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Impact of patient information leaflets on doctor–patient communication in the context of acute conditions: a prospective, controlled, before–after study in two French emergency departments
  1. Mélanie Sustersic1,2,
  2. Marisa Tissot2,
  3. Julie Tyrant2,
  4. Aurelie Gauchet3,
  5. Alison Foote2,
  6. Céline Vermorel2,
  7. Jean Luc Bosson2
  1. 1 Emergency Department, Grenoble Mutualist Hospital Group (Groupe Hospitalier Mutualiste de Grenoble), Grenoble, France
  2. 2 Research Department, Grenoble Alpes University Hospital, Grenoble, France
  3. 3 Psychology Department, Grenoble Alpes University, Saint-Martin-d’Heres, France
  1. Correspondence to Dr Mélanie Sustersic; melanie.sustersic{at}


Objective In the context of acute conditions seen in an emergency department, where communication may be difficult, patient information leaflets (PILs) could improve doctor–patient communication (DPC) and may have an impact on other outcomes of the consultation. Our objective was to assess the impact of PILs on DPC, patient satisfaction and adherence, and on patient and doctor behaviours.

Design Prospective, controlled, before–after trial between November 2013 and June 2015.

Setting Two French emergency departments.

Participants Adults and adolescents >15 years diagnosed with ankle sprain or an infection (diverticulitis, infectious colitis, pyelonephritis, pneumonia or prostatitis).

Intervention Physicians in the intervention group gave patients a PIL about their condition along with an oral explanation.

Main outcome measures 7–10 days later, patients were contacted by phone to answer questionnaires. Results were derived from questions scored using a 4-point Likert scale.

Main findings Analysis of the 324 patients showed that PILs improved the mean DPC score (range: 13–52), with 46 (42–49) for 168 patients with PILs vs 44 (38-48) for 156 patients without PILs (p<0.01). The adjusted OR for good communication (having a score >35/52) was 2.54 (1.27 to 5.06). The overall satisfaction and adherence scores did not show significant differences. In contrast, satisfaction with healthcare professionals and timing of medication intake were improved with PILs. The overall satisfaction score improved significantly on per-protocol analysis. When using PILs, doctors prescribed fewer drugs and more examinations (radiology, biology, appointment with a specialist); the need for a new medical consultation for the same pathology was reduced from 32.1% to 17.9% (OR 0.46 [0.27 to 0.77]), particularly revisiting the emergency department.

Conclusion In emergency departments, PILs given by doctors improve DPC, increase patients’ satisfaction with healthcare professionals, reduce the number of emergency reconsultations for the same pathology and modify the doctor’s behaviour.

Trial registration number NCT02246361.

  • Doctor-Patient Communication
  • Patient Information Leaflet
  • acute condition
  • emergency department
  • satisfaction
  • patient behavior
  • doctor behavior
  • adherence

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Patient consent for publication Not required.

  • MT and JT contributed equally.

  • Contributors MS, AG and JLB conceived the project. MS, JT and MT conducted the study. CV and JLB performed the statistical analyses, interpreted the results and prepared the figures. MS, JLB, JT, MT, AG and AF wrote the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval The study was approved by the regional ethics committee on 31 October 2013 (CECIC Rhone-Alpes-Auvergne, Clermont-Ferrand, France).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Extra data are available by emailing MS (

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