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

N/ACompletedNCT01207180

University of North Carolina, Chapel Hill157 enrolled

Overview

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).

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 Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

DOUBLE

Enrollment

157

Conditions

Patient Discharge

Interventions

Phone call follow-upOTHER

A nurse will call the patient to counsel patients on their medications and following up with their primary care provider.

Satisfaction surveyOTHER

Patients will be given a satisfaction survey.

Control group --- no interventionOTHER

Control group

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

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

Locations (1)

University of North Carolina Emergency Department

Chapel Hill, North Carolina, United States

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

Time frame: 5-8 days after discharge from the ED

Return to the ED within 30 days of initial visit

Time frame: 30-35 days after discharge from ED

Cost of the intervention

Time frame: 35 days after last patient enrolled

Data from ClinicalTrials.gov

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