Effect of Modality on Discharge Instruction in Patients Receiving Outpatient Antibiotic Prescriptions From the Emergency Department

Study Overview
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Brief Summary
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Outpatient antibiotics are frequently prescribed from the emergency department, and limited health literacy may impact compliance with recommended treatments. The investigators are looking to determine if patient preference for multimodality discharge instructions for outpatient antibiotic therapy varies by health literacy level, and if modality effected patient-reported antibiotic compliance and 72-hour antibiotic pick-up.

Detailed Description
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This is a prospective randomized trial that includes consenting patients discharged with outpatient antibiotics. Health literacy is assessed using a validated health literacy assessment, the Newest Vital Sign (NVS). Patients are randomized to a discharge instruction modality: 1) standard of care, typed and verbal medication and case-specific instructions; 2) standard of care plus text messaged instructions sent to the patient's cell phone; or 3) standard of care plus voicemailed instructions sent to the patient's cell phone. Antibiotic pick-up is verified with the patient's pharmacy at 72 hours. Patients are called at 30 days to determine antibiotic compliance.

Official Title
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Effect of Modality on Discharge Instruction in Patients Receiving Outpatient Antibiotic Prescriptions From the Emergency Department

Conditions
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Modality of Discharge Instructions

Intervention / Treatment
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* Other: Text Message
* Other: Voicemail


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Emergency department patient being prescribed an outpatient antibiotic or the parent of a patient under the age of 18 being prescribed on outpatient antibiotic Exclusion Criteria: Doesn't have a cell phone that can receive text messages and voicemail messages Unable to provide informed consent Prisoners
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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 |
| --- | --- |
| No Intervention: Standard of Care<br>Written discharge instructions only | |
| Experimental: Text Message<br>Written discharge instructions plus a text message with antibiotic prescription instructions | Other: Text Message<br>* A text message with instructions is sent to the patient<br>|
| Experimental: Voicemail<br>Written discharge instructions plus a voicemail with antibiotic prescription instructions | Other: Voicemail<br>* A voicemail with instructions is sent to the patient<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 72-hour antibiotic pickup | Whether or not the patient picked up their antibiotic prescription at the pharmacy | 72 hours | 
| Antibiotic compliance | If the patient completed the entire course of antibiotics | 30 days |