Substance Use Disorder (SUD)NCT07030192
Peer Support Workers Feasibility Study
A study testing Peer support service in people with Substance Use Disorder (SUD), run by University of British Columbia at 1 site in Canada.
Trial summary
Many people with high-risk opioid use visit emergency departments (EDs), facing a high risk of death if they leave before completing care. Peer support workers (Peer) - people with lived experience of substance use - may improve patient comfort, reduce early departures, and potentially lower mortality rates. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Substance Use Disorder (SUD)
- What is being tested?
- Peer support service
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 3,181 participants
- Where
- 1 siteCanada
- Study dates
- 23 Nov 2024to Dec 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Emergency Department (ED) patient at Vancouver General Hospital (VGH)
- Age 18 years or older
- Identified as using substances
- Able to receive or decline peer support services during the ED visit
Who cannot join
- Under 18 years of age
- Does not report substance use
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Canada1 site, 1 recruiting
- Recruiting
Vancouver General Hospital
Vancouver, British Columbia, V5Z 1M9
Jessica Moe, MD, jessica.moe@ubc.ca
About this study
Official title: Promoting Safety and Equity in Chaos: A Feasibility Study of Peer Support Workers to Support People Who Use Drugs in Emergency Departments
Many people with high-risk opioid use visit emergency departments (EDs), facing a high risk of death if they leave before completing care. Peer support workers (Peer) - people with lived experience of substance use - may improve patient comfort, reduce early departures, and potentially lower mortality rates. This study aims to evaluate how a hospital-implemented ED Peer program can enhance patient support, reduce barriers to care, and provide harm-reduction resources in a person-centred and trauma-informed manner. The study will also validate the outcome and obtain preliminary estimates of the benefits of decreasing patients who leave the ED before completing care.
Read the detailed description
The main objectives of the study are to 1) to describe, and evaluate the feasibility and acceptability of a novel ED Peer program implemented by the Vancouver Coastal Health at the Vancouver General Hospital (VGH) ED, 2) to evaluate the feasibility of creating a randomized shift schedule in support of a future definitive randomized controlled trial, 3) to validate outcomes related to patients leaving before completing care using administrative data from the National Ambulatory Care Reporting System (NACRS), and 4) to obtain preliminary estimates of incidence of patients who leave the ED before completing care, to inform sample size calculations for a definitive randomized controlled trial.
The study will take place at Vancouver General Hospital (VGH), a large ED with approximately 97,000 visits per year, serving a diverse urban population. Investigators will evaluate our randomized shift schedule generation, and will describe our intervention and patient population through data within our Peer interaction logs and linkages to regional data. To understand our intervention and patient and provider experiences, investigators will use a mixed methods design to comprehensively collect, analyze, and interpret both qualitative and quantitative data. This approach will provide insights from multiple perspectives, offering a robust understanding of the relationships and potential contradictions within the evidence, thereby enriching the data and deepening our understanding of the findings.
Investigators will evaluate feasibility and acceptability of the Peer program at engaging patients with specific demographic, health history, and risk profiles. Investigators will assess the degree to which patients of different backgrounds access and engage with Peer services, and what characteristics affect patient acceptance of Peer services offered. Investigators will then work with the ED leadership team to target and tailor the program to best meet the needs of patients at highest risk.
This feasibility study will set the foundation for a definitive randomized controlled trial, which will be the first to compare patients with substance use who leave EDs before completing care during shifts with Peer availability versus without, addressing a critical knowledge gap. The definitive trial will engage multiple sites across Canada to rigorously evaluate ED Peer effectiveness, with the potential to scale up an intervention that could improve patient outcomes on a national scale.
- Conditions
- Substance Use Disorder (SUD)
- Being tested
- Peer support service
- Keywords
- Peer support workers, Substance use, Emergency department
- Medical subject headings
- Substance-Related Disorders, Emergencies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Peer support serviceBehavioural
Peers approach identified patients who could potentially benefit from peer support services. Peers offer a range of supports tailored to individual patients' needs, which include referrals to clinical and social support services (e.g., social work, addictions specialist, Indigenous patient navigator, community-based addictions resources), resources (e.g., blankets, food, naloxone kit, sterile drug use supplies, information brochures), providing emotional support, and liaising between patients and healthcare providers to communicate information about patients' condition and ED trajectory.
Peer support workers share their personal experiences to guide patients through their ED visit and to facilitate awareness and understanding of available resources.
| Study group | Role | What they receive |
|---|---|---|
| Peer support service | Experimental | Patients presenting with substance use related complaints during days and times where a Peer is available to provide services, as per an a priori, randomized schedule Receives: Behavioral: Peer support service |
| No Peer intervention | No intervention | Patients with substance use presentations who present to EDs on days and times when a Peer is not available, as per an a priori, randomized schedule |
What is being measured
The primary outcome is the main question the study is designed to answer.
