Use of a Brief Phone Call After ED Discharge

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01893931
• Other study ID #: 12-1278
• Status: Completed
• Phase: N/A
• First received: June 24, 2013
• Last updated: July 8, 2016
• Start date: August 2013
• Est. completion date: May 2016

Study information

• Verified date: July 2016
• Source: University of North Carolina, Chapel Hill
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

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.

Description:

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 2003
• Est. completion date: May 2016
• Est. primary completion date: May 2016
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 65 Years and older

Eligibility

Inclusion Criteria:

• All patients age 65 and above discharged from the ED

• English speaking

Exclusion Criteria:

• Younger than 65 years of age

• Unable to pass 6-item memory screener

• Lives in skilled nursing facility

Study Design

Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention

Related Conditions & MeSH terms

• Discharge Planning
• Emergencies
• Emergency Medicine
• Geriatrics
• Patient Readmission

Intervention

Behavioral:
• ED Discharge & Medication Call
Patients will receive a follow up phone call from a nurse to review discharge instructions and provide any necessary patient navigation.
• Placebo Comparator

Locations

Country	Name	City	State
United States	University of North Carolina	Chapel Hill	North Carolina

Sponsors (2)

Lead Sponsor	Collaborator
University of North Carolina, Chapel Hill	The William R. Kenan, Jr. Charitable Trust

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Time to the first occurrence of hospital readmission, emergency department visit, or death.	Measured by (1) Self-report via a phone call to the patient or care giver up to 35 days post-discharge, and (2) Utilization of existing medical records.	0-35 days	No
Secondary	Time elapsed from initial emergency department visit to Physician follow up		0-35 Days	No
Secondary	Patient satisfaction as reported by phone survey		0-35 Days	No