From the Food and Drug Administration.
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Contraindications↗
SEARCH · Search PubMed
Results for “Hotlines”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
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From the Health Resources and Services Administration.
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HIV Infections↗
From the Food and Drug Administration.
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Certification↗
What to do with a patient who smokes.
Despite the reality that smoking remains the most important preventable cause of death and disability, most clinicians underperform in helping smokers quit. Of the 46 million current smokers in the United States, 70% say they would like to quit, but only a small fraction are able to do so on their own because nicotine is so highly addictive. One third to one half of all smokers die prematurely. Reasons clinicians avoid helping smokers quit include time constraints, lack of expertise, lack of financial incentives, respect for a smoker's privacy, fear that a negative message might lose customers, pessimism because most smokers are unable to quit, stigma, and clinicians being smokers. The gold standard for cessation treatment is the 5 As (ask, advise, assess, assist, and arrange). Yet, only a minority of physicians know about these, and fewer put them to use. Acceptable shortcuts are asking, advising, and referring to a telephone "quit line" or an internal referral system. Successful treatment combines counseling with pharmacotherapy (nicotine replacement therapy with or without psychotropic medication such as bupropion). Nicotine replacement therapy comes in long-acting (patch) or short-acting (gum, lozenge, nasal spray, or inhaler) forms. Ways to counter clinicians' pessimism about cessation include the knowledge that most smokers require multiple quit attempts before they succeed, that rigorous studies show long-term quit rates of 14% to 20%, with 1 report as high as 35%, that cessation rates for users of telephone quit lines and integrated health care systems are comparable with those of individual clinicians, and that no other clinical intervention can offer such a large potential benefit.
Antidepressive Agents↗
Evaluation of a patient file folder to improve the dissemination of written information materials for cancer patients.
BACKGROUND: Many cancer centers make available to patients written information material to supplement verbal information provided by clinicians. Randomized trials have demonstrated that providing such information can increase patient knowledge and satisfaction. However, little data are available regarding effective means of dissemination of such materials. The purpose of this study was to determine whether providing patients with a personal file folder after their first clinic appointment would improve the dissemination of written information materials and increase patient satisfaction. METHODS: A before/after study was performed. Consecutive patients with newly diagnosed cancer attending the Hamilton Regional Cancer Centre were selected randomly and interviewed by telephone within 1-2 weeks of the first clinic appointment regarding the number of information pamphlets received, patient satisfaction, and general preference for written information materials. The preintervention evaluation (T1) occurred over a 4-month period followed by the introduction of the personal file folder into the clinical practice. Six weeks after its introduction, the postintervention (T2) evaluation took place over the ensuing 4 months. RESULTS: A total of 300 patients completed the evaluation (150 each in T1 and T2). Responding patients in the two time periods were comparable with respect to background demographic variables. The mean number of information pamphlets received by patients increased with the introduction of the personal file folder from 2.4+/-2.0 standard deviations (SD) in T1 to 3.6+/-2.5 SD in T2 (P=0.0001). The percentage of patients planned for treatment who received treatment-related information increased from 36% (42 of 116 patients) in T1 to 65% (68 of 105 patients) in T2 (P=0.002). Mean patient satisfaction increased from 3.3+/-1.1 SD to 3.8+/-1.0 SD over the 2 time periods (P=0.0001). The majority of patients (87%) believed it was important to receive written information materials. CONCLUSIONS: The patient file folder increased the dissemination of written information materials and currently is being incorporated into routine practice.
Attitude↗
Telephone-based guided self-help for binge eating disorder: a feasibility study.
This feasibility study describes a novel form of guided self-help for treating binge eating disorder (BED). Over a 3-month period, a lay therapist provided first weekly (for 1 month) and then biweekly telephone-based guidance to supplement a self-help program. Eligible participants met DSM-IV criteria for BED, based on the Eating Disorder Examination (EDE). Of 9 women initially admitted into the study, 7 completed the self-help program. Upon completion, outcome was determined using the EDE-Questionnaire and the Brief Symptom Inventory (BSI). Binge eating frequency decreased markedly; BSI scores also decreased significantly. All women reported high levels of satisfaction with the intervention. Participants commented favorably about the flexibility, accessibility, and autonomy afforded by the telephone-based administration of guidance. Results suggest that telephone-based guided self-help is a viable mode of service delivery for some women with BED. Recommendations are made for further improvement of this form of self-help.
Adult↗
CANDID--Counselling and Diagnosis in Dementia: a national telemedicine service supporting the care of younger patients with dementia.
