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Comprehension deficits among older patients in a quick diagnostic unit

Authors Hvidt LN, Hvidt KN, Madsen K, Schmidt TA

Received 4 February 2014

Accepted for publication 4 March 2014

Published 16 April 2014 Volume 2014:9 Pages 705—710

DOI https://doi.org/10.2147/CIA.S61850

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Lisa Nebelin Hvidt,1,2 Kristian Nebelin Hvidt,3 Kim Madsen,1 Thomas A Schmidt1

1Department of Emergency Medicine, Holbæk University Hospital, Holbæk, 2Department of Geriatrics, Gentofte University Hospital, Copenhagen, 3Division of Cardiology, Department of Medicine, Holbæk University Hospital, Holbæk, Denmark

Background: Higher prevalence of multiple illnesses and cognitive impairment among older patients pose a risk of comprehension difficulties, potentially leading to medication errors. Therefore, the objective of this study was to investigate comprehension of discharge ­instructions among older patients admitted to a Quick Diagnostic Unit (QDU).
Methods: One hundred and two patients discharged from the QDU answered a questionnaire covering understanding of their hospitalization and discharge plan. Patients’ ability to recall discharge instructions and awareness of comprehension deficits, ie, ability to identify the misconceived information, were evaluated by comparing the questionnaires with the discharge letters. The population was divided into an older group (age ≥65 years) and a younger group.
Results: The older group (n=40) was less able to recall correct medication instructions when compared to the younger group (54% versus 78%, respectively; P=0.02). In multiple logistic regression analysis, correct recall of medication instructions was 4.2 times higher for the younger group compared to the older group (odds ratio 4.2, 95% confidence interval 1.5–11.9, P=0.007) when adjusted for sex and education. The older patients were less aware of their own comprehension deficits, and in respect to medication instructions awareness decreased 6.1% for each additional year of age (odds ratio 0.939, 95% confidence interval 0.904–0.98, P=0.001) when adjusted for sex and education.
Conclusion: Older patients were less able to recall correct medication instructions and less aware of their comprehension deficits after discharge from a QDU. The findings of the ­present study emphasize the importance of thorough communication and follow-up when treating older patients.

Keywords: geriatrics, communication, discharge information, medication

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