Oct 1 2012
By Sarah Guy, medwireNews Reporter
While the majority of older patients treated and released from emergency departments (EDs) understand their discharge information, half do not understand how long their condition could last, and a third do not understand medication warnings, show study results.
Understanding discharge information has a direct effect on how patients rate their quality of care, add the study authors in the BMJ Quality and Safety.
"Our findings suggest that efforts to enhance continuity between the ED and primary care should focus on educating patients and their families about the ED diagnosis, expected duration of symptoms and/or illness, return precautions, potential medication side effects and the appropriate time frame for follow-up," remark Susan Hastings (Veterans Affairs Medical Center [VAMC], Durham, North Carolina, USA) and team.
The team interviewed 305 individuals aged 65 years and above (or a proxy, in 56 cases) within 48 hours of being discharged from the VAMC ED between October 2008 and March 2010, to evaluate their perception of ED discharge information and quality of care. In all, 61% of visits resulted in prescription of at least one new medication, note the researchers.
While 79% of patients and proxies reported understanding the cause of the problem leading to the ED visit, 43% did not understand at least one element of the discharge information.
Hastings and colleagues found that 95% of respondents understood the purpose of the medication they had been prescribed, 98% understood how often to take it, and 92% understood how long to take it for.
By contrast, 30% of patients and proxies did not understood the potential side effects of new medications, and 29% did not understand their warning signs. However, if patients' conditions worsened, the majority (90%) knew who to contact, with 77% specifying the ED.
In multivariate analysis, understanding the cause of the problem, its expected duration, and the contingency plan increased the likelihood that patients and their proxies rated ED care quality as excellent by a respective 2.3, 1.6, and 2.2 times compared with their peers who did not understand these elements.
Hastings and co-investigators suggest that delivery of ED information could be improved, for example, by including printed materials. They found that 43% of patients reported not receiving any printed or written material before they left the ED, and that "increased use of printed materials that the patient can refer to at home seems a prudent strategy."
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