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PubMed2003

Telephone counselling as an adjunct to nicotine patches in smoking cessation: a randomised controlled trial.

OBJECTIVES: To investigate the effectiveness of telephone counselling as an adjunct to nicotine replacement therapy (NRT) by transdermal patch in smoking cessation. DESIGN: Randomised controlled trial. PARTICIPANTS AND SETTING: 854 smokers from New South Wales, aged 18 years and older, who had smoked at least 10 cigarettes per day for the past year and responded to newspaper advertisements between October 2001 and January 2002; the trial was conducted between October 2001 and August 2002. INTERVENTIONS: Random allocation to either NRT alone or NRT plus telephone counselling (5 sessions spaced according to a relapse-sensitive call schedule). MAIN OUTCOME MEASURES: Self-reported abstinence assessed by telephone questionnaires at 1, 2, 3 and 6 months: 28-day continuous abstinence at 3 and 6 months, and 90-day continuous abstinence at 6 months. RESULTS: 28-day continuous abstinence rates among participants receiving telephone counselling were significantly greater than among those not receiving telephone counselling at both 3 and 6 months (31.6% v 25.1%; P = 0.04 at 3 months; and 30.1% v 22.4%; P = 0.01 at 6 months). Similarly, 90-day continuous abstinence rates at 6 months were significantly greater for participants receiving counselling (26.7% v 18.6%; P = 0.004). CONCLUSION: Telephone counselling as an adjunct to NRT increases abstinence rates beyond the use of NRT alone.

Administration, Cutaneous↗
PubMed1999

Ovarian cancer treatment: the benefit of patient telephone follow-up post-chemotherapy.

Approximately 2,500 women in Canada were diagnosed with cancer of the ovary in 1997 (NCIC, 1997). Standard therapy consists of surgical tumour debulking and cytotoxic chemotherapy. Very little data are available examining the most appropriate outpatient management of patients receiving chemotherapy. The objective of this study was to assess the impact of and benefit received from telephone follow-up between chemotherapy treatments for patients with cancer of the ovary. Patients with cancer of the ovary were treated every three to four weeks with a cisplatin-based chemotherapy. Telephone follow-up was performed five to seven days post-treatment by the gynaecology oncology liaison nurse. Follow-up addressed issues pertinent to treatment and disease side effects. A patient survey addressing the impact of telephone follow-up was performed on a sample of the patient population. Thirty-one patients responded to the survey: Eighty-seven per cent found that receiving a call post-chemotherapy was reassuring and helpful. Eighty-three per cent stated that medications could be adjusted according to the severity of side effects. Eighty per cent of patients agreed that most issues had been dealt with at the time of telephone follow-up. Sixty-four per cent felt that their concerns had been addressed during the phone calls, and only 22% had suggestions on how to improve follow-up. Telephone follow-up during chemotherapy was a valuable tool in assessing patient needs, side effects, and concerns experienced during treatments. Telephone follow-up may facilitate early identification of patient problems allowing appropriate and timely intervention.

Aftercare↗
PubMed2001

Reference laboratory telephone service quality.

OBJECTIVES: To establish the rates with which reference laboratories resolve inquiries telephoned to them from primary laboratories and to identify reference laboratory practices associated with higher rates of inquiry resolution. DESIGN AND PARTICIPANTS: For 2 months, or until 50 contacts had occurred, 545 primary laboratories participating in the College of American Pathologists Q-Probes laboratory quality improvement program prospectively documented and characterized telephone inquiries they made to a reference laboratory of their choice. Participants also cataloged their own laboratory's demographic and practice characteristics and their reference laboratory's customer service characteristics. MAIN OUTCOME MEASURE: Rates with which reference laboratories resolved telephone inquiries. RESULTS: Participants characterized 11 031 (78.7%) of 14 017 telephone inquiries as resolved by the reference laboratories. Ranked according to inquiry resolution rates, primary laboratories in the 90th percentile characterized reference laboratories as resolving 100% of their inquiries; those in the 10th percentile characterized reference laboratories as resolving only 54.2% of their inquiries. The rate of resolved inquiries was significantly higher (P =.0047) for participants using reference laboratories with 24-hour customer service than it was for participants using reference laboratories with less than 24-hour service. Most primary laboratories (80.9%) chose to monitor 1 of 11 national reference laboratories; in this subset, median rates of inquiry resolution ranged from 90.2% to 55.0% (P <.0001), despite no significant variation in other measured customer service characteristics. CONCLUSIONS: Primary laboratories experience significant differences in the rates with which reference laboratories resolve telephone inquiries. The performance benchmark for reference laboratories is resolution of at least 90% of telephone inquiries from primary laboratory customers.

