124 Chapter 6 information due to cognitive, hearing and visual impairments.[10] Older adults are also more prone to the negative consequences of comprehension deficits than their younger counterparts.[10,24-28] With EDs as the common entry point to healthcare for the ever-increasing elderly population, the problem of poor patient comprehension of EDdischarge instructions and related adverse outcomes is expected to increase further. Better insight into the effects of teach-back at ED discharge on service utilization and on outcomes for older adults could help health professionals and policy-makers decide whether or not to structurally implement this communication method as part of ED discharge care. Therefore, our pilot study aimed to determine whether teach-back in the ED is feasible and might reduce (unplanned) ED-revisits. In addition, we sought to determine whether teach-back would improve older patients’ comprehension and retention of discharge instructions, self-management at home and satisfaction with the provision of the discharge instructions. Besides evaluating the intervention effects, we conducted this pilot study to test the study logistics, to gain information for optimizing intervention delivery and adherence and to obtain empirical evidence of study parameters to help design a future (larger) clinical trial. Methods Study Design We performed a nonrandomized, pre-post pilot study using the guide for Transparent Reporting of Evaluations with Nonrandomized Designs (TREND). [29] The study consisted of two phases: the pre-intervention phase (four months) and the post-intervention phase (four months). The pre-intervention phase investigated data of patients who received standard discharge care (i.e., the provision of verbal discharge instructions and preformatted written discharge information). The post-intervention phase investigated data from patients who received teach-back in addition to the standard discharge care. The study was conducted from March 1 to October 31, 2019 and was retrospectively registered in the ISRCTN registry as a clinical trial (ISRCTN90792228). The local medical ethical committee approved this study (identification number: 2019-5166). Deidentified datasets are available from the corresponding author upon reasonable request. Patients or the public were not involved in the design, conduct, reporting or dissemination plans of our study.
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