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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

This study has been completed.
Sponsor:
Collaborator:
The Duke Endowment
Information provided by (Responsible Party):
Kevin Biese, MD, University of North Carolina, Chapel Hill
ClinicalTrials.gov Identifier:
NCT01207180
First received: September 13, 2010
Last updated: November 17, 2011
Last verified: November 2011
  Purpose

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).


Condition Intervention
Patient Discharge
Other: Phone call follow-up
Other: Satisfaction survey
Other: Control group --- no intervention

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

Further study details as provided by University of North Carolina, Chapel Hill:

Primary Outcome Measures:
  • Whether patient obtained medications prescribed at their discharge from ED [ Time Frame: 5-8 days after discharge from ED ] [ Designated as safety issue: No ]
  • Whether patient is using medications that were prescribed at their ED discharge correctly [ Time Frame: 5-8 days after discharge from ED ] [ Designated as safety issue: No ]
  • Whether the patient arranged a follow-up appointment with their primary care provider [ Time Frame: 5-8 days after discharge from ED ] [ Designated as safety issue: No ]
  • Whether patient attended visit with their primary care provider after discharge from the ED [ Time Frame: 30-35 days after discharge from ED ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Patient's satisfaction with ED visit [ Time Frame: 5-8 days after discharge from the ED ] [ Designated as safety issue: No ]
  • Return to the ED within 30 days of initial visit [ Time Frame: 30-35 days after discharge from ED ] [ Designated as safety issue: No ]
  • Cost of the intervention [ Time Frame: 35 days after last patient enrolled ] [ Designated as safety issue: No ]

Enrollment: 157
Study Start Date: September 2010
Study Completion Date: November 2010
Primary Completion Date: November 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 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.
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.
Placebo Comparator: 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.
Other: Satisfaction survey
Patients will be given a satisfaction survey.
Placebo Comparator: Control group
Patients in this group will receive no phone call at 1-3 days.
Other: Control group --- no intervention
Control group

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.

  Eligibility

Ages Eligible for Study:   65 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
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
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01207180

Locations
United States, North Carolina
University of North Carolina Emergency Department
Chapel Hill, North Carolina, United States, 27599
Sponsors and Collaborators
University of North Carolina, Chapel Hill
The Duke Endowment
Investigators
Principal Investigator: Kevin J Biese, MD University of North Carolina, Chapel Hill
  More Information

No publications provided by University of North Carolina, Chapel Hill

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Kevin Biese, MD, Assistant Professor of Emergency Medicine, University of North Carolina, Chapel Hill
ClinicalTrials.gov Identifier: NCT01207180     History of Changes
Other Study ID Numbers: 10-0978
Study First Received: September 13, 2010
Last Updated: November 17, 2011
Health Authority: United States: Institutional Review Board

Keywords provided by University of North Carolina, Chapel Hill:
emergency medicine
primary care physicians

Additional relevant MeSH terms:
Emergencies
Disease Attributes
Pathologic Processes

ClinicalTrials.gov processed this record on November 20, 2014