C. K. Clarke|Steven Friedman|Kevin Shi|Tamara Arenovich|Jose Monzón|Christopher Culligan
Emergency department discharge instructions comprehension and compliance study
University of Toronto|University Health Network|University of Toronto|Toronto Western Hospital|University Health Network|University of Toronto|Toronto Western Hospital|University Health Network|University of Toronto|Toronto Western Hospital|University of Toronto|University Health Network|University of Toronto|Toronto Western Hospital
assess patient comprehension emergency department discharge instructions describe predictors patient compliance discharge instructionspatients departing emergency department innercity teaching hospital invited undergo structured interview reading test participate followup telephone interview 2 weeks later two physicians blinded others data scored patient comprehension discharge information compliance discharge instructions interrater reliability assessed using kappaweighted statistic correlations assessed using spearmans rank correlation coefficient fishers exact testof 106 patients approached 88 83 enrolled interrater reliability physician rating scores high kappa 066 approximately 60 subjects demonstrated reading ability grade 7 level comprehension positively associated reading ability r 029 p 001 english first language r 027 p 001 reading ability positively associated years education r 043 p 00001 first language r 024 p 003 inversely associated age r 021 p 005 nonenglish first language need translator associated poorer comprehension discharge instructions related compliance compliance discharge instructions correlated comprehension r 031 p 001 associated age language education years anglophone country reading ability format discharge instructions followup modality association family physicianemergency department patients demonstrated poor reading skills comprehension factor significantly related compliance therefore future interventions improve compliance emergency department instructions effective focus improving comprehension