OBJECTIVES: To audit and evaluate the introduction of a novel support service for younger people with dementia, their families and the professionals caring for them. DESIGN: A retrospective review of all calls received by a telephone helpline over a 2-year period. SETTING: CANDID (Counselling and Diagnosis in Dementia) offers direct access, by telephone and e-mail, to specially trained nurse/counsellors who record the caller's query, provide emotional support and practical advice. In addition to general advice, clinical details are held for patients registered with the service so that the advice given can be tailored to the patient's specific need and routed via the general practitioner for action. Advice is reviewed by a consultant neurologist and psychiatrist. SUBJECT: Callers to the CANDID helpline, who made a total of 1,121 calls. MAIN OUTCOME MEASURES: Details of the caller and of the patient they were caring for. Reason for calling and advice given to the caller RESULTS: Of the 1,121 calls received during the first 2 years of operation, 547 were 'registered' calls relating to 241 individual patients where more specific advice could be given through the GP. The remaining 574 'generic' calls were from members of the public and healthcare professionals who had heard about the service and were seeking information and advice. Reasons for calls were divided into three broad categories: general information; clinical advice; and advice on social issues. Among the registered callers, 50% of calls were for clinical advice. Letters were sent to GPs on 67 occasions; 48 (56%) provided information only for the GP, 16 (24%) advised a secondary referral and eight (12%) advised on the use of specific medication. CONCLUSION: The service has become rapidly accepted and used by families of patients and members of the public. Healthcare professionals have made less use of the service than anticipated, but it is hoped that this will increased as information about the service becomes disseminated.
Adolescent↗
Telephone helplines for people with dementia.
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Adult↗
Telephone consultation and triage: effects on health care use and patient satisfaction.
BACKGROUND: Telephone consultation is the process where calls are received, assessed and managed by giving advice or by referral to a more appropriate service. In recent years there has been a growth in telephone consultation developed, in part, as a response to increased demand for General Practitioner (GP) and Accident and Emergency (A&E) department care. OBJECTIVES: To assess the effects of telephone consultation on safety, service usage and patient satisfaction and to compare telephone consultation by different health care professionals. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials, the specialised register of the Cochrane Effective Practice and Organisation of Care (EPOC) group, Pubmed, EMBASE, CINAHL, SIGLE, and the National Research Register. We checked reference lists of identified studies and review articles and contacted experts in the field. The search was not restricted by language or publication status. SELECTION CRITERIA: Randomised controlled trials (RCTs), controlled studies, controlled before/after studies (CBAs) and interrupted time series (ITSs) of telephone consultation or triage in a general health care setting. Disease specific phone lines were excluded. DATA COLLECTION AND ANALYSIS: Two reviewers independently screened studies for inclusion in the review, extracted data and assessed study quality. Data were collected on adverse events, service usage, cost and patient satisfaction. Due to heterogeneity we did not pool studies in a meta-analysis and instead present a narrative summary of the findings. MAIN RESULTS: Nine studies met our inclusion criteria, five RCTs, one CCT and three ITSs. Six studies compared telephone consultation versus normal care; four by a doctor, one by a nurse and one by a clinic clerk. Three studies compared telephone consultation by different types of health care workers; two compared nurses with doctors and one compared health assistants with doctors or nurses. Three of five studies found a decrease in visits to GP's but two found a significant increase in return consultations. In general at least 50% of calls were handled by telephone advice alone. Seven studies looked at accident and emergency department visits, six showed no difference between the groups and one, of nurse telephone consultation, found an increase in visits. Two studies reported deaths and found no difference between nurse telephone triage and normal care. REVIEWERS' CONCLUSIONS: Telephone consultation appears to reduce the number of surgery contacts and out-of-hours visits by general practitioners. However, questions remain about its affect on service use and further rigorous evaluation is needed with emphasis on service use, safety, cost and patient satisfaction.
Emergency Service, Hospital↗
Pesticide illness surveillance: review of the National Pesticide Hazard Assessment Program.
Regarding consultations on pesticide exposures by Oregon State University, the following information is summarized: 1) source of queries; 2) locations of exposure; 3) types of chemicals; and 4) nature of the illnesses. The majority of queries involve nonagricultural exposures in the home and workplace. Principal sources of referral are from the National Pesticide Telecommunications Network (toll-free number), state departments of agriculture, and state extension services. In addition to illnesses, the system also responds to press releases such as those that occurred after the withdrawal of chlordane. Previously unsuspected clinical problems have been reported (suggesting new areas of research need), including cases associated with long-acting organophosphates, such as chlorpyrifos, and with the pyrethroids.
Adult↗
User evaluation of an arthritis information telephone service.
Arthritis patients are prone to misperceptions, forgetfulness, and the use of unproven remedies. They also may become noncompliant and be unaware of community resources. Informational or educational programs such as the Arthritis Information Service of Alabama may be useful for reducing these problems. There have been several reports concerning the use of telephone services (e.g.), for providing information about specific diseases but few concerning arthritis. An important step in the evaluation of a telephone information service is the surveying of user opinions concerning the service's procedures and its benefits. The purposes of the present study were to estimate the percentage of users who believed they had benefited from service usage, to identify the potential benefits of service usage, and to identify the groups most likely to report benefits.