Distribution of randomized Peer shifts by day of week
Assessed by examining the distribution of scheduled Peer shifts across each day of the week over the 48-week randomized schedule period. The schedule was developed in collaboration with human resources and ED operational leadership and approved as meeting hospital employee policy. The randomization approach used block-based scheduling with built-in constraints (e.g., mandatory weekends off). This outcome evaluates whether the resulting schedule achieved an even weekday/weekend distribution.
Unit of Measure: Number and percentage of Peer shifts scheduled per day of the week
Measured: Over the 48-week randomized schedule period approved to meet hospital staffing policy
Proportion of Peer interactions with complete standardized documentation
Assessed by the proportion of Peer interactions that were fully recorded using the standardized Peer interaction log, with completion defined by filling all required fields.
Unit of Measure: Percentage of interactions with complete logs
Measured: Up to 15 months post-study initiation
Identification of substance use-related ED visits for Peer and No Peer shift comparison
Investigators will obtain regional ED data with all visit information on all ED visits made during our study period. Investigators will use randomized schedule to identify dates and times of Peer shifts and control shifts. Investigators will then assess proportion of patients who left before medically advised among those presenting with substance use-related complaints during times with ED Peers available, compared to times without Peers. Investigators will analyze patients with presenting complaints that denote common complications of substance use (localized swelling/redness, substance withdrawal, and substance misuse/intoxication). This cohort can be identified using administrative data alone, allowing investigators to identify a reliable comparator group when ED Peers are not present. .
Measured: Up to 15 months post-study initiation
Characterization of Patients Receiving the Peer Intervention
Investigators will describe characteristics of patients who received the Peer intervention using information from interaction logs (including sex and gender) and linked administrative data (e.g., preceding substance use-related encounters; databases described below).
Measured: Baseline. Up to 15 months post-study initiation.
Patients leaving the ED prior to completing care
Investigators will use a linear regression model to compare the shift-level percentage of visits resulting in left before medically advised(primary outcome) during intervention (Peer) and control (no Peer) shifts, among all visits made by patients with our presenting complaints of interest. Patients presenting in the Peer shifts will be included in the analysis irrespective of whether they received the Peer intervention, i.e., an intent-to-treat approach. The model will adjust for shift-level covariates including: day of week, shift type (morning/afternoon/night), and ED volume.
Measured: Baseline. Data will be linked and assessed at the conclusion of the feasibility study, up to 15 months post-study initiation.
"Treatment effect in the treated" analysis
Investigators note that the shift-level analysis includes many patients who are not targets for the intervention. This is unavoidable because the absence of screening in the control arm renders it impossible to identify who would be eligible for the intervention, but including non-target patients introduces noise into the analysis and dilutes the observed effect. Hence, investigators will use a mixed-effect logistic regression at the patient level to compare the probability of left before medical advice in patients who presented with a specific complaint (e.g., substance misuse) and received the intervention, to patients in the control arm who presented with the same complaint. Investigators will use medical record numbers collected by Peers as part of the interaction logs to identify people who interacted with a Peer. The model will adjust for age, sex, time of day, day of week, month, ambulance arrival, triage acuity, and presenting complaint.
Measured: Up to 15 months post-study initiation
Secondary outcomes (3)
Thematic summary of Indigenous patients' experiences with the Peer program based on storytelling and sharing circles
Indigenous patient perspectives on the Peer program will be collected through culturally grounded storytelling and sharing circles. Sessions will be guided by open-ended questions to explore perceived safety, support, and emotional impact of Peer involvement in the emergency department. Transcripts will be analyzed using Indigenous-informed thematic analysis to identify key insights and priorities for culturally safe care.
Unit of Measure: Themes and narratives identified through qualitative analysis
Measured: Within 6 months after the patient's ED visit involving Peer interaction
Thematic summary of healthcare providers' perceptions of the Peer program assessed through focus groups
Acceptability of the Peer program among healthcare providers will be evaluated using semi-structured focus groups conducted between 3-15 months post-implementation. Discussions will explore perceived value, observed patient impact, integration into ED workflows, challenges, and suggestions for improvement. Audio recordings will be transcribed and analyzed using thematic content analysis to identify recurring patterns and representative quotes.
Unit of Measure: Thematic categories identified through qualitative analysis
Measured: From 3 to 15 months after program implementation
Patient-reported acceptability of the Peer program using the Peer patient survey
Acceptability will be assessed using the Peer patient survey, a 15-item questionnaire completed by patients following interaction with a peer support worker. Each item is scored on a 5-point Likert scale ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). Items assess patient experiences related to respect, emotional safety, ease of communication, clarity of information, comfort, confidentiality, and teamwork. The primary reported outcome will be the mean overall score across all 15 items. Secondary analyses may report item-level distributions.
