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PubMed2005

Is there a difference in health estimates between people with listed and unlisted telephone numbers?

OBJECTIVE: To examine the characteristics of people with a silent telephone by demographic and health-related issues and to assess the potential bias in telephone surveys that use the White Pages as the sampling frame. METHOD: A representative annual population health survey of South Australians aged 15 years and over conducted in 1994, 1998, 1999 and 2002. Self-reported information on telephone connection and listings in the White Pages was provided by participants. Questions were included in the 1998 survey on reasons why telephone number was not listed. RESULTS: The rate of unlisted telephone numbers significantly increased (17.3% to 20.2%) in South Australia between 1994 and 2002. People with an unlisted number are more likely to be living in the metropolitan area, single adult households, current smokers, and in the younger age groups. In the multivariate analyses the only health and risk factor variable that was consistently significant over the years was smoking status. The main reason for having an unlisted number was to avoid market research or telemarketing calls (33%). CONCLUSION: Telephone surveys using White Pages samples are suitable to collect information for prevalence on most commonly collected self-reported health conditions and health-related issues. The exception is smoking status. IMPLICATIONS: The use of Whites Pages telephone samples is a suitable method for obtaining population health information because it is efficient when there is limited time and funds.

Adolescent↗
PubMed2005

Preventing communication errors in telephone medicine.

Errors in telephone communication can result in outcomes ranging from inconvenience and anxiety to serious compromises in patient safety. Although 25% of interactions between physicians and patients take place on the telephone, little has been written about telephone communication and medical mishaps. Similarly, training in telephone medicine skills is limited; only 6% of residency programs teach any aspect of telephone medicine. Increasing familiarity with common telephone challenges with patients may help physicians decrease the likelihood of negative outcomes. We use case vignettes to highlight communication errors in common telephone scenarios. These scenarios include giving sensitive test results, requests for narcotics, managing ill patients who are not sick enough for the emergency room, dealing with late-night calls, communicating with unintelligible patients, and handling calls from family members. We provide management strategies to minimize the occurrence of these errors.

Communication↗
PubMed1997

Telephone follow-up for case finding of domestic violence in an emergency department.

OBJECTIVE: To determine whether telephone follow-up of selected female patients seen in an urban ED would improve domestic violence (DV) case finding. METHODS: A prospective, cross-sectional study was conducted on consecutive female patients between the ages of 16 and 65 years treated in an urban trauma center during July and August 1995. Record review identified those patients with conditions suggesting increased risk for DV: injury; substance abuse; complaints or diagnoses related to stress, anxiety, depression, or panic attack; or complaints of headache, nonspecific abdominal pain, generalized fatigue, or numbness lasting > 1 week. Attempts were made to telephone all patients who had high-risk presentations within 3 days of their emergency visits. Patients were contacted by a trained interviewer regarding the circumstances of their visits. RESULTS: There were 142 (9%) high-risk presentations out of 1,500 ED visits by women. Of these high-risk visits, 68 patients denied DV, 19 patients did no speak English, 16 patients gave an incorrect telephone number, 18 patients could not be reached after 3 telephone calls, and 6 patients did not give a telephone number. Of the remaining 15 patients, 5 were diagnosed at the initial visit as having experienced DV, and 10 admitted on the follow-up call that the visit had been related to DV or emotional stress at home. CONCLUSION: A structured interview, conducted via telephone in follow-up of released ED patients, identified an additional 10 victims out of 142 high-risk presentations and 1,500 total ED presentations. This approach is labor-intensive, with a relatively low yield. Nonetheless, prospective identification of selective high-risk cases by physicians, coupled with subsequent social service telephone contact, may be a complement in department case finding.

Adolescent↗
PubMed2007

New challenges for telephone survey research in the twenty-first century.

Telephone surveys are critical for examining cross-sectional characteristics of population subgroups, tracking trends in prevalence of conditions and risk behaviors over time, identifying risk factors associated with multiple health conditions, and assessing the effects of interventions. Technology has aided telephone research through advances such as computer-assisted telephone interviewing. However, technology such as answering machines and caller ID has contributed to declines in response rates and has increased costs of conducting telephone surveys. The exponential increase in cell phone utilization presents a challenge to the tradition of random digit dial (RDD) surveys of households. Because telephone surveys are used by other industries such as marketing and public opinion polling, the marketplace may help drive innovation and adaptation. Cell phones have made telephone communication an even greater part of the everyday culture and could make potential telephone survey respondents even more accessible to public health researchers.

