Video clips for patient comprehension of atrial fibrillation and deep vein thrombosis in emergency care. A randomised clinical trial

Abstract

Abstract Integrating video clips in the discharge process may enhance patients’ understanding and awareness of their condition. To determine the effect of video clip-integrated discharge discussion on patient comprehension of atrial fibrillation (AF) and deep vein thrombosis (DVT), and their main complications (stroke and pulmonary embolism), we designed a multicentre, pragmatic, parallel groups, randomised clinical trial, that was conducted at two Emergency Units in Italy. A convenience sample of 144 adult patients (or their caregivers) discharged home with either AF or DVT were randomised to receive standard verbal instructions (control) or video clip-integrated doctor-patient discharge discussion. Participants were guided by the discharging physician through the clip. Mean score for primary outcome (knowledge of the diagnosis and its potential complication) (range 0–18) was 5.87 (95% CI, 5.02–6.72] in the control group and 8.28 (95% CI, 7.27–9.31) in the intervention group (mean difference, −2.41; 95% CI, −3.73 to −1.09; p < 0.001). Among secondary outcomes, mean score for knowledge of the prescribed therapy (range 0–6) was 2.98 (95% CI, 2.57–3.39) in the control group and 3.20 (95% CI, 2.73–3.67) in the study group (mean difference, −0.22; 95% CI, −0.84 to 0.39). Mean score for satisfaction (range 0–12) was 7.34 (95% CI, 6.45–8.23) in the control arm and 7.97 (95% CI, 7.15–8.78) in the intervention arm (mean difference, −0.625; 95% CI −1.82 to 0.57). Initiation rate of newly prescribed anticoagulants was 80% (36/45) in the control group and 90.2% (46/51) in the intervention group. Among 109 patients reached at a median follow up of 21 (IQR 16–28) months, 5.55% (3/54) in the control arm and 1.82% (1/55) in the intervention arm had developed stroke or pulmonary embolism. In this trial, video clip-integrated doctor-patient discharge discussion, improved participants comprehension of AF and DVT and their main complications. Physicians should consider integrating these inexpensive tools during the discharge process of patients with AF or DVT. Trial Registration: ClinicalTrials.gov Identifier “NCT03734406”.