Short CommunicationThe effects of an informational video on patient knowledge, satisfaction and compliance with venous thromboembolism prophylaxis: A pilot study☆
Introduction
Venous thromboembolism (VTE) is the leading cause of preventable deaths in hospitalized patients [1]. It has been estimated that over 2 million adults suffer from VTE each year, resulting in nearly $30 billion in healthcare costs annually [2]. National agencies including the Joint Commission and American Public Health Association (APHA) encourage health systems to increase and standardize VTE patient education [1], [3]. Although several effective methods of prevention exist, VTE prophylaxis rates among hospitalized patients remain poor [4].
The ENDORSE study, a multinational, cross-sectional survey, found that only 39.5% and 58.5% of medical and surgical patients at risk for VTE received recommended prophylaxis, respectively [5]. Further, a 2003 APHA survey noted that 74% of patients had little or no awareness of VTE, and more than half of those with some knowledge of VTE could not name a single risk factor for the condition [6]. At the same time, patient refusal is the leading cause for not administering pharmacological thromboprophylaxis as ordered in the hospital setting [7].
Several studies have demonstrated that increasing patient knowledge can effectively improve compliance with therapy [8], [9]. Patient compliance and understanding of VTE is especially important, as most symptomatic VTE events associated with hospital stays happen after discharge [4]. However, barriers to provision of this education, such as increased workload demands [10], may prevent clinicians from spending sufficient time with patients to explain all aspects of VTE. Informational videos represent a possible solution to provide baseline knowledge without increasing in-person counseling time with clinicians, and studies in a variety of settings describe improved disease-related knowledge and satisfaction among patients who watch educational videos compared to other approaches [11], [12], [13]. This study investigated the impact of a brief educational video, VTE and You: An Educational InPHARMmercial, on patient knowledge, satisfaction, prophylaxis rates, and compliance.
Section snippets
Study design
This was a single-center, randomized, controlled trial of patients recruited from an adult medicine service at the University of Michigan Hospital between January and August, 2011. It was approved by the University of Michigan Institutional Review Board (study HUM00039256). All patients provided written informed consent.
Patients
Adult patients receiving pharmacological or mechanical VTE prophylaxis based on electronic medical records were eligible. Patients were excluded if researchers were unable to
Results
Of 549 patients screened, 79 met study criteria and were enrolled. Twenty-nine patients were assigned to the video group and 50 were assigned to the no video group; this imbalance was possible because an unrestricted randomization table was used as opposed to a technique designed to achieve even enrollment (e.g., a “block” design). Twenty-three patients did not complete the study: 13 were discharged or otherwise unavailable (6 video, 7 no video); 7 declined to continue (1 video, 6 no video); 2
Discussion
In this study, a brief patient education video (VTE and You: An Educational InPHARMmercial) in combination with any education provided by the healthcare team, significantly improved patient knowledge of VTE and its prevention. Patients who watched the video also reported higher satisfaction with their VTE education. Compliance with VTE prophylaxis was similar between groups, but the inpatient setting, short follow up time, small sample size for each comparison, and other methodologic factors
Conflicts of interest
All authors report no conflicts of interest.
Acknowledgements
Work was completed at University of Michigan Health System. The authors vouch for the completeness and accuracy of the manuscript and confirm all patient/personal identifiers have been removed or disguised so the patient/person(s) described are not identifiable and cannot be identified through the details of the story. There was no funding source for this study. We would like to acknowledge Kathleen Welch, M.S., M.P.H. from the University of Michigan Center for Statistical Consultation and
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This work was previously presented at the CHEST annual meeting in Honolulu, HI on October 26th, 2011.