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PubMed2001

Telephone support group intervention for persons with hemophilia and HIV/AIDS and family caregivers.

The purpose of this pilot project was to test the feasibility of a telephone support group intervention for persons with hemophilia and HIV/AIDS and for their family caregivers. Their support needs were unique because they did not identify with predominant groups of persons with AIDS and were geographically dispersed from peers. The 12 week intervention involved separate telephone support groups for hemophiliacs and for family caregivers. The two groups, comprised of a predetermined maximum of six people, were co-led by a professional and a peer. The support group for family caregivers involved six people and the group for men with hemophilia included five people, including one peer facilitator and one professional facilitator in each group. The telephone support group discussions were taped, transcribed, and analyzed for prevalent themes. The peer and professional facilitators maintained weekly field notes. All participants reported that the telephone groups had a positive impact on meeting their support needs. They believed that they had benefitted from sharing information and that the support groups had decreased their feelings of isolation and loneliness. Participants, however, contended that the intervention should be longer than 12 weeks.

Adaptation, Psychological↗
PubMed1998

Telephone or face-to-face interviews?: a decision made on the basis of a pilot study.

De Vaus (1991) highlights five main considerations that may be key factors in decisions about whether to use telephone or face-to-face interviews for survey work: response rates, ability to produce representative samples, effects on interview schedule design, quality of responses and implementation problems. De Vaus' discussion of these five issues is outlined at the start of this article. The five issues are then applied to the experiences of researchers conducting a study on continence care. Description and discussion of pilot interviews, which explored both interview modes, are followed by a similar examination of the main study which employed telephone interviews. Ideas in this discussion are supported and challenged by reference to other publications on the subject of telephone and face-to-face interviews. The success of the decision to use telephone interviews in the main study is evaluated and recommendations are made.

Humans↗
PubMed2003

Identification of common themes from after-hour telephone calls made to urology residents.

OBJECTIVES: To characterize the content and sources of after-hour telephone calls from a general urology practice so that common themes can be identified and incorporated into the education of urology residents. METHODS: After-hour telephone calls were prospectively assessed for 6 months by a single senior urology resident. Calls occurring on weekends/holidays and between 5 PM and 8 AM on weekdays were directly referred to the on-call resident. The day of week, time, source, initiating event, and required action from each call was recorded. Exclusion criteria included calls regarding established hospital urology in-patients and duplicate calls from individual patients calling more than once within 24 hours. RESULTS: Eighty-seven calls were collected. Seventy percent occurred on weekends, primarily between 8 AM and 5 PM. The most common source was from outpatients (56%) followed by emergency room physicians (30%). In general, 61% and 26% of all calls regarded new urologic symptoms and postoperative issues, respectively. Urinary calculi were the most common specific reason for a call, followed by lower urinary tract symptoms and hematuria. An acute urologic evaluation was required for 27% of all telephone calls. Nine patients (10%) required admission within 48 hours of calling. CONCLUSIONS: The education of urology residents should emphasize telephone evaluations of patients who present with urinary calculi and common postoperative issues. The number of after-hour calls may be able to be reduced if patients and nonurologist physicians are also educated in the management of nonacute urologic problems.

Diagnosis-Related Groups↗
PubMed2002

Can clinical features of bipolar-I disorder be assessed reliably on the telephone?

BACKGROUND: The reliability of telephone interviews for rating 25 selected individual items of the Diagnostic Interview for Genetic Studies (DIGS) was assessed among persons with remitted bipolar disorder I (BPD I, n = 20). METHODS: The Diagnostic Interview for Genetic Studies (DIGS) was administered directly (with two raters present) and by telephone in random order to 20 adults with bipolar disorder I. RESULTS: Telephone interviews achieved reliability comparable to direct interviews for 16 items (64%), but were considered unsatisfactory for seven others (28%). Two other items, which evaluated the overlap between substance abuse and mood disorder, were considered unreliable for both methods of interview. LIMITATIONS: The presence of two interviewers for the in-person interview may have led to over-estimation of in-person reliability. Investigator bias in favor of phone interviews and a relatively small sample may have confounded the results. CONCLUSIONS: Telephone interviews may be used to evaluate individuals with BPD I in remission, provided the limitations of this method are recognized. They have limited reliability for dissecting overlap between mood abnormalities and psychotic phenomena or substance abuse.