Unit of Measure: Mean overall score (1-5 scale).
Scale Range: 1 (Strongly Disagree) to 5 (Strongly Agree); higher scores indicate higher acceptability of the Peer program.
Measured: Up to 15 months post-study initiation
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Jun 2025
- Study start23 Nov 2024
- Primary completionSep 2027 (estimated)
- Study completionDec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Substance Use Disorder (SUD)Studies of the same condition, open and under way.
- More trials run by University of British ColumbiaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 3,181 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of British Columbia
- Sponsor type
- University, hospital or other
- Collaborators
- Vancouver Coastal Health Research Institute, BC Centers for Disease Control
- Responsible party
- Principal investigator, Jessica Moe, University of British Columbia
- Investigators
- Jessica Moe, MD, Principal investigator, University of British Columbia
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07030192
- Sponsor's protocol ID
- H24-03008
- Status last verified
- Nov 2025
- First submitted
- 3 Jun 2025
- Last updated
- 21 Nov 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: There is no plan to make individual participant data available to other researchers
Study at a glance
From the registry record, last updated by the sponsor on 21 Nov 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Promoting Safety and Equity in Chaos: A Feasibility Study of Peer Support Workers to Support People Who Use Drugs in Emergency Departments
- ClinicalTrials.gov ID
- NCT07030192
- Acronym / sponsor ID
- H24-03008
- Conditions
- Substance Use Disorder (SUD)
- Keywords
- Peer support workers, Substance use, Emergency department
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 3,181 participants (estimated)
- Lead sponsor
- University of British ColumbiaUniversity, hospital or other
- Collaborators
- Vancouver Coastal Health Research Institute, BC Centers for Disease Control
- Study start
- 23 Nov 2024 (actual)
- Primary completion
- Sep 2027 (estimated)
- Study completion
- Dec 2027 (estimated)
- First posted
- 22 Jun 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Many people with high-risk opioid use visit emergency departments (EDs), facing a high risk of death if they leave before completing care. Peer support workers (Peer) - people with lived experience of substance use - may improve patient comfort, reduce early departures, and potentially lower mortality rates. This study aims to evaluate how a hospital-implemented ED Peer program can enhance patient support, reduce barriers to care, and provide harm-reduction resources in a person-centred and trauma-informed manner. The study will also validate the outcome and obtain preliminary estimates of the benefits of decreasing patients who leave the ED before completing care.
Detailed description
The main objectives of the study are to 1) to describe, and evaluate the feasibility and acceptability of a novel ED Peer program implemented by the Vancouver Coastal Health at the Vancouver General Hospital (VGH) ED, 2) to evaluate the feasibility of creating a randomized shift schedule in support of a future definitive randomized controlled trial, 3) to validate outcomes related to patients leaving before completing care using administrative data from the National Ambulatory Care Reporting System (NACRS), and 4) to obtain preliminary estimates of incidence of patients who leave the ED before completing care, to inform sample size calculations for a definitive randomized controlled trial.
The study will take place at Vancouver General Hospital (VGH), a large ED with approximately 97,000 visits per year, serving a diverse urban population. Investigators will evaluate our randomized shift schedule generation, and will describe our intervention and patient population through data within our Peer interaction logs and linkages to regional data. To understand our intervention and patient and provider experiences, investigators will use a mixed methods design to comprehensively collect, analyze, and interpret both qualitative and quantitative data. This approach will provide insights from multiple perspectives, offering a robust understanding of the relationships and potential contradictions within the evidence, thereby enriching the data and deepening our understanding of the findings.
Investigators will evaluate feasibility and acceptability of the Peer program at engaging patients with specific demographic, health history, and risk profiles. Investigators will assess the degree to which patients of different backgrounds access and engage with Peer services, and what characteristics affect patient acceptance of Peer services offered. Investigators will then work with the ED leadership team to target and tailor the program to best meet the needs of patients at highest risk.
