When one of our patients is discharged from an emergency department (ED) or inpatient unit, they leave with discharge instructions with our the intent that they will be followed carefully. But are they? Glick et al. (10.1542/peds.2016-4165) share with us a systematic review that examined parental management of ED and inpatient instructions in terms of parental knowledge and execution of those instructions. Using their search strategy to find experimental or observational studies, 64 studies were found of which ¾ were ED studies.
Sadly, the results of this systematic review are not what we would hope, with studies reporting frequent dosing and other medication errors, missed follow-up appointments, and misunderstood instructions as to what to worry about and come back for. Language, insurance type, and complexity of the discharge plan all contribute to the problem in reducing adherence to our instructions. There is a lot to learn from this systematic review even if most of the studies are observational and not experimental, so follow our directions and link to this review article to learn more, and in turn hopefully improve the adherence of your own patients to the discharge instructions that you or others at the hospital or ED give them.
