Discharge Planning for Elderly Patients in the Emergency Department: Use of a Brief Phone Call After Discharge to Improve Medication Utilization and Physician Follow-up
Study Details
Study Description
Brief Summary
The investigators hypothesize that the acquisition and correct utilization of medications as well as arranging and attending follow-up appointments will improve as a result of a phone call intervention 1-3 days after elderly patients are discharged from the emergency department (ED).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Older patients seen in the ED are at high risk of functional decline and return visits to the ED. Previous studies have shown that a comprehensive assessment by a geriatric specialist at the time of discharge from the ED along with extensive integration with home services and/or referral to community services can decrease functional decline and return visits to the ED as well as increase patient satisfaction, but this intervention is resource intensive requiring a geriatric discharge specialist to be available to the emergency department 24 hours a day/ 7 days a week. It is also known that in other patient populations telephone reminders to make follow up appointments can increase rate of follow up and that comprehension of discharge instructions is the primary barrier to compliance with discharge instructions. It has been shown that telephone follow-up interviews are feasible for geriatric patients discharged from the ED, and that many elderly patients discharged from the ED do not understand their discharge instructions or attend follow-up appointments. However, there are no published studies evaluating whether a follow up telephone call after discharge from the ED can improve patient compliance with the medical treatment plan including obtaining follow - up appointments and obtaining prescribed medications as well as using them appropriately. We seek to determine if we can increase compliance with medications and outpatient follow up with a phone call from a nurse provider 1-3 days after discharge.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Follow-up phone call from Nurse Patients in this are will receive a phone call follow-up from a nurse 1-3 days after their discharge from the ED. |
Other: Phone call follow-up
A nurse will call the patient to counsel patients on their medications and following up with their primary care provider.
|
| Placebo Comparator: Satisfaction survey This group of patients will receive a phone call from a student who will conduct a brief satisfaction survey of the patient's experience in the ED. |
Other: Satisfaction survey
Patients will be given a satisfaction survey.
|
| Placebo Comparator: Control group Patients in this group will receive no phone call at 1-3 days. |
Other: Control group --- no intervention
Control group
|
Outcome Measures
Primary Outcome Measures
- Whether patient obtained medications prescribed at their discharge from ED [5-8 days after discharge from ED]
- Whether patient is using medications that were prescribed at their ED discharge correctly [5-8 days after discharge from ED]
- Whether the patient arranged a follow-up appointment with their primary care provider [5-8 days after discharge from ED]
- Whether patient attended visit with their primary care provider after discharge from the ED [30-35 days after discharge from ED]
Secondary Outcome Measures
- Patient's satisfaction with ED visit [5-8 days after discharge from the ED]
- Return to the ED within 30 days of initial visit [30-35 days after discharge from ED]
- Cost of the intervention [35 days after last patient enrolled]
Eligibility Criteria
Criteria
Inclusion Criteria:
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Age 65 or over
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Discharged from the UNC emergency department
Exclusion Criteria:
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In the hospital at the time of phone call follow-up
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Neither the patient nor their responsible party are able to pass a standardized test to assess cognitive function
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University of North Carolina Emergency Department | Chapel Hill | North Carolina | United States | 27599 |
Sponsors and Collaborators
- University of North Carolina, Chapel Hill
- The Duke Endowment
Investigators
- Principal Investigator: Kevin J Biese, MD, University of North Carolina, Chapel Hill
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 10-0978