Arthritis↗
Effect of counselor training on skills development and psychosocial status of volunteers with systemic lupus erythematosus.
Volunteers with systemic lupus erythematosus were recruited for a telephone service to provide psychosocial support to peers. The volunteers attended an 8-week counselor training program. The aim was to evaluate the impact of the training on counselors' skill development and to record possible changes in the counselors' psychosocial status. A second group of trainees (n = 15) was used as a delayed control for the first group (n = 14). The data were analyzed using multivariate repeated measures analysis of variance. Tests chosen to monitor psychosocial status included: Arthritis Impact Measurement Scales Anxiety and Depression subscales, Arthritis Helplessness Index, Wallston General Self-Efficacy Scale, University of California at Los Angeles Loneliness Scale, Rosenberg Self-Esteem, and Campbell Personal Competence scales. Tests selected to measure skills and knowledge.
Clinical Competence↗
Users evaluate LupusLine, a telephone peer counseling service.
OBJECTIVE: To assess the impact of LupusLine during its pilot phase of operation by determining patterns of utilization and user satisfaction. LupusLine is a peer counseling service designed to provide ongoing emotional support from home to home by telephone appointment. METHODS: One hundred fifty-three respondents were surveyed, using a 72-item structured questionnaire administered over the telephone by interviewers separately trained and hired specifically for this purpose. The questionnaire was pilot tested on 10 volunteers with systemic lupus erythematosus (SLE), and a panel of related health professionals reviewed the questionnaire for face validity. RESULTS: Most users were women (94.5%) who had SLE themselves (87.5%) and who called the service because of recent changes in their physical functioning and reported feelings of depression and anxiety about their illness. Forty-one percent of respondents made 6 or more calls to their assigned peer counselor. Respondents reported high levels of satisfaction across 5 highly correlated measures, with 92% of callers reporting at least moderate satisfaction with the service. Over 60% of respondents who reported a change in 6 "feeling" categories attributed this change to using LupusLine. Fewer users reported a change in 4 specific behaviors since using the service, but more respondents attributed changes, when they occurred, to LupusLine. CONCLUSIONS: Based on these initial findings, we believe that telephone networks similar to the LupusLine model may be able to offer substantial benefit to people coping with the complex, ongoing psychosocial challenges of SLE. Further, the at-home accessibility and low cost of such volunteer-based interventions may play an ever more needed role in the present health care environment.
Adult↗
Postmarketing surveillance for drug safety in pregnancy: the Organization of Teratology Information Services project.
BACKGROUND: Although medications are frequently used during pregnancy, premarketing studies exclude pregnant women, with the result that maternal and fetal risks of medications are largely unknown prior to marketing. METHODS: To demonstrate the feasibility of using Teratology Information Services (TISs) to identify potential subjects who may participate in postmarketing surveillance studies regarding medications taken during pregnancy, maternal characteristics and pregnancy exposure data routinely collected from callers to member agencies of the Organization of Teratology Information Services (OTIS) were pooled for two one-month periods. RESULTS: A total of 3536 calls inquiring about 7746 different agents were received from pregnant women. Of the 40 medications about which pregnant women most frequently asked, the top two were nonprescription acetaminophen and pseudoephedrine, three were prescription drugs with a U.S. Food and Drug Administration pregnancy label category D designation, and five were prescription antidepressants. CONCLUSIONS: TISs are well positioned to prospectively ascertain medication exposures in large numbers of pregnant women and may be an exceptional resource for conducting postmarketing surveillance for the safety of medications taken during pregnancy.
Abnormalities, Drug-Induced↗
Potential reduction of costs and hospital emergency department visits resulting from prehospital transtelephonic triage--the Shahal experience in Israel.
BACKGROUND: The rising cost of services provided by hospital emergency departments is of major concern. Attempts to reduce the costs of emergency cardiac care have thus far focused primarily on medical and administrative management in the hospital. The role of the patient in appropriate prehospital decision-making has been generally ignored. HYPOTHESIS: Membership in "Shahal" (an integrative telemedicine system) may have beneficial effects on patient decision-making and national health costs. METHODS: During a 6-month period, a random group of subscribers who had called for medical assistance during the previous 24 h were asked what action they would have taken had they not been Shahal subscribers. All study patients were followed for at least 7 days. RESULTS: In all, 1,608 subscribers (age 71 +/- 13 years) were included. Of these, 514 replied that they "would have waited," 363 "would have contacted their physicians," and 731 "would have sought emergency department care." Of the presenting medical problems, 86% were resolved without utilizing hospital facilities. A mobile intensive care unit was dispatched in 412 (26%) cases. A cost estimate of abuse indicated that the service resulted in a savings to the national economy of approximately $830,000 per 10,000 members per year. CONCLUSIONS: This study demonstrated that Shahal membership can reduce costs of medical care and the number of hospital emergency department visits.
