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

NCT ID: NCT01207180

Last Updated: 2011-11-18

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 157 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2010-09-30
• Study Completion Date: 2010-11-30

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.

Conditions

Patient Discharge

Keywords

emergency medicine; primary care physicians

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: DOUBLE

Study Groups

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.

Group Type: EXPERIMENTAL

Phone call follow-up

Intervention Type: OTHER

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

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.

Group Type: PLACEBO_COMPARATOR

Satisfaction survey

Intervention Type: OTHER

Patients will be given a satisfaction survey.

Control group

Patients in this group will receive no phone call at 1-3 days.

Group Type: PLACEBO_COMPARATOR

Control group --- no intervention

Intervention Type: OTHER

Control group

Interventions

Phone call follow-up

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

Intervention Type: OTHER

Satisfaction survey

Patients will be given a satisfaction survey.

Intervention Type: OTHER

Control group --- no intervention

Control group

Intervention Type: OTHER

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

• Minimum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

The Duke Endowment

OTHER

Sponsor Role: collaborator

University of North Carolina, Chapel Hill

OTHER

Sponsor Role: lead

Responsible Party

Kevin Biese, MD

Assistant Professor of Emergency Medicine

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Kevin J Biese, MD

Role: PRINCIPAL_INVESTIGATOR

University of North Carolina, Chapel Hill

Locations

University of North Carolina Emergency Department

Chapel Hill, North Carolina, United States

Countries

United States

References

Biese K, Lamantia M, Shofer F, McCall B, Roberts E, Stearns SC, Principe S, Kizer JS, Cairns CB, Busby-Whitehead J. A randomized trial exploring the effect of a telephone call follow-up on care plan compliance among older adults discharged home from the emergency department. Acad Emerg Med. 2014 Feb;21(2):188-95. doi: 10.1111/acem.12308.

Reference Type: DERIVED

PMID: 24673675 (View on PubMed)

Other Identifiers

10-0978

Identifier Type: -

Identifier Source: org_study_id