Adolescent↗
PubMed2003

Telephone call contact for post-discharge surveillance of surgical site infections. A pilot, methodological study.

Accurate determination of superficial surgical-site infection (SSI) requires post-discharge surveillance (PDS) for up to 30 days. To be useful for regional or national audit the method must be effective, inexpensive, and acceptable to patients. We assessed the role of telephone calls to patients in PDS of SSI in 3150 patients in 32 Scottish hospitals undergoing groin hernia repair during one year. Overall, 104 (3.3%) patients opted out of the audit by declining to give a contact telephone number, 96 (3.0%) could not provide a personal telephone contact number, and 12 could not be contacted, a compliance rate of 93.3%. Two thousand, nine hundred and thirty-eight patients were contacted at one or all of the call points, i.e. 10, 20, or 30 days postoperatively, from a single call centre by medical records clerks, working to a piloted protocol. Contact data, including contact at all three time points are available on 2665 (84.6%) patients. All patients who believed their wound to be infected were seen by a healthcare worker (HCW) to confirm or refute the diagnosis. Of the 2665 patients in whom complete data are available, 140 (5.3%) patients developed confirmed wound infection and a further 57 (2.1%) thought their wound was infected, but this was not confirmed by the HCW. Patients appeared to welcome the concept of telephone contact. Methods for identifying all patients eligible for surveillance need to be improved. However, we believe this method of patient contact could be appropriate for PDS in regional or national audit.

Data Collection↗
PubMedDate not supplied

Effectiveness of telephone contact as an adjunct to a self-help program for smoking cessation: a randomized controlled trial in Spanish smokers.

This study evaluated the effect of telephone counseling as an adjunct to a self-help program for smoking cessation conducted through the mail. We obtained demographic and consumption information on those smokers who requested participation in the study. These participants (N = 200) were randomized into two study groups: (1) the standard self-help group (n = 100) (median age: 35.1 years; pretreatment consumption of 28.0 cigarettes/day); (2) the self-help group receiving additional multiple-contact telephone counseling (n = 100) (median age: 36.7 years; pretreatment consumption of 27.3 cigarettes/day). At the 12-month follow-up, the carbon monoxide in expired air was used to distinguish nonsmokers from smokers. Significant differences were found in the rates of continuous abstinence in both groups for each period evaluated. In the standard self-help group, the continuous abstinence rate at the 3-month follow-up was 21%, 18% at the 6-month follow-up, and 14% at the 12-month follow-up. The telephone counseling group yielded a 48% continuous abstinence rate at the 3-month follow-up, 40% at the 6-month follow-up, and 27% at the 12-month follow-up. The results of this randomized controlled trial show that telephone counseling was an effective aid for the smoking cessation program.

Adult↗
PubMed1999

Using the telephone to improve health behavior and health service delivery.

The technology for using the telephone to deliver interventions to improve health behavior and health care has expanded dramatically and exciting innovations continue to emerge. These developments enable the telephone to be used to deliver individualized services to a broad cross section of target groups, while minimizing logistic and system barriers, and cost. However, as telephone-delivered interventions have proliferated, a number of questions remain concerning the elements that are essential to their effectiveness. We provide a broad overview of telephone interventions, published in the past 10 years to identify gaps in knowledge about these services, and make recommendations for future program development and evaluation.

Attitude to Health↗
PubMed2001

Prospective assessment of symptom palliation for patients attending a rapid response radiotherapy program. feasibility of telephone follow-up.

Clinical trials generally include motivated patients with relatively good performance status. This can result in an overestimation of the effectiveness of an intervention. Clinic follow-up protocols for outcome assessment after palliative treatments suffer from high attrition rates. In this study, the feasibility of telephone follow-up for the assessment of symptom palliation in patients receiving outpatient palliative radiotherapy as a tool to evaluate outcome was examined. Patients referred for palliative radiotherapy were asked to rate their symptom distress using the modified Edmonton Symptom Assessment System (ESAS) at initial consultation. Patient demographics and analgesic consumption were collected. For those who received radiotherapy, follow-up was conducted through telephone interviews at week 1, 2, 4, 8, and 12 post-treatment using the same modified ESAS and analgesic diary. One hundred ninety patients received radiotherapy to 256 sites from January to August 1999. Seventy-eight patients (41%) died during the 12-week follow-up period. The percentage of surviving patients responding to the telephone interview ranged from 63% to 68% during the 12-week study. Telephone follow-up is a feasible tool for the prospective outcome assessment of symptom palliation in this population. It compares well to clinic visits or mailed questionnaires. However, to improve the follow-up rates, other modalities may also need to be implemented.