This feasibility study will set the foundation for a definitive randomized controlled trial, which will be the first to compare patients with substance use who leave EDs before completing care during shifts with Peer availability versus without, addressing a critical knowledge gap. The definitive trial will engage multiple sites across Canada to rigorously evaluate ED Peer effectiveness, with the potential to scale up an intervention that could improve patient outcomes on a national scale.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Peer support service | Experimental | Behavioral: Peer support servicePatients presenting with substance use related complaints during days and times where a Peer is available to provide services, as per an a priori, randomized schedule |
| No Peer intervention | No intervention | –Patients with substance use presentations who present to EDs on days and times when a Peer is not available, as per an a priori, randomized schedule |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Emergency Department (ED) patient at Vancouver General Hospital (VGH)
- Age 18 years or older
- Identified as using substances
- Able to receive or decline peer support services during the ED visit
Key exclusion criteria (2 listed)
- Under 18 years of age
- Does not report substance use
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Peer support servicePeers approach identified patients who could potentially benefit from peer support services. Peers offer a range of supports tailored to individual patients' needs, which include referrals to clinical and social support services (e.g., social work, addictions specialist, Indigenous patient navigator, community-based addictions resources), resources (e.g., blankets, food, naloxone kit, sterile drug use supplies, information brochures), providing emotional support, and liaising between patients and healthcare providers to communicate information about patients' condition and ED trajectory. Peer support workers share their personal experiences to guide patients through their ED visit and to facilitate awareness and understanding of available resources. | Behavioural | Peer support service |
Primary outcome
Distribution of randomized Peer shifts by day of week
Time frame: Over the 48-week randomized schedule period approved to meet hospital staffing policy
Assessed by examining the distribution of scheduled Peer shifts across each day of the week over the 48-week randomized schedule period. The schedule was developed in collaboration with human resources and ED operational leadership and approved as meeting hospital employee policy. The randomization approach used block-based scheduling with built-in constraints (e.g., mandatory weekends off). This outcome evaluates whether the resulting schedule achieved an even weekday/weekend distribution. Unit of Measure: Number and percentage of Peer shifts scheduled per day of the week
Proportion of Peer interactions with complete standardized documentation
Time frame: Up to 15 months post-study initiation
Assessed by the proportion of Peer interactions that were fully recorded using the standardized Peer interaction log, with completion defined by filling all required fields. Unit of Measure: Percentage of interactions with complete logs
Identification of substance use-related ED visits for Peer and No Peer shift comparison
Time frame: Up to 15 months post-study initiation
Investigators will obtain regional ED data with all visit information on all ED visits made during our study period. Investigators will use randomized schedule to identify dates and times of Peer shifts and control shifts. Investigators will then assess proportion of patients who left before medically advised among those presenting with substance use-related complaints during times with ED Peers available, compared to times without Peers. Investigators will analyze patients with presenting complaints that denote common complications of substance use (localized swelling/redness, substance withdrawal, and substance misuse/intoxication). This cohort can be identified using administrative data alone, allowing investigators to identify a reliable comparator group when ED Peers are not present. .
Characterization of Patients Receiving the Peer Intervention
Time frame: Baseline. Up to 15 months post-study initiation.
Investigators will describe characteristics of patients who received the Peer intervention using information from interaction logs (including sex and gender) and linked administrative data (e.g., preceding substance use-related encounters; databases described below).
Patients leaving the ED prior to completing care
Time frame: Baseline. Data will be linked and assessed at the conclusion of the feasibility study, up to 15 months post-study initiation.
Investigators will use a linear regression model to compare the shift-level percentage of visits resulting in left before medically advised(primary outcome) during intervention (Peer) and control (no Peer) shifts, among all visits made by patients with our presenting complaints of interest. Patients presenting in the Peer shifts will be included in the analysis irrespective of whether they received the Peer intervention, i.e., an intent-to-treat approach. The model will adjust for shift-level covariates including: day of week, shift type (morning/afternoon/night), and ED volume.
"Treatment effect in the treated" analysis
Time frame: Up to 15 months post-study initiation
Investigators note that the shift-level analysis includes many patients who are not targets for the intervention. This is unavoidable because the absence of screening in the control arm renders it impossible to identify who would be eligible for the intervention, but including non-target patients introduces noise into the analysis and dilutes the observed effect. Hence, investigators will use a mixed-effect logistic regression at the patient level to compare the probability of left before medical advice in patients who presented with a specific complaint (e.g., substance misuse) and received the intervention, to patients in the control arm who presented with the same complaint. Investigators will use medical record numbers collected by Peers as part of the interaction logs to identify people who interacted with a Peer. The model will adjust for age, sex, time of day, day of week, month, ambulance arrival, triage acuity, and presenting complaint.
3 secondary outcomes
Thematic summary of Indigenous patients' experiences with the Peer program based on storytelling and sharing circles
Time frame: Within 6 months after the patient's ED visit involving Peer interaction
Thematic summary of healthcare providers' perceptions of the Peer program assessed through focus groups
Time frame: From 3 to 15 months after program implementation
Patient-reported acceptability of the Peer program using the Peer patient survey
Time frame: Up to 15 months post-study initiation
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Nov 2025.
- Individual participant dataSharing planned: No. There is no plan to make individual participant data available to other researchers
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Jessica Moe, MD principal investigator
University of British Columbia
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Peer support service in people with Substance Use Disorder (SUD), run by University of British Columbia at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 21 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Cindy Liu, BSc (778-929-1281, cindy.q.liu@ubc.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Distribution of randomized Peer shifts by day of week (time frame: Over the 48-week randomized schedule period approved to meet hospital staffing policy). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Nov 2025.