Bias↗
PubMed2005

[Telephone triage performed by emergency room physicians].

OBJECTIVE: To determine the applicability and utility of a telephone triage performed by physicians in a pediatric emergency department (PED). PATIENTS AND METHOD: All the telephone consultations registered between 2003-10-1 and 2004-10-3 were reviewed. The variables analyzed were: telephone call record (n = 2,560), compliance with the advice given (randomized sample of patients who were not referred to the PED and all patients who were referred) and parent satisfaction (callers over a 1-month period were contacted). A protocol for answering queries was organized and residents received specific training. RESULTS: There were 59,088 episodes and 2,560 calls were registered (1 call/23 episodes). Forty-eight percent of the calls were received between 5 and 11 pm. All calls were answered by a physician (72% residents, 28% attending physicians). The most frequent reason for calling was to seek advice on symptoms. Eighty-two percent of the calls were resolved through telephone instructions to be carried out in the home. A total of 274 patients were advised to attend the PED, but 29% did not attend, usually because the child's symptoms improved. Twenty patients were admitted to the hospital (6 to wards, 14 to the observation unit). Of the patients not advised to attend, 21% attended the PED and 0.9% were admitted (compared with 7.2% in the referral group, p = 0.0001). More than 90% of the families questioned were satisfied with the advice given. Seventy-five percent would have attended the PED if telephone consultation had not been available. By giving telephone advice, we avoided 115 visits in 1 month. COMMENTS: If special training programs and answering systems are established after a training period, telephone consultation in a PED is a safe and useful method of performing patient triage. Satisfaction among families was high.

Child↗
PubMed2004

Validation of a 26-point telephone version of the Mini-Mental State Examination.

The objective of this study was to assess the convergent validity of a 26-point Telephone Mini-Mental State Examination (MMSE) in a longitudinal cohort of 46 Alzheimer's disease (AD) patients. Paired in-person and telephone MMSE observations were collected within 35 days of each other. The setting was the Stanford/VA Alzheimer's Center in Palo Alto, California, and patients' residences. The 30-point Folstein MMSE was administered in-person, and a 26-point telephone version of the MMSE, adapted from the Adult Lifestyles and Function Interview (ALFI)-MMSE. Total scores for the in-person and telephone MMSE versions correlated strongly (Pearson's r =.88, P <.001). Hearing impairment and education level did not significantly affect telephone-based performance. The Telephone MMSE can be used to validly estimate in-person MMSE scores of patients with AD. Use of this practical measure can enhance reassessment if returning to the clinic is difficult or if a change in the patient's medical condition merits a check of mental status by telephone.

Aged↗
PubMed2006

Use of telephone care in a cardiovascular disease management programme for type 2 diabetes patients in Santiago, Chile.

OBJECTIVES: In 2004, the Chilean National Ministry of Health instituted a cardiovascular disease (CVD) management programme aimed at improving diabetes care among patients treated in the public healthcare system. We sought to identify the characteristics of patients participating in the CVD programme and the feasibility of extending its reach through structured nurse telephone contacts between outpatient encounters. METHODS: We surveyed 569 low-income adults with type 2 diabetes treated in public clinics of Santiago, to assess patients' participation in the CVD programme and willingness to use telephone care services. Surveys were linked to information from medical records. RESULTS: One-third of patients met the target of two visits to the CVD programme in the previous 6 months, and an additional 32% made more than three visits. Use of the CVD programme was associated with greater patient satisfaction, even after controlling for potential confounders. However, 27% of patients had inadequate programme contact, and many of these patients were in poor health. Many CVD programme participants reported difficulties with lifestyle changes, and greater contact with the CVD programme was not associated with healthier behaviours. Most patients (95%) reported telephone access and 37% had used the telephone to contact their clinic. The majority of patients would be willing to use telephone care for additional behaviour change and emotional support. Patients with fewer CVD programme visits were particularly likely to report willingness to use telephone care. DISCUSSION: Clinic-based CVD disease management services reach a large number of socio-economically vulnerable Chileans with diabetes. However, barriers to access remain, and planned telephone care services may increase the reach of self-management support.

