Discharge Instructions: Do Illustrations Help Our Patients Understand Them?☆☆☆★

Abstract 

Study objective: To determine whether the addition of illustrations to discharge instructions improves patient comprehension.

Design: Randomized, blinded, prospective study. A blinded investigator asked a series of questions designed to test the participant's comprehension of the discharge instructions. There were 10 possible correct responses. Setting: Emergency department of a rural Level I trauma center. Participants: Convenience sample of 101 patients discharged with the diagnosis of laceration. Interventions: Patients were randomly assigned to receive discharge instructions with (n=54) or without (n=47) illustrations. Results: The median number of correct responses was five. Patients with illustrations were 1.5 times more likely to choose five or more correct responses than those without illustrations (65% versus 43%; P =.033). The effect of illustrations varied by demographic group. Among nonwhites (n=51), patients with illustrations were more than twice as likely to choose five or more correct responses (P =.032). Among patients with no more than a high school education (n=71), patients with illustrations were 1.8 times more likely to choose five or more correct responses (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 for patients who have sustained lacerations improves patient comprehension. There is a larger effect among patients who are nonwhite, female, or have no more than a high school education. [Austin PE, Matlack R, Dunn KA, Kesler C, Brown CK: Discharge instructions: Do illustrations help our patients understand them? Ann Emerg Med March 1995;25:317-320.]