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
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Patient Discharge
- Sponsor
- University of North Carolina, Chapel Hill
- Enrollment
- 157
- Locations
- 1
- Primary Endpoint
- Whether patient obtained medications prescribed at their discharge from ED
- Status
- Completed
- Last Updated
- 14 years ago
Overview
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).
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.
Investigators
Kevin Biese, MD
Assistant Professor of Emergency Medicine
University of North Carolina, Chapel Hill
Eligibility Criteria
Inclusion Criteria
- •Age 65 or over
- •Discharged from the UNC emergency department
Exclusion Criteria
- •In the hospital at the time of phone call follow-up
- •Neither the patient nor their responsible party are able to pass a standardized test to assess cognitive function
Outcomes
Primary Outcomes
Whether patient obtained medications prescribed at their discharge from ED
Time Frame: 5-8 days after discharge from ED
Whether patient is using medications that were prescribed at their ED discharge correctly
Time Frame: 5-8 days after discharge from ED
Whether the patient arranged a follow-up appointment with their primary care provider
Time Frame: 5-8 days after discharge from ED
Whether patient attended visit with their primary care provider after discharge from the ED
Time Frame: 30-35 days after discharge from ED
Secondary Outcomes
- 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)