Adult↗
PubMed1996

Telephone follow-up after discharge from the hospital: does it make a difference?

Two systems of telephone follow-up of discharged patients were compared in this 3-month study. All medical and surgical patients on five nursing units of one acute care institution were included, yielding a sample of over 1,400 patients. One group of patients was called 2 to 3 days after discharge; another group received a brochure describing a nurse-run telephone service they could call. A third group of patients received no intervention. More than 90% of patients who were called had questions about self-care and recovery at home. Only nine patients initiated calls to the nurse telephone service. The three groups did not differ in patient satisfaction with health education or readmission rates within 30 days of discharge. This study suggests that patients have continued health education needs after discharge but are unlikely to actively seek needed information from a hospital-based telephone service.

Follow-Up Studies↗
PubMed2000

Electronic telephone directory listings: preferred sampling frame for a population-based study of childhood cancer in Australia.

PURPOSE: We report our telephone-based system for selecting community control series appropriate for a complete Australia-wide series of Ewing's sarcoma cases. METHODS: We used electronic directory random sampling to select age-matched controls. The sampling has all listed telephone numbers on an up-dated CD-Rom. RESULTS: 95% of 2245 telephone numbers selected were successfully contacted. The mean number of attempts needed was 1.94, 58% answering at the first attempt. On average, we needed 4.5 contacts per control selected. Calls were more likely to be successful (reach a respondent) when made in the evening (except Saturdays). The overall response rate among contacted telephone numbers was 92.8%. Participation rates among female and male respondents were practically the same. The exclusion of unlisted numbers (13.5% of connected households) and unconnected households (3.7%) led to potential selection bias. However, restricting the case series to listed cases only, plus having external information on the direction of potential bias allow meaningful interpretation of our data. CONCLUSION: Sampling from an electronic directory is convenient, economical and simple, and gives a very good yield of eligible subjects compared to other methods.

Adolescent↗
PubMed2002

Telephone vs. face-to-face notification of HIV results in high-risk youth.

PURPOSE: To increase the number of high-risk and homeless youth who receive human immunodeficiency virus (HIV) test results and posttest counseling. METHODS: Oral HIV testing and counseling were offered to high-risk and homeless youth at sites at which youth congregate throughout Portland, Oregon. Subjects were randomized to receive test results and posttest counseling either in a face-to-face manner or with the option of telephone notification. Self-reported demographic and risk-behavior information was collected prior to HIV testing. The differences in the proportion of youth who received their test results were analyzed according to the notification method and demographic characteristics using SPSS. RESULTS: Among the 351 youth who were tested, 48% followed up to receive test results and posttest counseling. Adolescents most likely to receive their results were female, older (19-24 years), and white and those who reported high-risk behaviors. Those given the option of telephone notification were significantly more likely to receive their results than those required to have face-to-face notification (odds ratio = 2.301, 95% confidence interval of 1.499, 3.534). This was true regardless of age, race, history of previous HIV testing, or presence of high-risk behaviors. Two youths tested positive for HIV corroborating previous reports of low HIV prevalence in this population. Both were assigned to the face-to-face notification group and, therefore, no HIV positive results were given by telephone. CONCLUSIONS: The option of telephone notification significantly increased the proportion of youth who received posttest counseling and results following community-based testing.

AIDS Serodiagnosis↗
PubMedDate not supplied

A brief, regular, proactive telephone "coaching" intervention for diabetes: rationale, description, and preliminary results.

Telephone-delivered interventions (TDIs) represent a potentially cost-effective method to increase medical adherence. TDIs for diabetes patients have typically been delivered by nurses or computerized telephone messaging. Psychology undergraduates, however, are less costly than nurses, have a strong background in behavioral science, and provide the personal relationship missing with computerized contact. This paper presents the rationale for and description of a brief, regular, proactive telephone intervention designed to be delivered by psychology undergraduates (i.e., paraprofessionals). "Coaches" administer a 15-min telephone intervention weekly for 3 months and biweekly for 3 additional months. Guided by a semistructured protocol that focuses on behavioral goals, coaches provides support, collaborative problem-solving, and apply basic cognitive-behavioral techniques. Results from a pilot study on type 1 diabetes patients are presented. This preliminary evidence suggests that the program is feasible, acceptable to a large majority of patients, and effective in reducing HbA1c levels.

