Trial Outcomes & Findings for PATient Navigator to rEduce Readmissions (NCT NCT02114515)

NCT ID: NCT02114515

Last Updated: 2019-02-15

Results Overview

Change in T-score from baseline to 30 days post discharge (30 days minus baseline). A change in t-score \<0 indicates improvement. A change equal to 0 indicates no change. A change \>0 indicates worsening.

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 1029 participants
• Primary outcome timeframe: 30 days post discharge
• Results posted on: 2019-02-15

Participant Flow

Participant milestones

Measure	Usual Care Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
Overall Study STARTED	511	518
Overall Study COMPLETED	378	368
Overall Study NOT COMPLETED	133	150

Reasons for withdrawal

Measure	Usual Care Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
Overall Study Lost to Follow-up	52	55
Overall Study Death	12	12
Overall Study Withdrawal by Subject	4	22
Overall Study Other	65	61

Baseline Characteristics

PATient Navigator to rEduce Readmissions

Baseline characteristics by cohort

Measure	Usual Care n=511 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=518 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.	Total n=1029 Participants Total of all reporting groups
Age, Categorical <=18 years	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Age, Categorical Between 18 and 65 years	412 Participants n=5 Participants	423 Participants n=7 Participants	835 Participants n=5 Participants
Age, Categorical >=65 years	99 Participants n=5 Participants	95 Participants n=7 Participants	194 Participants n=5 Participants
Age, Continuous	49.9 years STANDARD_DEVIATION 17.0 • n=5 Participants	49.8 years STANDARD_DEVIATION 16.5 • n=7 Participants	49.9 years STANDARD_DEVIATION 16.8 • n=5 Participants
Sex: Female, Male Female	290 Participants n=5 Participants	277 Participants n=7 Participants	567 Participants n=5 Participants
Sex: Female, Male Male	221 Participants n=5 Participants	241 Participants n=7 Participants	462 Participants n=5 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	40 Participants n=5 Participants	49 Participants n=7 Participants	89 Participants n=5 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	471 Participants n=5 Participants	468 Participants n=7 Participants	939 Participants n=5 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	0 Participants n=5 Participants	1 Participants n=7 Participants	1 Participants n=5 Participants
Race (NIH/OMB) American Indian or Alaska Native	1 Participants n=5 Participants	3 Participants n=7 Participants	4 Participants n=5 Participants
Race (NIH/OMB) Asian	4 Participants n=5 Participants	6 Participants n=7 Participants	10 Participants n=5 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants
Race (NIH/OMB) Black or African American	424 Participants n=5 Participants	423 Participants n=7 Participants	847 Participants n=5 Participants
Race (NIH/OMB) White	62 Participants n=5 Participants	72 Participants n=7 Participants	134 Participants n=5 Participants
Race (NIH/OMB) More than one race	7 Participants n=5 Participants	4 Participants n=7 Participants	11 Participants n=5 Participants
Race (NIH/OMB) Unknown or Not Reported	13 Participants n=5 Participants	10 Participants n=7 Participants	23 Participants n=5 Participants
Region of Enrollment United States	511 participants n=5 Participants	518 participants n=7 Participants	1029 participants n=5 Participants

PRIMARY outcome

Timeframe: 30 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 30 days post discharge (30 days minus baseline).

A change in t-score <0 indicates improvement. A change equal to 0 indicates no change. A change >0 indicates worsening.

Outcome measures

Measure	Usual Care n=406 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=391 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Emotional Distress-Anxiety (v1.0, SF4a)	-0.2 T-score Standard Error 0.5	-1.7 T-score Standard Error 0.5

PRIMARY outcome

Timeframe: 30 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 30 days post discharge (30 days minus baseline).

A change in t-score <0 indicates worsening. A change equal to 0 indicates no change. A change >0 indicates improvement.

Outcome measures

Measure	Usual Care n=405 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=391 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Informational Support (v2.0, SF4a)	2.3 T-score Standard Error 0.6	2.5 T-score Standard Error 0.6

SECONDARY outcome

Timeframe: 30 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 30 days post discharge (30 days minus baseline).

A change in t-score <0 indicates worsening. A change equal to 0 indicates no change. A change >0 indicates improvement.

Outcome measures

Measure	Usual Care n=401 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=390 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Emotional Support (v2.0, SF4a)	-0.1 T-score Standard Error 0.5	-0.1 T-score Standard Error 0.5

SECONDARY outcome

Timeframe: 30 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 30 days post discharge (30 days minus baseline).

A change in t-score <0 indicates worsening. A change equal to 0 indicates no change. A change >0 indicates improvement.

Outcome measures

Measure	Usual Care n=403 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=391 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Instrumental Support (v2.0, SF4a)	1.0 T-score Standard Error 0.5	0.6 T-score Standard Error 0.5

SECONDARY outcome

Timeframe: 30 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 30 days post discharge (30 days minus baseline).

A change in t-score <0 indicates worsening. A change equal to 0 indicates no change. A change >0 indicates improvement.

Outcome measures

Measure	Usual Care n=408 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=389 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Global Health, Physical (v1.1, SF)	4.6 T-score Standard Error 0.4	4.4 T-score Standard Error 0.4

SECONDARY outcome

Timeframe: 30 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 30 days post discharge (30 days minus baseline).

A change in t-score <0 indicates worsening. A change equal to 0 indicates no change. A change >0 indicates improvement.

