Use of Teach Back to Improve Comprehension of Discharge Instructions for Emergency Patients With Limited Health Literacy
Primary Purpose
Conditions Influencing Health Status
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Teach-back
Sponsored by

About this trial
This is an interventional health services research trial for Conditions Influencing Health Status focused on measuring Health Literacy, Teach-back, Emergency
Eligibility Criteria
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.
Sites / Locations
- Barnes-Jewish Hospital Emergency Department
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
Teach-back
Standard Discharge Instructions
Arm Description
Patients are prompted to state back in their own words their comprehension of the information given to them at discharge.
Patient receives usual discharge instructions as administered by the nurse assigned to the patient.
Outcomes
Primary Outcome Measures
Objective comprehension
Concordance between audio taped comprehension compared to review of medical record using 5 level scale of concordance
Secondary Outcome Measures
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.
Full Information
NCT ID
NCT01968291
First Posted
October 10, 2013
Last Updated
October 22, 2013
Sponsor
Washington University School of Medicine
1. Study Identification
Unique Protocol Identification Number
NCT01968291
Brief Title
Use of Teach Back to Improve Comprehension of Discharge Instructions for Emergency Patients With Limited Health Literacy
Official Title
The Impact of Teach-back on Comprehension of Discharge Instructions Among Emergency Patients With Limited Health Literacy: A Randomized, Controlled Study
Study Type
Interventional
2. Study Status
Record Verification Date
October 2013
Overall Recruitment Status
Completed
Study Start Date
June 2012 (undefined)
Primary Completion Date
August 2012 (Actual)
Study Completion Date
August 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Washington University School of Medicine
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
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.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Conditions Influencing Health Status
Keywords
Health Literacy, Teach-back, Emergency
7. Study Design
Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
254 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Teach-back
Arm Type
Experimental
Arm Description
Patients are prompted to state back in their own words their comprehension of the information given to them at discharge.
Arm Title
Standard Discharge Instructions
Arm Type
No Intervention
Arm Description
Patient receives usual discharge instructions as administered by the nurse assigned to the patient.
Intervention Type
Behavioral
Intervention Name(s)
Teach-back
Intervention Description
Patients are asked to repeat back in their own words their understanding of the discharge information that was provided to them.
Primary Outcome Measure Information:
Title
Objective comprehension
Description
Concordance between audio taped comprehension compared to review of medical record using 5 level scale of concordance
Time Frame
Questions evaluating comprehension were administered during the discharge interview immediately following discharge from the ED at the index visit (Day 1).
Secondary Outcome Measure Information:
Title
self-reported comprehension
Description
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.
Time Frame
Questions evaluating self-reported comprehension were administered during the discharge interview immediately following discharge from the ED at the index visit (Day 1).
Other Pre-specified Outcome Measures:
Title
patient satisfaction
Description
Patient satisfaction as measured by 4 questions modified from the Consumer Assessment of Health Providers & Systems (CAHPS) Clinician & Group Surveys
Time Frame
Questions evaluating satisfaction were administered during the discharge interview immediately following discharge from the ED at the index visit (Day 1).
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
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.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard T Griffey, MD, MPH
Organizational Affiliation
Washington University School of Medicine
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Kim A Kaphingst, PhD
Organizational Affiliation
Washington University School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Barnes-Jewish Hospital Emergency Department
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Use of Teach Back to Improve Comprehension of Discharge Instructions for Emergency Patients With Limited Health Literacy
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