Computer-Assisted Instruction↗
PubMed1998

Impact of telephone reinforcement of risk reduction education on patient compliance.

Smoking and hyperlipidemia are key risk factors resulting in peripheral arterial disease. These risk factors can be reduced when appropriate lifestyle changes are made, especially for patients less than 60 years of age. Therefore patient education regarding smoking cessation and healthy diet changes may positively impact the course of disease. The ability to make a lifestyle change is affected by (1) an individual's belief that his or her behavior affects the condition and (2) the social support received from family, especially a primary caregiver. This pilot study compared two randomized groups of patients with peripheral arterial disease for a 1-year period. The control group received the standardized teaching plan regarding smoking cessation and diet at the postoperative clinic visit. The experimental group received the standardized teaching plan in addition to quarterly telephone calls to reinforce smoking cessation and diet information. At the end of 1 year, both groups received follow-up telephone calls at the conclusion of the study for endpoint data collection. Specifically, this project investigated the following research statements: (1) Patients who receive periodic telephone follow-up will have greater compliance with the recommendations regarding smoking and diet than those who do not receive follow-up. (2) Patients whose caregivers are compliant with the recommendations regarding smoking cessation and diet will have significantly higher compliance themselves. The data were analyzed by using cross tabulation, sign test, and McNemar's test for nonparametric data to measure mobility, overall perception of health, knowledge of risk reduction information, and compliance with the smoking cessation and low fat/cholesterol diet plan. The results of this pilot study revealed no significant differences between the control and experimental groups. Telephone reinforcement was not sufficient in this study to influence lifestyle change. However, standardized teaching improved diet scores in both groups. Differences were found between smokers and nonsmokers.

Female↗
PubMedDate not supplied

Postcard and telephone reminders for unclaimed prescriptions: a comparative evaluation using survival analysis.

OBJECTIVE: This study investigated unclaimed prescription reminders with the goal of developing practical and useful recommendations for pharmacies interested in reminding patients to pick up unclaimed prescriptions. Based on the recipient and mode of the reminder notification, this study measured differences in unclaimed prescription pickup time. DESIGN: This study was conducted using a convenience sample of three independent pharmacies in a large Midwestern city. A total of 120 subjects with prescriptions remaining unclaimed after 3 or 4 working days were included in the study. Once identified as unclaimed, these prescriptions were randomly assigned into a control group or one of the following four intervention groups: (1) a telephone reminder to the patient, (2) telephone notification to the prescribing physician, (3) a postcard reminder to the patient, and (4) postcard notification to the prescribing physician. RESULTS: The results suggest that different methods of pharmacist-initiated reminder systems may affect time to prescription pickup in community pharmacy practice. Marginally significant differences were found among the five study groups and the time to prescription pickup (P = .09). Compared with the control group, neither telephone nor postcard reminders--to patients or physicians--significantly decreased the mean number of days to pickup of potentially abandoned prescriptions. CONCLUSION: The actual value of an unclaimed prescription reminder program may reside in improved relationships with customers and with the medical community. The effort and expense of implementing and maintaining an unclaimed prescription reminder system should be balanced against the opportunity to establish and improve pharmacist-patient and pharmacist-physician relationships. Further research in different pharmacy settings should investigate the effectiveness of (1) postcard versus telephone reminders, (2) physician versus patient notification, and (3) the effects of reminders on patient outcomes.

Community Pharmacy Services↗
PubMedDate not supplied

Using the Vista 350 telephone to communicate the results of home monitoring of diabetes mellitus to a central database and to provide feedback.