Outcome measures

Measure	Usual Care n=408 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=389 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Global Health, Mental (v1.1, SF)	0.8 T-score Standard Error 0.4	0.6 T-score Standard Error 0.4

SECONDARY outcome

Timeframe: 60 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 60 days post discharge (60 days minus baseline).

A change in t-score <0 indicates improvement. A change equal to 0 indicates no change. A change >0 indicates worsening.

Outcome measures

Measure	Usual Care n=375 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=365 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Emotional Distress-Anxiety (v1.0, SF4a)	0.3 T-score Standard Error 0.6	-1.1 T-score Standard Error 0.6

SECONDARY outcome

Timeframe: 60 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 60 days post discharge (60 days minus baseline).

A change in t-score <0 indicates worsening. A change equal to 0 indicates no change. A change >0 indicates improvement.

Outcome measures

Measure	Usual Care n=373 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=363 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Informational Support (v2.0, SF4a)	1.7 T-score Standard Error 0.6	2.0 T-score Standard Error 0.7

SECONDARY outcome

Timeframe: 60 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 60 days post discharge (60 days minus baseline).

A change in t-score <0 indicates worsening. A change equal to 0 indicates no change. A change >0 indicates improvement.

Outcome measures

Measure	Usual Care n=372 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=363 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Emotional Support (v2.0, SF4a)	0.1 T-score Standard Error 0.5	-0.2 T-score Standard Error 0.5

SECONDARY outcome

Timeframe: 60 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 60 days post discharge (60 days minus baseline).

A change in t-score <0 indicates worsening. A change equal to 0 indicates no change. A change >0 indicates improvement.

Outcome measures

Measure	Usual Care n=374 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=363 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Instrumental Support (v2.0, SF4a)	0.8 T-score Standard Error 0.5	1.0 T-score Standard Error 0.5

SECONDARY outcome

Timeframe: 60 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 60 days post discharge (60 days minus baseline).

A change in t-score <0 indicates worsening. A change equal to 0 indicates no change. A change >0 indicates improvement.

Outcome measures

Measure	Usual Care n=372 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=365 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Global Health, Physical (v1.1, SF)	3.4 T-score Standard Error 0.5	3.6 T-score Standard Error 0.4

SECONDARY outcome

Timeframe: 60 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Change in T-score from baseline to 60 days post discharge (60 days minus baseline).

A change in t-score <0 indicates worsening. A change equal to 0 indicates no change. A change >0 indicates improvement.

Outcome measures

Measure	Usual Care n=372 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=366 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
PROMIS Global Health, Mental (v1.1, SF)	-1.3 T-score Standard Error 0.5	01.1 T-score Standard Error 0.4

SECONDARY outcome

Timeframe: 30 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Caregiver-reported and confirmed by EHR review

Outcome measures

Measure	Usual Care n=502 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=497 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
Death	4 Participants	7 Participants

SECONDARY outcome

Timeframe: 60 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Caregiver-reported and confirmed by EHR review

Outcome measures

Measure	Usual Care n=493 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=488 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
Death	9 Participants	9 Participants

SECONDARY outcome

Timeframe: 30 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Confirmed by EHR review

Outcome measures

Measure	Usual Care n=503 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=495 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
Re-hospitalization or Death	100 Participants	112 Participants

SECONDARY outcome

Timeframe: 60 days post discharge

Confirmed by EHR review

Outcome measures

Measure	Usual Care n=493 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=487 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
Re-hospitalization or Death	147 Participants	159 Participants

SECONDARY outcome

Timeframe: 30 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Confirmed by EHR review

Outcome measures

Measure	Usual Care n=503 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=495 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
ED Visit, Re-hospitalization, or Death	156 Participants	154 Participants

SECONDARY outcome

Timeframe: 60 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Confirmed by EHR review

Outcome measures

Measure	Usual Care n=494 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=487 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
ED Visit, Re-hospitalization, or Death	210 Participants	216 Participants

SECONDARY outcome

Timeframe: 14 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

Self-reported

Outcome measures

Measure	Usual Care n=405 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=388 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
Outpatient Healthcare Visit	137 Participants	112 Participants

SECONDARY outcome

Timeframe: 14 days post discharge

Population: Due to missing data, the number of participants analyzed may be less than the numbers provided in the Participant Flow module.

EHR-reported

Outcome measures

Measure	Usual Care n=511 Participants Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=507 Participants Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
Outpatient Healthcare Visit	236 Participants	232 Participants

Adverse Events

Usual Care

Serious events: 12 serious events

Other events: 0 other events

Deaths: 12 deaths

Usual Care + PArTNER

Serious events: 12 serious events

Other events: 0 other events

Deaths: 12 deaths

Serious adverse events

Measure	Usual Care n=511 participants at risk Hospital usual care Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge.	Usual Care + PArTNER n=518 participants at risk Navigator intervention: (Community health worker, peer-led telephone support line, usual care) Hospital usual care: Written discharge instructions provided to patients prior to hospital discharge. Community health worker: The community health worker provides social support, literacy appropriate education, and acts as a conduit between the patient and the patient's medical team Peer-led telephone support line: The peer-led telephone support line will provide social support, peer-to-peer coaching, and facilitate communication with the patient's medical care team.
General disorders All-cause death	2.3% 12/511 • Adverse event data were collected from enrollment through 60 days after hospital discharge.	2.3% 12/518 • Adverse event data were collected from enrollment through 60 days after hospital discharge.

Other adverse events

Adverse event data not reported

Additional Information

Jerry A. Krishnan, MD, PhD

University of Illinois at Chicago

Phone: 312-413-3291

Email: partner@uic.edu

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place