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Keywords:

  • informed consent;
  • medication compliance;
  • telephone study;
  • noncompliance

Abstract

Objectives:  The objectives were to determine whether mandated research requirements for consent in the emergency department (ED) falsely distorts the results of a survey of patient-reported compliance with ED prescriptions and, in addition, to ascertain the level of patient compliance to medication instructions and find out the degree of displeasure expressed by patients called without prior consent.

Methods:  Patients given new prescriptions for a medicine to be taken regularly over a period of less than 30 days were eligible. A convenience sample of eligible patients was randomized to having consent obtained during their ED visit or at the time of telephone follow-up. Patients were called 7–10 days after their ED visit to determine their compliance with the prescription. Compliance rates between the two groups were compared, as was the prevalence of displeasure expressed by patients called without prior consent.

Results:  Of 430 enrolled patients, 221 were randomized to receive ED consent for telephone follow-up, and 209 received telephone follow-up without prior ED consent. Telephone follow-up was successful in 318 patients (74%). The rate of noncompliance was slightly higher in the group without ED consent, 74/149 (50%; 95% confidence interval [CI] = 41% to 58%) than the group who gave ED consent for telephone follow-up, 67/169 (40%; 95% CI = 32% to 42%; p = 0.07). Among the two groups, 141/318 (44%) did not fill the prescription (n = 42) or took it incorrectly (n = 99). Only 1 (0.7%) of the 149 patients with successful telephone follow-up without prior ED consent expressed displeasure at this telephone call.

Conclusions:  Medicine noncompliance is a significant issue for patients discharged from the ED in this study. Although there was a trend toward greater compliance in patients who consented to the follow-up call, this did not reach statistical significance. ED patients do not object to receiving telephone follow-up for a research survey without giving prior consent.