PURPOSE: Self-monitoring of blood glucose has become routine practice in the management of diabetes mellitus. When all the data is complete, however, the amount of information to be taken into account when making therapeutic decisions becomes overwhelming not only for the patient but for the healthcare provider. Computers excel at processing large amounts of information quickly and impassively, which makes them potentially helpful for collating and communicating the data in a manner that facilitates decision-making by patient and healthcare provider. This should in turn improve control and help prevent acute and chronic complications. METHOD: Using the Vista 350 telephone, we have developed a system that enables patients with diabetes to record home monitoring data to a central database and receive feedback summaries. A small trial was conducted to determine if the Vista 350 telephone is an acceptable and feasible method to communicate the results of home monitoring of diabetes mellitus to a central database and receive feedback summaries. A total of 35 volunteers with insulin-requiring diabetes mellitus in the London area were randomly allocated to either use the Vista 350 phone for 6 months, or to a control group that continued to use traditional methods for recording home monitoring data. RESULTS: 33 of the 35 patients enrolled completed the trial. All 16 patients who began using the phone continued to do so for 6 months confirming the feasibility of the system. Questionnaires completed at 3 and 6 months confirmed the Vista 350 telephone system to be acceptable to the subjects. The results will enable some minor modifications to be made to the telephone system before a larger definitive trial, designed to determine the effect on diabetes control, is conducted later this year.

Blood Glucose Self-Monitoring↗
PubMed2003

The effect of different methods of collecting data: mail, telephone and filter data collection issues in utility measurement.

When collecting data researchers can interview participants, conduct telephone interviews, or mailout questionnaires. Often mixed methods are used. Whether these methods produce equivalent data is under-researched in the health-related quality of life (HRQoL) field. In addition, the effect of using filter questions has not been researched among HRQoL multi-attribute utility instruments. This study randomly sampled from Melbourne, Australia, and employed a test-retest design to investigate whether mail or telephone interview made any difference to Assessment of Quality of Life (AQoL) instrument utility scores. A filter question AQoL version investigated the effect of filters on scores. There was no significant difference in standard AQoL scores between mail self-completion and telephone interview, regardless of which was administered first. Inclusion of filter questions encouraged respondents to select the best response category thereby screening out minor health conditions. The effect was to increase utility scores by 0.06 or 7%. This effect has not been previously reported in utility instruments and has profound implications for economic evaluations using cost-utility analysis; there are implications for researchers using filter questions in general. In conclusion, researchers should feel confident that utility scores elicited from the standard AQoL through self-completion mail and telephone interview administrations are directly comparable.

Adult↗
PubMed2004

Improving physician coverage of pneumococcal vaccine: a randomized trial of a telephone intervention.

Improved pneumococcal vaccine (PPV) immunization for seniors is a national goal of the Medicare program. This study examined whether adding a simple telephone follow-up to an existing mailed physician performance feedback under the Medicare program would increase the impact on billed pneumococcal immunizations. Medicare fee-for-service claims data were used to select New York primary care physicians with high volume (n = 732) or African-American serving (n = 329) practices. All practices received mailed feedback on their 1999 Medicare practice specific PPV coverage rates, along with educational materials and offers of assistance. Practices were also randomized to receive telephone calls directing attention to the mailing and further promoting improvements in PPV coverage or no active follow-up. Physicians randomized to telephone follow-up showed significantly higher rates of practice specific PPV coverage in 2000 than those receiving the routine mailing only, and 27% vs. 17% (p = 0.01) of high volume physicians and 34% vs. 22% (p = .052) of African American serving physicians achieved at least a 5% increase in their cumulative PPV claims coverage. This study concludes that telephone follow-up is an effective and straightforward method to enhance the impact of practice specific feedback to promote improvements in Medicare PPV immunization. However, improved methods may be needed to induce a large percentage of physicians to change.

Aged↗
PubMed1995

A randomized trial of self-help materials, personalized feedback, and telephone counseling with nonvolunteer smokers.

The incremental effects of (a) a self-help booklet alone, (b) self-help booklet with computer-generated personalized feedback, and (c) self-help booklet, personalized feedback, and outreach telephone counseling were evaluated in a population-based, nonvolunteer sample of smokers. Smokers (N = 1,137) were identified through a telephone survey of a random sample of 5,903 enrollees in a health maintenance organization and randomized to a no-treatment control group or 1 of the 3 intervention conditions. Smoking status was ascertained 3, 12, and 21 months postrandomization. Cotinine validation of self-reported cessation was obtained at the 12-month follow-up. Overall, the telephone counseling significantly increased smoking cessation at the 3-month follow-up, but not at 12 or 21 months. Among smokers who were precontemplative at baseline, telephone counseling significantly increased prevalent abstinence at 3 and 12 months and continuous abstinence at 21 months (defined as self-reported abstinence at 3, 12, and 21 months).

Adult↗