Humans↗
PubMed1999

Telephone interviews vs. workstation sessions for acquiring quality of life data.

Patient quality of life data can be acquired in a variety of ways, including over the telephone and through computerized questionnaires. However, if the method of collection produces different results, medical decisions regarding appropriate and cost-effective care may be influenced by collection method. We conducted an experiment where subjects had two quality of life measures, the time trade-off and rating scale utilities, assessed both in telephone interivews and via computer touchscreens. The order of telephone and touchscreen was randomized. We found that rating scale utilities were similar whether obtained via the telephone or via touchscreen regardless of which was done first. However, patients who had their time trade-off utilities assessed over the telephone first did not provide as consistent responses as those elicited first via touchscreen (p = 0.01). Caution is suggested when considering eliciting time trade-off over the telephone with subjects who have not had time trade-off elicited previously.

Analysis of Variance↗
PubMed2000

Telephone follow-up after the emergency department visit: experience with acute asthma. On behalf of the MARC Investigators.

STUDY OBJECTIVE: This study explored how a variety of demographic and illness-related factors were associated with telephone follow-up among patients visiting the emergency department for acute asthma. METHODS: We performed a prospective cohort study as part of the Multicenter Airway Research Collaboration (MARC). The study was performed at 77 EDs in 22 US states and 4 Canadian provinces. ED patients, ages 2 to 54 years, who presented with acute asthma underwent a structured interview during their visit. Two weeks later, research personnel attempted to contact participants by telephone, using numbers obtained during the ED interview. RESULTS: A total of 1,847 adult and 1,184 pediatric patients were interviewed in the ED. Of these, 1,308 (71%) adult patients and 1,026 (87%) pediatric patients were successfully reached for 2-week telephone follow-up. Multivariate analyses revealed the factor most strongly related to contact was age, with pediatric patients being 2.5 times more likely to be reached than adults (95% confidence interval 2.0 to 3.2). Also, participants who were black, low in socioeconomic status, lacking a primary care provider, and exposed to tobacco smoke were significantly less likely to have been reached (all P <.001). CONCLUSION: In contrast to some reports in the literature, telephone contact rates were high. However, successful contact was not equally likely among all patient groups. Although the high contact rates support the feasibility of telephone follow-up of asthmatic patients visiting the ED, the results also act as a reminder of the potential biases that may arise when using telephone contact for clinical, quality assurance, and research reasons.

Adolescent↗
PubMed2000

[Home care support by telephone consultation service at a palliative care unit].

Since the condition of a cancer patient in the terminal phase changes every day, it is difficult for patients at home to maintain stability unless symptom management and a support system are available. In order to reduce the anxiety of these patients and their families during this period and to support meaningful home care, a telephone consultation service of telephone calls from the Palliative Care Unit (PCU) was begun in October 1994. At this point, telephone calls have been made to 515 patients. The status of the telephone service last year (January to December 1999) is summarized herein. 1. Since patients and their families can contact the PCU at any time, they feel more secure. 2. Since patients and their families are telephoned from the PCU, they do not hesitate to consult the physician or nurse calling. 3. Physicians and nurses can ascertain a patient's condition and problems and cope with these aspects in a timely manner. 4. As a result, patients and their families can spend the time remaining in the patient's life with fewer symptoms suffered by the patient. In conclusion, this telephone consultation service has become an important system as part of the outpatient support system.

Female↗
PubMed2001

The Australian experience: global system for mobile communications wireless telephones and hearing aids.

