Geriatrics Clinical Trial
Official title:
Discharge Planning for Older Adults in the Emergency Department: Use of a Brief Phone Call After Discharge to Decrease Return Visits to the Emergency Department and Re-admissions to the Hospital
The purpose of this study is to determine whether a phone call from a nurse within 1-3 days
after discharge from the Emergency Department (ED) decreases return visits to the ED/
hospital admissions/ death (combined outcome) in patients age 65 and above. As secondary
outcomes, time to follow up appointment with physician and economic impact of this
intervention will be assessed.
Patients 65 years of age and older will be randomized following discharge from the ED into
one of two groups. Group 1(Intervention) will receive a phone call collecting information
about understanding of ED discharge instructions and guiding patient through the discharge
instructions, and Group 2 (Placebo) will receive a follow up phone call for a satisfaction
survey.
We hypothesize return visits to the ED and readmission to the hospital will decrease as a
result of the nurse phone call intervention.
Procedures: All patients age 65 and above will be randomized to one of two groups within 1-3
days after discharge from the UNC ED: 1) Interventional follow-up phone call; or 2) Placebo
phone call, implementing only a satisfaction survey.
The intervention phone call will ask whether patients have obtained the newly prescribed
medicines, ask if the patient understands the instructions for taking the medicines and
inquire if a patient has made an appointment with his/her personal physician. The caller
will attempt to answer questions about the medicines, and encourage patients to take the
medicines as directed. The caller will also encourage the patients to follow-up with their
own physician in a timely manner and offer to help with setting up follow up appointments if
needed.
Subsequently, 30-35 days after ED discharge, all patients will receive a phone call to
evaluate rates of compliance with medicines and scheduling follow-up appointments. All calls
will be made by trained nurses.
Using an α 0.05 and β 0.80 we will need to enroll 2235 patients to detect a decrease in ED
return visits/re-admission/ death of 6%. There will be one interim analysis 1 year into the
two year planned study.
;
Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention
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