Aged↗
PubMed2006

Outcomes of oral anticoagulant therapy managed by telephone vs in-office visits in an anticoagulation clinic setting.

BACKGROUND: Anticoagulation management by a dedicated anticoagulation clinic improves patient outcomes compared to routine medical care. Telephone-based anticoagulation management has been described but has not been compared to management with traditional office-based visits. The objective of this study was to compare warfarin-related monitoring outcomes, clinical end points, and the use of health-care resources as a result of warfarin-related complications in anticoagulation clinic patients whose management was conducted by telephone or in-office-based visits. SETTING: Two university-affiliated anticoagulation clinics in Seattle, WA, and Chicago, IL. METHODS: A retrospective, observational cohort design was used to investigate anticoagulation clinic patients who were managed by telephone encounters compared to those managed during face-to-face in-office encounters. RESULTS: A total of 234 patients were evaluated; 117 patients managed by telephone were compared to 117 patients managed in office-based clinic visits. Monitoring outcomes (ie, time in therapeutic range and clinic visits per patient-year) were similar between groups. Differences in major bleeding (5.67% vs 5.62% per patient-year, respectively) and thromboembolic events (1.42% vs 2.81% per patient-year, respectively) between telephone-managed and face-to-face-managed patients did not reach statistical significance. The same was true for differences in the frequency of emergency department visits and hospital admissions to manage complications of warfarin therapy. CONCLUSIONS: Telephone-based management of oral anticoagulation through a pharmacist-staffed anticoagulation clinic yielded clinical outcomes that were at least as favorable as those associated with traditional office-based visits. Telephone follow-up can be successfully used to manage warfarin therapy in patients who are unable to present in person to an anticoagulation clinic.

Administration, Oral↗
PubMed2001

Reports of alcohol-related harm: telephone versus face-to-face interviews.

OBJECTIVE: To assess the effect of mode of administration in alcohol surveys (telephone vs face-to-face interviews), prevalence rates of self-reported harms due to alcohol were compared for two datasets with equivalent measures. METHOD: Two national alcohol surveys were used: the 1990 Warning Labels Survey, in which random digit dialing was used to generate a sample of 2,000 adults interviewed by telephone, and the 1990 National Alcohol Survey (face-to-face interviews), a probability sample of U.S. adults living in households (N = 2,058). Both surveys included identical items on five areas of alcohol-related harm, yielding one composite index of any harm reported in the last 12 months that was compared between the two surveys for current drinkers. RESULTS: After controlling for demographic characteristics and alcohol use, the telephone survey yielded significantly higher rates of alcohol-related health harm, work harm and "any harm" as compared to the in-person survey. The interaction between heavier drinking (five or more drinks during 1 day, weekly or more often) and method of data collection was significant for health harm and any harm. Respondents in the telephone survey who drank 5+ less than weekly were more likely than those interviewed in person to report health harm due to alcohol use; those in the telephone survey who drank 5+ weekly or more often were more likely to report any harm. CONCLUSIONS: Possible explanations for differences between the surveys include anonymity and fewer social desirability issues associated with telephone surveys, as well as potentially differing cognitive requirements in telephone versus face-to-face interviews.

Adult↗
PubMed2005

Effects of survey mode on self-reports of adult alcohol consumption: a comparison of mail, web and telephone approaches.

OBJECTIVE: Mail and Web surveys are two possible alternatives for reducing potential nonresponse bias in telephone-based studies of alcohol consumption. Mail surveys have been a staple of epidemiological research, but there is a dearth of similar research on Web surveys. Most studies using Web surveys have been conducted among college students or other specialized populations where Internet penetration is relatively high. The present study examines differences in self-reports of alcohol consumption among adult members of the general public surveyed by mail, Web and telephone. METHOD: Web and mail versions of the 2003 Behavioral Risk Factor Surveillance System (BRFSS) instrument, traditionally a telephone-only survey, were developed and administered to address-matched households drawn from the random-digit dialed sampling frame used for the BRFSS. Comparisons were made with results from the ongoing telephone-based surveillance. RESULTS: A total of 4,051 interviews (836 mail, 1,143 Web, and 2,072 telephone) were completed with adults ages 18 or older in four U.S. states. The findings indicate considerable variation in the estimates for heavy drinking (five or more drinks on an occasion during the past 30 days) obtained across these modes and population subgroups, particularly among the Web respondents. CONCLUSIONS: Mail surveys appear to be a viable alternative to more traditional telephone surveys, whereas use of Web surveys with the general public appears more problematic. Both approaches, however, may complement telephone studies when used in mixed-mode designs. Because alcohol consumption is associated with a number of diseases, caution is required when using different modes of data collection in epidemiological studies.

