading sepsis organization in the U.S. that works to save lives and reduce suffering by improving sepsis awareness and care, as well as a key patient stakeholder group for this study.
Over the next three years this research study, done in collaboration with the University of Pittsburgh School of Medicine’s Department of Critical Care Medicine, UPMC, and other providers, will test enhanced care strategies to best support sepsis survivors in managing this complex condition and avoiding a return to the hospital. The trial also will enroll survivors of severe pneumonia, which is the primary infection that leads to sepsis. Sepsis survivors are also more susceptible to pneumonia. The study will be co-led by Namita Ahuja, MD, senior medical director at UPMC Health Plan and Sachin Yende, MD, MS, professor of critical care medicine and clinical and transitional science at the University of Pittsburgh.
The PCORI funding will support one of the largest clinical trial of sepsis and pneumonia survivors to date, aiming to enroll more than 1,600 participants. While most research in this field is focused on implementing care for survivors in an outpatient clinic setting, this study will bring care into the home with a remote patient monitoring platform, which uses the patient’s smartphone to track vitals and alert clinicians to changes. Patients will be enrolled in different degrees of monitoring and types of interventions, including palliative care to improve quality of life.
“Before we even enroll our first patient, this trial is a major advance for our field,” said Yende, also vice president of critical care and deputy chief of staff at the Veterans Affairs Pittsburgh Healthcare System. “More and more, people are surviving sepsis. But that’s not enough, we want them to thrive. This trial will test several at-home interventions and as it progresses increase the number of patients we enroll in the better performing arms of the study while phasing out the less successful interventions. Even during the trial, we want our patients to get the best possible care.”
The UPMC integrated delivery and finance system provides a unique laboratory for this trial, by uniting the payer, clinicians, and researchers under one umbrella. The team hopes that — in addition to research findings that may improve sepsis outcomes — the study design will create a roadmap for deploying remote health care technologies and testing interventions for other conditions.
“Our health plan is focused on determining the best strategies to improve the effectiveness of our interventions for our members, ultimately elevating the quality of care while appropriately utilizing resources,” said Ahuja, who also serves as clinical assistant professor of geriatrics at University of Pittsburgh School of Medicine. “This study will help us understand the impact that earlier intervention, through remote monitoring, can have on patient experience and outcomes. Health systems and payers can use the information and infrastructure developed during this study to determine how to solve for these challenging questions in other chronic and complex conditions in a way that maximizes patient-centered outcomes.”
This announcement marks the seventh time in the past seven years that the UPMC Center for High-Value Health Care has been selected to receive prestigious PCORI funding related to stakeholder-driven comparative effectiveness research and dissemination, bringing the total funding to $18.2 million. Prior and current studies range from engaging individuals with serious mental illness in strategies to improve overall health and wellness to using telehealth and digital tools to manage chronic disease. PCORI-funded studies are selected following a highly competitive review process in which patients and caregivers, clinicians, clinical investigators, policymakers, and other important stakeholders come together to evaluate the proposals.
This year’s award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.