Aged↗
Reaching and treating Spanish-speaking smokers through the National Cancer Institute's Cancer Information Service. A randomized controlled trial.
Although the prevalence of smoking is lower among Hispanics than among the general population, smoking still levies a heavy public health burden on this underserved group. The current study, Adiós al Fumar (Goodbye to Smoking), was designed to increase the reach of the Spanish-language smoking cessation counseling service provided by the National Cancer Institute's Cancer Information Service (CIS) and to evaluate the efficacy of a culturally sensitive, proactive, behavioral treatment program among Spanish-speaking smokers. Adiós was a 2-group randomized clinical trial evaluating a telephone-based smoking cessation intervention. Spanish-speaking smokers (N = 297) were randomized to receive either standard counseling or enhanced counseling (EC). Paid media was used to increase the reach of the Spanish-language smoking cessation services offered by the CIS. The Adiós sample was of very low socioeconomic status (SES), and more than 90% were immigrants. Calls to the CIS requesting smoking cessation help in Spanish increased from 0.39 calls to 17.8 calls per month. The unadjusted effect of EC only approached significance (OR = 2.4, P = .077), but became significant after controlling for demographic and tobacco-related variables (OR = 3.8, P = .048). Adiós al Fumar demonstrated that it is possible to reach, retain, and deliver an adequate dose of treatment to a very low SES population that has traditionally been viewed as difficult to reach and hard to follow. Moreover, the findings suggest that a proactive, telephone-counseling program, based on the Treating Tobacco Use and Dependence Clinical Practice Guideline and adapted to be culturally appropriate for Hispanics, is effective. Cancer 2007. (c) 2006 American Cancer Society.
Adult↗
Use of the internet and of the NHS direct telephone helpline for medical information by a cognitive function clinic population.
BACKGROUND: Internet websites and medical telephone helplines are relatively new and huge resources of medical information ("cybermedicine" and "telemedicine", respectively) accessible to the general public without prior recourse to a doctor. STUDY OBJECTIVES: To measure use of internet websites and of the NHS Direct telephone helpline as sources of medical information by patients and their families and/or carers attending a cognitive function clinic. DESIGN AND SETTING: Consecutive patients seen by one consultant neurologist over a six-month period in the Cognitive Function Clinic at the Walton Centre for Neurology and Neurosurgery, a regional neuroscience centre in Liverpool, UK. RESULTS: More than 50% of patients and families/carers had internet access; 27% had accessed relevant information, but none volunteered this. 82% expressed interest in, or willingness to access, websites with relevant medical information if these were suggested by the clinic doctor. Although 61% had heard of the NHS Direct telephone helpline, only 10% of all patients had used this service and few calls related to the reason for attendance at the Cognitive Function Clinic. CONCLUSIONS: Internet access and use is common in a cognitive function clinic population. Since information from internet websites may shape health beliefs and expectations of patients and families/carers, appropriately or inappropriately, it may be important for the clinic doctor to inquire about these searches. Since most would use websites suggested by the doctor, a readiness to provide addresses for appropriate sites may prove helpful.
Adult↗
Rheumatology telephone helplines: patient and health professionals' requirements.
OBJECTIVES: The aim of this study was to ascertain patients' and health professionals' requirements from a rheumatology helpline and how such a service should be delivered. METHODS: Self-completed questionnaires were administered to both users of rheumatology helplines, patients and health professionals (HPs), and providers of rheumatology services at five UK NHS trusts. Additional data were sought from experts in the field. Information was elicited on access to the service, preferred waiting time for response to a call, acceptability of an answerphone and choice of HP responding. Quantitative data were analysed using percentages and Chi-squared tests. Open questions were analysed as free text responses, and organized into clusters of themes. RESULTS: A total of 607 questionnaires were returned, 523 from users (411 patients, 112 health professionals) and 84 from providers. There were no significant differences across the five Trusts. The top six reasons for patients contacting the helpline were: advice on changes in condition, drug information, understanding symptoms, blood results, information on diagnosis, and appointment queries. All groups recommended a return call on the same day and were happy to leave an answerphone message. HP users requested additional access via e-mail and fax. Rheumatology practitioners were deemed the most appropriate personnel to staff a helpline. CONCLUSIONS: The findings of this study have contributed a valuable insight into the essential components of a rheumatology helpline service from a user and provider perspective. These data will add to existing recommendations for the management of a rheumatology helpline service and ultimately contribute to a proposal for national guidelines.
Adult↗