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

Patient Discharge Clinical Trial

Official title:

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01207180
• Other study ID #: 10-0978
• Status: Completed
• Phase: N/A
• First received: September 13, 2010
• Last updated: November 17, 2011
• Start date: September 2010
• Est. completion date: November 2010

Study information

• Verified date: November 2011
• 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 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).

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 information / eligibility

• Status: Completed
• Enrollment: 157
• Est. completion date: November 2010
• Est. primary completion date: November 2010
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 65 Years and older

Eligibility

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

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Health Services Research

Related Conditions & MeSH terms

• Emergencies
• Patient Discharge

Intervention

Other:
• Phone call follow-up
A nurse will call the patient to counsel patients on their medications and following up with their primary care provider.
• Satisfaction survey
Patients will be given a satisfaction survey.
• Control group --- no intervention
Control group

Locations

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

Sponsors (2)

Lead Sponsor	Collaborator
University of North Carolina, Chapel Hill	The Duke Endowment

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Whether patient obtained medications prescribed at their discharge from ED		5-8 days after discharge from ED	No
Primary	Whether patient is using medications that were prescribed at their ED discharge correctly		5-8 days after discharge from ED	No
Primary	Whether the patient arranged a follow-up appointment with their primary care provider		5-8 days after discharge from ED	No
Primary	Whether patient attended visit with their primary care provider after discharge from the ED		30-35 days after discharge from ED	No
Secondary	Patient's satisfaction with ED visit		5-8 days after discharge from the ED	No
Secondary	Return to the ED within 30 days of initial visit		30-35 days after discharge from ED	No
Secondary	Cost of the intervention		35 days after last patient enrolled	No