A digital, wireless telephone system, the Global System for Mobile Communications (GSM), was introduced in Australia in 1993. Studies were conducted at the National Acoustic Laboratories to determine how the use of GSM mobile telephones (i.e., wireless telephones) causes interference in hearing aids and how hearing aids could be made more immune to such interference. A measurement system was developed, and measurements are presented for a variety of standard and treated hearing aids. Effective treatments include the addition of shunt capacitors to the hearing aid circuit and shielding by applying a conductive coating to the hearing aid case. Some recently produced microphones also increase immunity. High immunity levels can be achieved in future hearing aids, sufficient to prevent interference from other people's use of a wireless telephone and that often permit use of digital mobile telephones by hearing aid users. Audiologists will have an increasing role in advising hearing aid wearers on the use of wireless telephones or other communications equipment.

Australia↗
PubMed2002

The effect of GP telephone triage on numbers seeking same-day appointments.

Telephone consultations with general practitioners (GPs) have not been shown to be an effective way to reduce the demandfor face-to face appointments during the surgery hours. This study aims to determine if GP telephone triage can effectively reduce the demandforface-to -face consultations for patients seeking same-day appointments in general practice. We report an interrupted time series, twoyears before and one year after introduction of GP-led telephone triage. Demand for face-to face appointments with a GPwas reduced by 39% (95% CI = 29 to 51%, P < 0.001). more than 92% of the telephone calls lasted less thanfive minutes. The telephone bill increased by 26%. For a substantial proportion of patients seeking same-day appointments telephone consultations were an acceptable alternative service.

Appointments and Schedules↗
PubMed2003

Suicidal hangings in jail using telephone cords.

In a three month period of 2000, three suicide hanging deaths involving the use of telephone cords occurred in Texas jails and were autopsied at the Southwestern Institute of Forensic Sciences in Dallas. In each case, the telephone was located within the cell, allowing the prisoners unhindered access at any time. Because of these incidents, two of the jails shortened their receiver cords to a total length of 6-8 in. The telephones were otherwise unaltered, and are still in the same locations. The third jail replaced their entire phone with a cordless telephone. Despite the attention that these cases received, standards have not been set regarding the type or placement of telephones used within jail cells, and a fourth incident in 2002 underscores this ongoing problem. These three incidents highlight the need to provide telephones that, if placed within holding cells or other jail cells, do not provide a possible means of suicide.

Adult↗
PubMed2005

Targeted routine asthma care in general practice using telephone triage.

BACKGROUND: There is a high non-attendance rate for traditional clinic-based routine asthma care in general practice. Alternative methods of providing routine asthma care need to be examined. AIM: To examine the cost and effectiveness of targeted routine asthma care in general practice using telephone triage, compared to usual clinic care. DESIGN OF STUDY: An open randomised controlled trial. SETTING: A single semi-rural practice in the southwest of England. METHOD: Adult patients with asthma were randomised to receive either their routine asthma care in the surgery or care by telephone triage. Asthma control parameters, health status and NHS resource utilisation were measured over the 12-month study period. RESULTS: One hundred and ninety-four patients were randomised and 35% per cent more patients (n = 84 versus n = 62) received more than one consultation in the telephone group. Asthma control as measured by the asthma control questionnaire (ACQ) was similar in the clinic and telephone groups: mean change in ACQ = -0.11 (95% CI = -0.32 to 0.11) versus -0.18 (95% CI = -0.38 to 0.02). Mean NHS costs were 210 pounds sterling per patient per year in the telephone group compared to 334 pounds sterling in the clinic group (P-value of bootstrapped difference = 0.071). CONCLUSION: Targeted routine asthma care by telephone triage of adult asthmatics can lead to more asthma patients being reviewed, at less cost per patient and without loss of asthma control compared to usual routine care in the surgery.

Adolescent↗
PubMedDate not supplied

Data gathering by telephone. An application in a study of clinical nursing.

