Limitations
deaths
RECRUITMENT
This study has some limitations. First, we were unable to reach our recruitment target. Second, although attrition was balanced across groups and was relatively low for this difficult-to-reach population, it reduced the statistical power of our patient-reported outcomes. However, the lack of change in the primary outcome between groups suggests that we would not have observed a statistically significant improvement in hospitalization rates even if we had reached our sample size target. Third, we had a relatively high number of deaths during the 6-month period, indicating the frailty of our population. Finally, we relied on PCPs to refer patients for the trial; it is unclear how nonreferred complex patients may have fared. Although the intended target was patients with medical complexity as a driver of their hospitalizations, it is difficult to disentangle behavioral health and substance use drivers of hospitalization, which may require different interventions.