Patient Follow-up After Consultation in Emergency Department
Patient Follow-up After Consultation in Emergency Department
Each year more than 15 million French people visit the emergency services and almost 80% of
 them come out without hospitalization after having undergone a clinical examination and
 possibly additional examinations.
Each year more than 15 million French people visit the emergency services and almost 80% of
 them come out without hospitalization after having undergone a clinical examination and
 possibly additional examinations.

 Following their discharge, compliance with discharge requirements and recommendations
 (treatment, monitoring, follow-up, etc.) is a determining factor in improving their health.
 Non-membership is linked to an increase in morbidity, mortality and use of the health system.
 Patient adherence to discharge instructions is conditional on patient understanding.
 Unfortunately, the environment of an emergency service often creates conditions for
 information and education of the patient that are often far from optimal or at least that are
 specific to a typical consultation.

 Data from the international literature showed that 78% of people who come out of emergency
 after consultation do not clearly understand the instructions and only 20% are aware of their
 lack of understanding. Waisman et al. Documented that 25% of patients did not understand
 their diagnosis and that 13% to 18% did not understand treatment instructions. Heng et al.
 Have shown that patients leaving after head trauma are unable to cite the symptoms that
 should prompt them to consult quickly.

 The involvement of healthcare teams to inform patients with the help of different
 communication media is therefore particularly important in trying to improve understanding
 and adherence to exit instructions. However, Zavala et al. Point to the fact that this is not
 necessarily sufficient.

 Some authors have identified factors of poor adherence: multiple chronic diseases, multiple
 drug treatments, psychiatric disorders, but also age, social isolation, depression, quality
 of life and socio-economic and cultural level , A low level of health literacy, or planned
 medical follow-up, the severity of the pathology and the perception of that severity by the
 patient, or the patient's dissatisfaction with medical instructions.

 The patients' adherence to the literature is evaluated in a varied manner according to the
 pathologies concerned: counting the number of tablets; Patient self-tracking log; Reports
 from physicians, reports by third parties (such as the patient's spouse); Electronic
 measurements (for example, metered-dose inhalers or electronic drop dispensers); Blood or
 urine dosage. The different methods used have advantages and disadvantages that need to be
 assessed according to the needs of the study we wish to implement. While declarative
 investigations in the assessment of patient adherence are criticized, no method has
 unfortunately been used as a benchmark for assessing adherence. The bibliographic search did
 not find any questionnaires that had been validated in this context. In order to evaluate the
 adhesion, the investigator will therefore opt for a semi-directed interview at D7 in order to
 better control a possible bias of memorization. This tool has known limitations including a
 tendency to overestimate adhesion, because patients tend to respond to what doctors want to
 hear. This will be taken into account in the interpretation of the results.
Inclusion Criteria:

 -  Major patient not benefiting from any legal protection measures.

 -  Speaking French.

 -  Outgoing after having received a consultation in a hospital emergency department.

 -  Accepting to participate in the study after being informed of the protocol.

 -  Having the possibility to be reached by telephone on J7.

 Exclusion Criteria:

 -  Patient with a pathology that does not allow him or her to understand instructions or
 express themselves.

 -  Patient under tutelage or curatorship or deprived of all freedom.