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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

Not Applicable
Completed
Conditions
Patient Discharge
Interventions
Other: Phone call follow-up
Other: Satisfaction survey
Other: Control group --- no intervention
Registration Number
NCT01207180
Lead Sponsor
University of North Carolina, Chapel Hill
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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
157
Inclusion Criteria
  • Age 65 or over
  • Discharged from the UNC emergency department
Read More
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
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Follow-up phone call from NursePhone call follow-upPatients in this are will receive a phone call follow-up from a nurse 1-3 days after their discharge from the ED.
Satisfaction surveySatisfaction surveyThis 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.
Control groupControl group --- no interventionPatients in this group will receive no phone call at 1-3 days.
Primary Outcome Measures
NameTimeMethod
Whether patient obtained medications prescribed at their discharge from ED5-8 days after discharge from ED
Whether patient is using medications that were prescribed at their ED discharge correctly5-8 days after discharge from ED
Whether the patient arranged a follow-up appointment with their primary care provider5-8 days after discharge from ED
Whether patient attended visit with their primary care provider after discharge from the ED30-35 days after discharge from ED
Secondary Outcome Measures
NameTimeMethod
Patient's satisfaction with ED visit5-8 days after discharge from the ED
Return to the ED within 30 days of initial visit30-35 days after discharge from ED
Cost of the intervention35 days after last patient enrolled

Trial Locations

Locations (1)

University of North Carolina Emergency Department

🇺🇸

Chapel Hill, North Carolina, United States

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