130 Patient Preference for Receiving Their Discharge Instructions From the Emergency Department

Abstract

Health literacy in the emergency department (ED) can be low. Misunderstanding aftercare instructions is associated with adverse outcomes. The use of video discharge instructions is associated with a higher disease comprehension rates and aftercare compliance compared to paper instructions. The objective of our study was to determine the method that patients preferred to receive their discharge instructions. We randomly assigned 196 active emergency department patients that had a diagnosis of either hypertension, asthma, congestive heart failure, or diabetes to first receive discharge instructions for their condition by watching a medical education video or by reviewing written discharge instructions. Subjects then received written discharge instructions or watched a medical video, respectively. After both interventions subjects completed a survey. Chi-square and descriptive statistics were used in the analysis. We found that 44% of emergency department patients preferred to receive discharge instruction information in video format compared to 18% in written format and 38% for both video and written formats. The preferred method of receiving discharge instructions for women (n = 122) was 38%, 21%, and 42% for video, written, and both video and written, respectively. The preferred method of receiving discharge instructions for men (n = 69) was 55%, 12%, and 33% for video, written, and both video and written, respectively. Men were more likely to prefer the video format compared to women (p = 0.05). There were no significant differences (p > 0.05) between subjects with hypertension, asthma, congestive heart failure, and diabetes for preferring to receive discharge instructions as video, written, or both or whether subjects received video or written instructions first. There were no significant differences in receiving discharge preference based on age, education level, or the existence of home Internet access (p > 0.05). Having learned something new by watching the video was associated with wanting to receive discharge instructions by video or written plus video formats (p < 0.001). Most ED patients preferred to receive their discharge instructions by watching a video or by watching a video along with written instructions, rather than by just receiving written discharge instructions.