Does information structuring improve recall of discharge information? A cluster randomized clinical trial.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2021
Historique:
received: 16 08 2020
accepted: 29 07 2021
entrez: 18 10 2021
pubmed: 19 10 2021
medline: 27 11 2021
Statut: epublish

Résumé

The impact of the quality of discharge communication between physicians and their patients is critical on patients' health outcomes. Nevertheless, low recall of information given to patients at discharge from emergency departments (EDs) is a well-documented problem. Therefore, we investigated the outcomes and related benefits of two different communication strategies: Physicians were instructed to either use empathy (E) or information structuring (S) skills hypothesizing superior recall by patients in the S group. For the direct comparison of two communication strategies at discharge, physicians were cluster-randomized to an E or a S skills training. Feasibility was measured by training completion rates. Outcomes were measured in patients immediately after discharge, after 7, and 30 days. Primary outcome was patients' immediate recall of discharge information. Secondary outcomes were feasibility of training implementation, patients' adherence to recommendations and satisfaction, as well as the patient-physician relationship. Of 117 eligible physicians, 80 (68.4%) completed the training. Out of 256 patients randomized to one of the two training groups (E: 146 and S: 119) 196 completed the post-discharge assessment. Patients' immediate recall of discharge information was superior in patients in the S-group vs. E-group. Patients in the S-group adhered to more recommendations within 30 days (p = .002), and were more likely to recommend the physician to family and friends (p = .021). No differences were found on other assessed outcome domains. Immediate recall and subsequent adherence to recommendations were higher in the S group. Feasibility was shown by a 69.6% completion rate of trainings. Thus, trainings of discharge information structuring are feasible and improve patients' recall, and may therefore improve quality of care in the ED.

Identifiants

pubmed: 34662341
doi: 10.1371/journal.pone.0257656
pii: PONE-D-20-21645
pmc: PMC8523048
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0257656

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Victoria Siegrist (V)

Emergency Department, University Hospital Basel, Basel, Switzerland.
Center for Cognitive and Decision Sciences, University of Basel, Basel, Switzerland.

Rui Mata (R)

Center for Cognitive and Decision Sciences, University of Basel, Basel, Switzerland.

Wolf Langewitz (W)

Department of Psychosomatic Medicine-Communication in Medicine, University Hospital Basel, Basel, Switzerland.

Heike Gerger (H)

Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland.
Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.

Stephan Furger (S)

Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland.

Ralph Hertwig (R)

Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany.

Roland Bingisser (R)

Emergency Department, University Hospital Basel, Basel, Switzerland.

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