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HOspitals and patients WoRking in Unity (HOW R U?): protocol for a prospective feasibility study of telephone peer support to improve older patients' quality of life after emergency department discharge
  1. Judy A Lowthian1,
  2. Alyse Lennox1,
  3. Andrea Curtis1,
  4. Jeremy Dale2,
  5. Colette Browning3,4,5,
  6. De Villiers Smit6,
  7. Gillian Wilson7,
  8. Debra O'Brien8,
  9. Cate Rosewarne9,
  10. Lee Boyd10,
  11. Cath Garner11,
  12. Peter Cameron1,6
  1. 1School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  2. 2Warwick Medical School, University of Warwick, Coventry, UK
  3. 3RDNS Institute, RDNS, Melbourne, Victoria, Australia
  4. 4International Institute for Primary Health Care Research, Shenzhen, China
  5. 5School of Primary Health Care, Monash University, Melbourne, Victoria, Australia
  6. 6Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia
  7. 7Volunteer Services, Alfred Health, Melbourne, Victoria, Australia
  8. 8Emergency Department, Cabrini Health, Malvern, Victoria, Australia
  9. 9Volunteer Services, Cabrini Health, Malvern, Victoria, Australia
  10. 10Nursing Services, Cabrini Institute, Cabrini Health, Malvern, Victoria, Australia
  11. 11Department of Mission and Strategy, Cabrini Health, Malvern, Victoria,  
  1. Correspondence to Dr Judy Lowthian, Judy.Lowthian{at}


Introduction Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers.

Methods and analysis A multicentre prospective uncontrolled feasibility study will enrol 50 community-dwelling patients aged ≥70 years with symptoms of loneliness or depression who are discharged home within 72 hours from the ED or acute medical ward. Participants will receive weekly supportive telephone calls over a 3-month period from a volunteer-peer. Feasibility will be assessed in terms of recruitment, acceptability of the intervention to participants and level of retention in the programme. Changes in level of loneliness (UCLA-3 item Loneliness Scale), mood (Geriatric Depression Scale-5 item) and health-related quality of life (EQ-5D-5L and EQ-VAS) will also be measured postintervention (3 months).

Ethics and dissemination Research ethics and governance committee approval has been granted for this study by each participating centre (reference: 432/15 and 12-09-11-15). Study findings will inform the design and conduct of a future multicentre randomised controlled trial of a postdischarge volunteer-peer telephone support programme to improve social isolation, loneliness or depressive symptoms in older patients. Results will be disseminated through peer-reviewed journal publication, and conference and seminar presentation.

Trial registration number ACTRN12615000715572, Pre-results.

  • social isolation
  • protocol
  • feasibility study
  • volunteer-peer
  • telephone-support

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  • Contributors JAL conceived and developed the study protocol. JD and CB provided expertise with design of the intervention. All authors contributed to refinement of the study protocol. AL and JAL drafted the manuscript, and all authors approved the final manuscript.

  • Funding This work was supported by a grant from the Monash Partners Academic Health Science Centre.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Alfred Health (432/15), Cabrini Health (12-09-11-15) and Monash University (CF15/4468-2015001934).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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