Background: There is a paucity of literature studying the effect of interventions such as video, audio, or any education adjuncts to augment patient understanding of their emergency department (ED) course and how this may affect health outcomes. Our study aims to examine if the addition of video discharge instructions (VDI) would improve patients’ comprehension, retention, and compliance.
Methods: This was an RCT conducted in the ED of a tertiary care center with a convenience sample of patients aged 18 years and older. We randomized discharged patients with diagnoses of either urinary tract infection (UTI), laceration, or concussion to one of two groups: (1) standard written discharge instructions plus video discharge instructions (intervention) or (2) standard written discharge instructions (control), and administered a baseline survey to determine instruction comprehension. Patients then completed a follow-up phone call approximately 1 week after the ED visit to determine retention, and compliance of instructions.
Results: 193 subjects were enrolled and randomized (67 UTI, 65 lacerations, 6 1 concussion) and 73% completed the follow-up interview (50 UTI, 47 lacerations, 44 concussion). Overall, 54% were female, 74% between ages 18-54, 43% had at least a bachelor’s degree, and 46% were privately insured. In the UTI group, at baseline, VDI patients were significantly more likely to identify 3 or more symptoms that should prompt return to the ED (50% vs 3%) and 3 or more UTI prevention techniques (20% vs 9%), but did not show significance at follow-up. VDI laceration patients were significantly more likely to identify at least one sign of an infected cut (97% vs 71%), but this was again not significantly different at follow-up. Finally, VDI concussion patients were significantly more likely to know to avoid strenuous exercise (97% vs 63%), drinking alcohol (39% vs 10%) and could name at least one medication to avoid (94% vs 43%). Again, these significances were not seen at follow-up. There was no difference in either self-reported helpfulness of the information in taking care of oneself or return to the ED for the same issue at the follow-up call for any diagnosis.
Conclusions: Our study showed that video discharge instructions did not significantly improve UTI, laceration, or concussion patient comprehension, retention, and compliance two weeks after discharge.