Clinical trial NCT02740348: Point-of-Care Follow-Up With Primary Care After Emergency Department Discharge
Official title: Point-of-Care Follow-Up With Primary Care After Emergency Department Discharge
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Conditions Influencing Health Status
Lead sponsor: George Washington University
Sponsor class: OTHER
First posted: 2016-04-15
Enrollment: 220
Sex: ALL
Minimum age (years): 18
Maximum age (years): 100
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: The purpose of this trial is to determine whether setting up a follow-up appointment for patients who received treatment and were discharged from the emergency department increases their compliance with the follow-up appointment. We are enrolling patients who need a follow-up visit, have health insurance but report do not have a primary care doctor. Patients are randomized to one of three treatment groups: (1) assistance setting up a follow-up appointment by a research assistant using ZocDoc; (2) ZocDoc information given to the subject to set up follow-up appointment by him/herself; or (3) usual discharge instructions by ED staff. Subjects are phoned approximately 2 weeks after the ED visit and asked whether they completed a follow-up visit, satisfaction with their ED visit, satisfaction with their follow-up visit, and additional ED treatment and recovery.

Detailed description: This is a randomized controlled trial involving adult emergency department (ED) patients who need a follow-up visit as defined by the ED provider (importance of follow-up rated as 5 or greater on a 0 to 10 scale). There is software available called ZocDoc that provides a user the ability to identify primary care providers who have open appointments and will take the person's health insurance (in network and outside of network) and list the doctors based on their proximity to the person in need. We are testing whether booking appointments for ED patients using ZocDoc vs. giving patients the information to use ZocDoc themselves vs. standard discharge instructions given by ED staff (i.e. you should follow-up with a primary care doctor) affects compliance with self-reported follow-up visits. We are enrolling patients while they are in the ED, completed a short baseline interview and then another interview with them over the telephone approximately two weeks after the index ED visit. The follow-up interview asks subjects whether they have completed a follow-up visit, satisfaction with the ED visit and the primary care visit, any other additional ED treatment and extent of recovery from the problem that brought them to the ED the first time.

Eligibility criteria: Inclusion Criteria: Patients with health insurance but report not having a primary care provider and are rated by the ED provider as needing a follow-up visit with a primary care provider (rated as moderate to high need by ED provider).

-

Exclusion Criteria: Patients doesn't want a primary care provider or patient doesn't want a follow-up visit. Patient is unable to understand consent, is a prisoner, or does not have access to email (because ZocDoc sends appointment information to email).

-

Primary outcomes:
measure: Self-reported follow-up visit
timeFrame: 2-4 weeks after the index ED visit
Secondary outcomes:
measure: Satisfaction with the ED visit
timeFrame: Measured 2 weeks after the index ED visit
measure: Satisfaction with the primary care visit
timeFrame: 2-4 weeks after the index ED visit
measure: Recovery from health problem
timeFrame: 2-4 weeks after the index ED visit
measure: Additional ED visit(s)
timeFrame: 2-4 weeks after the index ED visit
Other outcomes:
Locations:
city: Washington, D.C.
country: United States
facility: George Washington University Hospital
state: District of Columbia
Study officials:
affiliation: George Washington University
name: Tina Choudri, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Doran KM, Colucci AC, Hessler RA, Ngai CK, Williams ND, Wallach AB, Tanner M, Allen MH, Goldfrank LR, Wall SP. An intervention connecting low-acuity emergency department patients with primary care: effect on future primary care linkage. Ann Emerg Med. 2013 Mar;61(3):312-321.e7. doi: 10.1016/j.annemergmed.2012.10.021. Epub 2012 Dec 20.
citation: Chan TC, Killeen JP, Castillo EM, Vilke GM, Guss DA, Feinberg R, Friedman L. Impact of an internet-based emergency department appointment system to access primary care at safety net community clinics. Ann Emerg Med. 2009 Aug;54(2):279-84. doi: 10.1016/j.annemergmed.2008.10.030. Epub 2008 Dec 13.