COMMUNICATING INFORMATION TO PATIENTS - THE USE OF CARTOON ILLUSTRATIONS TO IMPROVE COMPREHENSION OF INSTRUCTIONS

Objective: To evaluate the effect of cartoon illustrations on patient comprehension of and compliance with ED release instructions. Methods: A prospective, randomized, controlled study of consecutive patients w ho presented to the ED of a community teaching hospital with laceratio ns necessitating wound repair during a three-month study period, At ED release, the patients were randomly assigned to receive wound care in structions with or without cartoon illustrations. Three days later, th e patients were followed up by telephone, A blinded investigator asked a series of questions designed to test the patient's recall of, under standing of, and compliance with wound care instructions. Results: A t otal of 234 patients were successfully contacted by telephone; 105 (45 %) had been given ED release instructions with cartoons, 129 (55%), wi thout cartoons. There was no significant difference in age, gender, le vel of education, or satisfaction with the ED visit between the two gr oups. The patients given cartoon instructions were more likely to have read the instructions (98% vs 79%, p < 0.001), were more likely to an swer all wound care questions correctly (46% vs 6%, p < 0.001), and we re more compliant with daily wound care (77% vs 54%, p < 0.01). Subset analysis of those patients who had less than a high school education (n = 57) demonstrated even larger differences between the two treatmen t groups in terms of comprehension of and compliance with ED release i nstructions. Conclusion: Cartoon illustrations are an effective strate gy for conveying information and may improve patient compliance with E D release instructions.