A nationwide aim is to lower 30-day readmission rates after hospitalization for acute decompensated heart failure (ADHF) and acute coronary syndrome (ACS). This research sought to ascertain the impact of a customized, pharmacist-delivered health literacy intervention on unscheduled health care usage, such as ER visits or hospital readmissions, after discharge. blinded outcome assessors and a controlled, randomized trial with hidden allocation Two university medical facilities for tertiary care. hospitalized adults who have been diagnosed with ADHF or ACS. Personalized phone follow-up after discharge, low-literacy adherence aids, inpatient pharmacist counseling, and pharmacist-assisted drug reconciliation. Time to first unplanned health care incident, which was defined as an emergency room visit or hospital readmission within 30 days of discharge, was the main outcome. The effects of the intervention were assessed using predetermined analyses by academic location, health literacy level (sufficient vs adequate), and cognitive function (impaired versus not impaired). 95 percent confidence intervals (CI) and adjusted hazard ratios (aHR) are provided. The research included 851 people who were enrolled at Brigham and Women's Hospital (BWH) and Vanderbilt University Hospital (VUH). When comparing patients who received treatments to controls, the main analysis revealed no statistically significant difference in the time to first unplanned hospital readmission or emergency room visit (aHR = 1.04, 95% CI 0.78-1.39). Treatment impact by location was shown to interact (p = 0.04 for interaction); BWH aHR = 1.44 (95 % CI 0.95-2.12); VUH aHR = 0.77, 95% CI 0.51-1.15. Among patients with low health literacy, the intervention decreased early unplanned health care usage (aHR 0.41, 95% CI 0.17-1.00). The treatment's impact on patient cognition was the same. Overall postdischarge unplanned health care consumption was not decreased by a customized, pharmacist-delivered, health literacy-sensitive intervention. Patients with low health literacy responded well to the intervention, indicating that pharmacists may benefit from focusing their efforts on this group.