title: 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.
abstract: 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.
  
  
  
  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).
  
  
  
  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.
  
  
  
  ACTRN12615000715572, Pre-results.
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Judy A
authors.initials: JA
authors.lastname: Lowthian
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Alyse
authors.initials: A
authors.lastname: Lennox
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: Curtis
authors.affiliation: Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Dale
authors.affiliation: RDNS Institute, RDNS, Melbourne, Victoria, Australia.|International Institute for Primary Health Care Research, Shenzhen, China.|School of Primary Health Care, Monash University, Melbourne, Victoria, Australia.
authors.forename: Colette
authors.initials: C
authors.lastname: Browning
authors.affiliation: Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia.
authors.forename: De Villiers
authors.initials: V
authors.lastname: Smit
authors.affiliation: Volunteer Services, Alfred Health, Melbourne, Victoria, Australia.
authors.forename: Gillian
authors.initials: G
authors.lastname: Wilson
authors.affiliation: Emergency Department, Cabrini Health, Malvern, Victoria, Australia.
authors.forename: Debra
authors.initials: D
authors.lastname: O'Brien
authors.affiliation: Volunteer Services, Cabrini Health, Malvern, Victoria, Australia.
authors.forename: Cate
authors.initials: C
authors.lastname: Rosewarne
authors.affiliation: Nursing Services, Cabrini Institute, Cabrini Health, Malvern, Victoria, Australia.
authors.forename: Lee
authors.initials: L
authors.lastname: Boyd
authors.affiliation: Department of Mission and Strategy, Cabrini Health, Malvern, Victoria,  .
authors.forename: Cath
authors.initials: C
authors.lastname: Garner
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.|Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Cameron
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005240:Feasibility Studies; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006801:Humans; D008132:Loneliness / Q000523:psychology*; D008297:Male; D010351:Patient Discharge; D010379:Peer Group; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012107:Research Design; D012944:Social Support; D013689:Telephone / Q000706:statistics & numerical data*
keywords: feasibility study; protocol; social isolation; telephone-support; volunteer-peer