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Use of a Brief Phone Call After ED Discharge

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ClinicalTrials.gov Identifier: NCT01893931
Recruitment Status : Completed
First Posted : July 9, 2013
Last Update Posted : July 11, 2016
Sponsor:
Collaborator:
The William R. Kenan, Jr. Charitable Trust
Information provided by (Responsible Party):
University of North Carolina, Chapel Hill

Brief 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.


Condition or disease Intervention/treatment Phase
Discharge Planning Emergency Medicine Geriatrics Patient Readmission Behavioral: ED Discharge & Medication Call Behavioral: Placebo Comparator Not Applicable

Detailed 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.


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 2003 participants
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
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
Study Start Date : August 2013
Actual Primary Completion Date : May 2016
Actual Study Completion Date : May 2016

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Placebo Comparator: Satisfaction Survey
Within 1-3 days after ED discharge, patients will be called by a nurse to complete a brief satisfaction survey.
Behavioral: Placebo Comparator
Active Comparator: ED Discharge and Medication Call
Within 1-3 days after ED discharge, patients will receive a follow up phone call from a nurse to review discharge instructions, review medication instructions, and provide any necessary patient navigation.
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.




Primary Outcome Measures :
  1. Time to the first occurrence of hospital readmission, emergency department visit, or death. [ Time Frame: 0-35 days ]
    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.


Secondary Outcome Measures :
  1. Time elapsed from initial emergency department visit to Physician follow up [ Time Frame: 0-35 Days ]
  2. Patient satisfaction as reported by phone survey [ Time Frame: 0-35 Days ]


Information from the National Library of Medicine

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Ages Eligible for Study:   65 Years and older   (Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

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

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01893931


Locations
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United States, North Carolina
University of North Carolina
Chapel Hill, North Carolina, United States, 27599
Sponsors and Collaborators
University of North Carolina, Chapel Hill
The William R. Kenan, Jr. Charitable Trust
Investigators
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Principal Investigator: John S Kizer, M.D. University of North Carolina, Chapel Hill
Principal Investigator: Kevin Biese, M.D. University of North Carolina, Chapel Hill

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: University of North Carolina, Chapel Hill
ClinicalTrials.gov Identifier: NCT01893931     History of Changes
Other Study ID Numbers: 12-1278
First Posted: July 9, 2013    Key Record Dates
Last Update Posted: July 11, 2016
Last Verified: July 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by University of North Carolina, Chapel Hill:
Geriatrics
Emergency Medicine
Care Transitions
Additional relevant MeSH terms:
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Emergencies
Disease Attributes
Pathologic Processes