Randomized trial of geragogy-based medication instruction in the emergency department

Medication adherence by older adults who are discharged from the emergency department (ED) is an essential attribute of effective treatment. Researchers have demonstrated that delivery of well-structured instructions increases the knowledge of discharge regimens and increases adherence among ED populations.

This study compared the level of medication knowledge of elderly ED patients receiving instruction by one of two teaching methods: the usual preprinted discharge instructions with handwritten medication information and individualized computer-generated discharge instructions designed within a geragogy framework.

The geragogy intervention included large-print, easily readable, specific information ordered within the elderly memory schema. This schema consists of purpose, administration, and emergency information in that order. The Knowledge of Medication Subtest by Horn and Swain (1977) was administered by telephone 48 to 72 hours after discharge. Sixty patients (38 women, 22 men) with a mean age of 76 years were randomly assigned to groups and completed the study at three rural ED sites.

Subjects in the geragogy-based intervention group demonstrated significantly more knowledge of medications than did subjects experiencing the usual discharge teaching method (t = 2.19, p = .016).

These findings suggest that a medication teaching intervention geared to the special needs of the elderly can be effective in increasing medication knowledge.