Overview
- The ACCOMPLISH trial, published Thursday, June 11, 2026, randomized 1,286 adults discharged after sepsis or lower respiratory tract infection to four remote monitoring strategies or to UPMC’s usual post-discharge care.
- The primary outcome—days alive at home at 90 days—was not improved by any monitoring approach and overall readmission rates were similar across groups with a 37.8% rate in the usual-care arm.
- The four interventions paired short or long symptom questionnaires delivered by smartphone with either a standard nurse response team or an enhanced team led by nurse practitioners with palliative expertise.
- Patients aged 65 and older did worse on monitoring, with fewer days at home and higher odds of readmission compared with usual care, signaling clear heterogeneity by age.
- Investigators and commentators say the results call for halting assumption-driven expansion, reassessing CMS reimbursement, tailoring technology and clinical workflows to complex older patients, and funding further trials and redesigns; the study was funded by PCORI.