This article addresses the use of the telephone in collection of research data. First, the authors review the benefits and limitations of data collection by telephone as they are discussed in the literature. Collection of data by telephone has been favorably compared to data collection by mail and by home interview. Next, use of the telephone in a study of individual and family health outcomes from cardiac surgery is discussed. Telephone data collection produced higher rates of return at less expense than did mail return of data. Thus, the use of the telephone was an effective and economic technique for data collection.

Cardiac Surgical Procedures↗
PubMed1987

Increasing appointment compliance through telephone reminders: does it ring true?

This study evaluated the effectiveness of telephone reminders on appointment-keeping in young people treated for gonorrhea. Compliance with scheduled follow-up was recorded for a total of 339 patients during three two-week periods, namely, initial baseline phase, intervention phase during which attempts were made to remind the patients by telephone, and repeat baseline phase. There was no overall improvement in compliance with follow-up during intervention (31%), compared to baseline (32%). However, data from the intervention phase revealed a significantly higher rate of appointment-keeping for those patients who were contacted (44%) than for patients who were not reachable (20%). Furthermore, when we reanalyzed the data as a function of telephone ownership for all patients who did not receive a reminder, return rates were significantly higher for patients owning telephones (32%) than for those denying phone ownership (18%). Thus, we conclude that the likelihood for appointment compliance was related more to sociobehavioral factors reflected in telephone ownership than to the telephone reminders.

Adolescent↗
PubMed1995

Increasing response rates in telephone surveys: a randomized trial.

BACKGROUND: Sampling frames and mode of contact and administration of questionnaires are important factors contributing to response rates and selection bias in population-based research. The purpose of this paper is to evaluate whether contact by mail before contact by telephone increases response rate, and to assess the concurrent validity of telephone surveys for collecting health research and service data. METHODS: Two thousand households were randomly selected from electronic white pages. Half were randomly allocated to receive or not to receive an explanatory letter before telephone contact. Interviewers were blinded to whether a household received a letter. Respondents aged 18 years or over were randomly selected from within each household using a Kish grid and interviewed by telephone. RESULTS: The overall response rate was 68 per cent [confidence interval (CI) 66-70]. The response rate of those who received the letter was 76 per cent (CI 73-79), and of those who did not receive the letter was 60 per cent (CI 56-63). Use of the Kish grid to select randomly a respondent decreased the response rate by less than 10 per cent. The internal validity of the data was as follows: in a 10 per cent sub-sample, the Kish grid had been correctly applied in 93 per cent of households, and in 99 per cent of households the exclusion criteria had been correctly adhered to. The external validity was as follows: comparisons with data obtained from the same reference population using similar instruments administered face-to-face revealed no meaningful or significant differences in population estimates. CONCLUSIONS: Mail-out before telephone contact greatly increases response rates at low cost. Telephone surveys can yield valid, useful data for health research and service evaluation.

Adult↗
PubMed1994

Health-related information postdischarge: telephone versus face-to-face interviewing.

This study had two primary aims: (1) to determine the usefulness of a telephone-administered health status questionnaire as an epidemiological survey instrument in groups at high risk for morbidity and disability; and (2) to evaluate the value of a telephone interview for making judgments about individual patient management. A structured telephone interview was compared with a face-to-face interview in 366 individuals with a stroke or an orthopedic condition up to 5 years after discharge from a rehabilitation hospital. Standardized assessments including the Barthel Index, the Zung Scale, the Reintegration to Normal Living (RNL) Index, and the Pfeiffer Short Portable Mental Status Questionnaire (SPMSQ), along with questions on health, medication use, and health events were administered using both modes. Comparability between the modes was also assessed according to the type of respondent, self, or proxy. On the Barthel Index, the Zung Scale, the RNL Index, and the SPMSQ the percentage of patients indicated as having no disability was similar between the modes. Proxies' responses were, in general, as consistent between the modes as patients' responses. The reliability coefficients indicated moderate to substantial agreement between the modes on the majority of indices and health-related questions. Discord between modes, when present, was greatest for individuals with moderate and severe disability, with less frequent reporting of disability on the telephone. This study supports the use of telephone interviews in determining the prevalence of disability in the community and supports the use of the telephone interview in the case finding process.