Adolescent↗
PubMed1998

Telephone charges and payments in a diabetes clinic.

OBJECTIVES: To determine reimbursement rates after initiation of charges for certain telephone calls in a pediatric diabetes care center. DESIGN: A review of charges and payments data during 1996. RESULTS: Four hundred seventy-two telephone calls initiated by patients and parents were billed during the study period. These calls regarded treatment of hypoglycemia, hyperglycemia, ketonuria, sick day treatment, and insulin dose changes. Insured patients were charged for 384 telephone calls and indigent patients were charged for 88 telephone calls. Telephone calls from insured patients generated charges of $9215 and payments of $3074. Insurance payments were $1677 (18% of charges), and patient payments were $1396 (15% of charges). Telephone calls from uninsured patients covered by Texas Medicaid or Chronically Ill and Disabled Children funding generated charges of $2193 and no payments. CONCLUSIONS: Telephone charges were reimbursed by all payors at an overall rate of 27%.

Ambulatory Care Facilities↗
PubMed1992

Brief supportive telephone outreach as a recruitment and intervention strategy for smoking cessation.

BACKGROUND: Formal efforts to recruit smokers into cessation programs have failed to reach large segments of the smoking population. Telephone intervention may represent a viable strategy to promote smoking cessation. An even more promising approach may be a combination of brief telephone support and outreach to identified smokers. METHODS: Telephone support for smoking cessation was provided to four identified smoker populations in Bloomington, Minn, one of three Minnesota Heart Health Program education communities. Smokers were randomly assigned to an intervention consisting of two 15-minute telephone calls approximately 1 to 3 weeks apart or to a nonintervention control. RESULTS: At the 6-month follow-up, a significant overall effect was found in favor of the intervention condition for both self-reported and cotinine-validated quitting. Differences between intervention and control conditions were no longer significant at 18 months. CONCLUSIONS: Smokers' receptivity to telephone intervention was at least moderately encouraging. The cost of intervention could be relatively low if trained volunteers initiated telephone calls. However, more intensive telephone intervention and support may be needed to produce lasting changes in smoking prevalence.

Adolescent↗
PubMed1998

Telephone coverage and measurement of health risk indicators: data from the National Health Interview Survey.

OBJECTIVES: This study compared health behavior variables for all US households and households with telephones to measure the potential impact of telephone coverage on estimates from telephone surveys. METHODS: Data were derived from the 1991 through 1994 version of the National Health Interview Survey. RESULTS: Ninety-five percent of respondents lived in households with telephones. Differences in health indicators were small (< 1%) in comparisons between all households and those with telephones. Results were similar when only respondents below the poverty level were included. CONCLUSIONS: Telephone noncoverage effects appear to be small, supporting the use of telephone surveys for health risk behavior surveillance with most population groups.

Adult↗
PubMed2003

A telephone-delivered intervention to improve glycemic control in type 2 diabetic patients.

This study was performed to investigate the effect of a telephone-delivered intervention on glycemic control and body mass index in Korean type 2 diabetic patients. 38 patients were randomly selected, with 20 assigned to a telephone group and 18 to a control group. The goal of the intervention was to keep blood glucose concentrations close to the normal range. The intervention was applied to the telephone group for 12 weeks. It consisted of continuous education and reinforcement of diet, exercise and medication adjustment, as well as frequent self-monitoring of blood glucose levels. Telephone intervention was performed twice per week for the first month, and then weekly for the second and third months. Subjects were requested to write self- management logs, including blood glucose, diet and an exercise diary. The diet diaries were analyzed by a dietitian, and subjects instructed about the results by telephone counseling or mail. All medication adjustments were communicated to the subjects' diabetes specialist. Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG) and 2-hour postprandial glucose were measured before, and after, the intervention. Patients in the telephone group had a mean decrease of 1.2%, with those in the control group having a mean increase of 0.6%, in HbA1c. There were no significant differences in the body mass index (BMI) between the two groups. These findings indicated that a telephone-delivered intervention would improve HbA1c, but would not affect BMI.

