DISCHARGE INSTRUCTIONS - DO ILLUSTRATIONS HELP OUR PATIENTS UNDERSTAND THEM

Study objective: To determine whether the addition of illustrations to discharge instructions improves patient comprehension. Design: Random ized, blinded, prospective study. A blinded investigator asked a serie s of questions designed to test the participant's comprehension of the discharge instructions. There were 10 possible correct responses. Set ting: Emergency department of a rural Level I trauma center. Participa nts: Convenience sample of 101 patients discharged with the diagnosis of laceration. Interventions: Patients were randomly assigned to recei ve discharge instructions with (n=54) or without (n=47) illustrations. Results: The median number of correct responses was five. Patients wi th illustrations were 1.5 times more likely to choose five or more cor rect responses than those without illustrations (65% versus 43%; P=.03 3). The effect of illustrations varied by demographic group. Among non whites (n=51), patients with illustrations were more than twice as lik ely to choose five or more correct responses (P=.032). Among patients with no more than a high school education (n=71), patients with illust rations were 1.8 times more likely to choose five or more correct resp onses (P=.038). Among women (n=48), patients with illustrations were 1 .7 times more likely to chose five or more correct responses (P=.006). Conclusion: The addition of illustrations to discharge instructions f or patients who have sustained lacerations improves patient comprehens ion. There is a larger effect among patients who are nonwhite, female, or have no more than a high school education.