Use of Teach Back to Improve Comprehension of Discharge Instructions for Emergency Patients With Limited Health Literacy

Study Overview
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Brief Summary
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The purpose of this study was to determine whether use of teach-back discharge instructions improve patient satisfaction and patients' self-reported and objective comprehension of discharge instructions in the emergency department when compared to standard discharge instructions.

Official Title
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The Impact of Teach-back on Comprehension of Discharge Instructions Among Emergency Patients With Limited Health Literacy: A Randomized, Controlled Study

Conditions
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Conditions Influencing Health Status

Intervention / Treatment
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* Behavioral: Teach-back


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients being discharged from the emergency department A score of 6 or less on the Rapid Estimate of Adult Literacy in Medicine, Revised (consistent with Limited Health Literacy) Exclusion Criteria: aphasia, non-English speaking, mental handicap, psychiatric chief complaint, too high acuity per physician, insurmountable communication barrier, evaluations for sexual assault, clinical intoxication.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Teach-back<br>Patients are prompted to state back in their own words their comprehension of the information given to them at discharge. | Behavioral: Teach-back<br>* Patients are asked to repeat back in their own words their understanding of the discharge information that was provided to them.<br>|
| No Intervention: Standard Discharge Instructions<br>Patient receives usual discharge instructions as administered by the nurse assigned to the patient. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Objective comprehension | Concordance between audio taped comprehension compared to review of medical record using 5 level scale of concordance | Questions evaluating comprehension were administered during the discharge interview immediately following discharge from the ED at the index visit (Day 1). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| self-reported comprehension | self reported comprehension of discharge instructions for the following areas: emergency department (ED) course (Tests and treatment); Post-ED care (medication instructions; home instructions; follow-up instructions); Return instructions. | Questions evaluating self-reported comprehension were administered during the discharge interview immediately following discharge from the ED at the index visit (Day 1). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Health Literacy, Teach-back, Emergency