Adult↗
PubMed1994

Management of upper respiratory tract infections by telephone.

We surveyed Utah general internists (N = 134) regarding their attitudes toward and practices associated with telephone management of upper respiratory tract infections. The questionnaire contained 3 case vignettes--viral upper respiratory tract infection, streptococcal pharyngitis, and acute infectious epiglottitis--and a series of questions were asked about telephone diagnosis, management preferences (clinic versus telephone), and telephone management practices. The 53 respondents (40%) were able to make important diagnostic distinctions about upper respiratory tract infections from a written vignette. As the likelihood of a complicated or serious condition increased, patients would be appropriately triaged for clinical evaluation. Most internists would make a written record of the telephone conversation. Only 1 internist of the 53 would charge for telephone management.

Acute Disease↗
PubMed1993

Access to general practice and general practitioners by telephone: the patient's view.

Postal surveys were conducted among samples of patients in four practices to determine accessibility of surgeries and general practitioners by telephone. Over half of the respondents reported being unable to get through to the surgery on their first attempt. Significant differences between practices were related to the number of patients served by each incoming line. Although all of the general practitioners involved were accessible to patients by telephone, only half of the respondents knew this. Significant differences in awareness levels between practices were related to policies and methods of disseminating this information. Satisfaction with the help received from doctors by telephone was uniformly high, but patients were less satisfied with the process of contacting a doctor, particularly where receptionists questioned callers about their problem. It is suggested that practices review the adequacy of their telephone systems against a recommended standard of one incoming line per 2500 patients and consider how information about their telephone policies and services can be effectively communicated to patients. Reception staff may need additional guidance on managing telephone contacts with patients.

Family Practice↗
PubMed1995

Use of telephone recording devices by poison centers in the United States.

To determine the extent of and rationale for the use of telephone recording devices by poison centers, a survey was distributed to 93 poison centers in the US during September 1991. Of the 62 respondents, 23 (37%) utilized and 39 did not utilize a telephone recording device. Telephone recording devices were primarily installed to address liability concerns followed by use for quality assurance, staff evaluation and training. The most frequent reason for not using a telephone recording device was the high cost and lack of funds (19) followed by considering it an unnecessary practice (8) and liability concerns (7). Poison centers certified by the AAPCC were more likely to record telephone conversations (p < 0.05) and accounted for 70% of centers with a recording device. A telephone recording device is employed by 1/3 of poison centers primarily to address liability concerns.

Data Collection↗
PubMedDate not supplied

Identifying patient symptoms after radiotherapy using a nurse-managed telephone interview.

PURPOSE/OBJECTIVES: To identify patients' symptoms following completion of radiotherapy for common cancers by a nurse-managed telephone interview. DESIGN: Quality assurance project. SETTING: Radiation therapy department in a community hospital in a large midwestern city. SAMPLE: One hundred eleven patients treated by radiotherapy for primary cancer of the prostate, head/neck, lung, and breast. METHODS: Two time points of data collection: nurses completed an end-of-treatment symptom evaluation within the last five days of treatment and conducted telephone interviews 14-21 days post-therapy. Interview questions were based on each individual's end-of-treatment symptoms and common site-specific side effects. MAIN RESEARCH VARIABLES: Symptoms at end of treatment and 14-21 days after therapy completion, nursing assessments and interventions, and length of telephone interview. FINDINGS: At the end of treatment, 104 (94%) patients were experiencing symptoms. Nurses contacted 106 (95%) patients by telephone 14-21 days after therapy completion and assessed symptoms in 84 (79%) patients. Nineteen (18%) patients reported the development of a new symptom. Nurses independently managed 95% of the calls. CONCLUSIONS: The majority of patients experienced symptoms in the immediate post-therapy period. Telephone follow-up interviews served as a mechanism for evaluating short-term morbidity and provided the opportunity for nurses to intervene with many patients. IMPLICATIONS FOR NURSING PRACTICE: A nurse-managed telephone follow-up program can be used as a component of a quality improvement process in radiation centers to assess patients' post-treatment symptoms and provide education and support.

Adult↗