Blood Glucose↗
PubMed1994

Telephone counseling interventions with caregivers of elders.

1. The use of the telephone in therapy has been documented in the care of disabled persons and persons with cancer and can be used with other populations. Telephone counseling is a feasible addition to the repertoire of assistance programs available. 2. The use of telephone counseling as an in-home intervention addresses some of the major limitations of out-of-home interventions, such as travel, making arrangements for an alternate caregiver, and worry due to absence from the care recipient. Telephone counseling also provides a means of reaching isolated or rural caregivers who have few or no available services. Telephone care can be a cost-effective, time efficient, and culturally acceptable intervention. 3. Telephone counseling has a potential value with caregivers comparable to the outcomes derived from pioneer mental health services, such as crisis intervention, suicide hot lines, and information and referral services. Nurses and other health care workers are encouraged to respond to the opportunities and challenges, as well as the promises, of telephone counseling intervention.

Activities of Daily Living↗
PubMed2002

Telephone interviewing: is it compatible with interpretive phenomenological research?

The telephone has long been used as a medium of communication. In more recent years the telephone has become a legitimate tool in marketing and survey research (Barriball et al. 1996). Telephone interviewing is becoming an increasingly popular form of interview for qualitative research (Carr & Worth 2001). Whilst there have been discussions in the literature on logistical advantages and disadvantages of telephone interviewing, there has been little debate as to whether this form of interview is compatible with qualitative health research. Much of the literature reporting this interview method is based on quantitative or structured questionnaire style research under the guise of 'qualitative' research. So the question remains: Is the telephone interview compatible with interpretive phenomenological research? This paper describes how telephone interviewing was used in a recently conducted interpretive phenomenological study, and argues that this is a methodologically and economically valuable data collection technique in qualitative research. Qualitative researchers should not rely exclusively on the face-to-face interview, as the telephone interview can be an equally valuable data collection approach.

Breast Feeding↗
PubMedDate not supplied

Quality telephone medicine. Training and triage.

The telephone is an integral part of medical care, yet it ranks as the number one source of patient and clinician dissatisfaction. Problems fall into three categories: (1) volume overload with access difficulties, (2) staffing and telephone triage, and (3) the stress on clinicians of non-emergency night calls. This paper summarizes a telephone medicine satisfaction survey among HMO pediatric department chiefs, reviews the variables that influence the quality of telephone medicine, and discusses the importance of training in telephone management skills. A four-step approach to improving telephone medicine is presented along with a telephone quality-of-care checklist applicable to most practices.

Attitude of Health Personnel↗
PubMed1999

[A comparison of 2 survey methods: the telephone versus the mails in the diabetic population of a health center].

OBJECTIVE: To find the differences between telephone and mail interview respect on answer rate, economic cost and characteristics of participants. To determine the knowledge of our diabetics about their disease. DESIGN: A descriptive transversal study. SETTING: Primary care Centro de San Gregorio, Telde, Las Palmas. PATIENTS: The diabetics type 1 and 2 (n = 566) of our centre, whose ages were 18-70 years. In order to apply the same health questionnaire through two different ways, we divided the sample into two random groups: mail group (n = 283) and telephone group (n = 283). RESULTS: The global answer rate was 51.6% (292 patients), 48% in the mail group (136 patients) and 55% in the telephone group (156 patients). The total cost of the mail survey was 41,000 pts. (104 pts. per mail), and the cost of telephone survey was 5.100 pts. (25.5 pts. per useful call). In the whole sample, we observed women more frequently in the answer group (56% of 292) than in the no answer group (44% of 274) (CI 95% 8.1-12.8). Also, in the answer group, the age was greater than in the no answer group (58.8 +/- 9.8 yr vs. 55.8 +/- 12.5 yr) (CI 95% 1.14-4.8). When we analyzed gender and age in each group, we observed the same differences in the telephone group but not in the mail group. More than the half questionnaire were correctly answer by 64% (167 patients). In the telephone group the "fit" rate was greater (70.6% of 153) than in the mail group (55.7% of 106) (CI 95% 3.2-26.6). CONCLUSIONS: A suitable answer rate was reached through both methods of interview, but telephone survey's was smaller. In the mail group, both genders and all ages groups answered in the same way. The knowledge of our diabetics about their disease was like as the found in another studies.

Adolescent↗