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PubMedDate not supplied

Effect of a telephone medication renewal service on blood pressure control.

OBJECTIVE: To evaluate the effect of a pharmacist-staffed telephone medication renewal service on blood pressure (BP) control. DESIGN: Retrospective review of telephone call logs and patient charts. SETTING: University-based family medicine clinic. PATIENTS AND OTHER PARTICIPANTS: All patients seen at the clinic with an International Classification of Diseases 9 code for hypertension during 2000. INTERVENTIONS: Age, sex, diagnosis of heart failure and/or diabetes, and frequency of clinic visits were recorded. Telephoned prescription renewal requests for 2000 were logged; patient name, age, medication requested, strength, and directions were recorded. Each log entry was reviewed to identify patients requesting a renewal for an antihypertensive agent. Patients with hypertension who used the renewal service were compared with those who did not. MAIN OUTCOME MEASURES: BP control rates were calculated for each group as the number of patients who met BP goals from the 1997 guidelines of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Analysis of variance and regression analysis were performed to examine the effect use of the renewal service had on BP control in both groups of patients. Covariables such as age, sex, and clinic visits were included in the model. RESULTS: Of the 938 patients seen for hypertension, 332 used the renewal service at least once. We found no statistical difference between the two groups with respect to BP control (P = .86; confidence interval [CI], 0.7-1.3). BP control did not improve more for patients who used the renewal service more frequently (P = .48; CI, 0.9-1.2). CONCLUSION: Use of the telephone medication renewal service had no effect on BP control. While increasing patients' access to medications is necessary, the results of this study suggest that this in itself is not sufficient to ensure good BP control.

Antihypertensive Agents↗
PubMed1978

Surveillance and follow-up of patients with implanted cardiac pacemaker by telephone transmission.

A follow-up study on pacemaker function in 15 patients with implanted cardiac pacemaker has been performed by telephone transmission. The transmitting set consisting of electrocardiograph, pacemaker pulse modulator and acoustic coupler was manipulated by the patients themselves. ECG, pacemaker pulse, and pulse rate were simultaneously transmitted through 1 channel to the receiver in our clinic. Of 56 patients with pacemaker, 15 patients were surveyed by telephone transmission. In these patients battery exhaustion was detected in 3, competition in 2, and lead fracture in 1. The fact that surveillance and follow-up of the patients with implanted cardiac pacemaker could be carried out by telephone transmission as well as by clinic visitation tells us that the telephone transmission is a useful method and plays an important role in a pacemaker clinic. Moreover our study established its further usefulness in the patient's preference due to difficulties in travelling to the pacemaker clinic and in reducing patient's anxiety.

Adolescent↗
PubMed1982

Reliability of telephone transmission facilities for computerized electrocardiogram analysis in Japan.

The reliability of telephone electrocardiogram (ECG) transmission facilities was assessed in order to carry out the computerized ECG analysis using the IBM-Bonner program. Simulated ECGs were transmitted repeatedly over telephones from an internal laboratory and from an external hospital which was 1,000 Km distant. The simulated ECG was transmitted in a highly reproducible state and with no appreciable distortion. The telephone ECG transmission facilities using the public telephone network in Japan proved to reliable for computerized ECG analysis.

Computers↗
PubMed2005

[Surveillance of risk factors for chronic diseases through telephone interviews].

OBJECTIVE: To describe methods and initial findings of a surveillance system of risk factors for chronic non-communicable diseases (CNCDs) based on telephone interviews. METHODS: Interviews undertaken in a random sample of the adult population of the Municipality of Sao Paulo living in households with telephone. Sampling was done in two steps and included the random selection of households and the random selection of the household member to be interviewed. The system's questionnaire investigated demographic and socioeconomic characteristics, food consumption and physical activity patterns, smoking, consumption of alcoholic beverages, recalled weight and height and reported medical diagnoses of hypertension and diabetes, among other topics. Prevalence estimates of selected risk factors for CNCDs were calculated for the adult population with telephone and for the city's entire adult population. In this last case, we applied sample weighting factors that took into account demographic and socioeconomic differences between the adult population with telephone and the entire adult population of the municipality. RESULTS: Strong differences between sexes were found for most risk factors: low consumption of fruit and vegetables, high consumption of alcohol and overweight were more frequent among men while sedentary lifestyle and hypertension were more frequent among women. Additional possibilities of stratification of risk factor prevalences allowed by the surveillance system are illustrated using age groups, schooling, and place of residence in the city. CONCLUSIONS: System performance was considered as good and was better than the performance observed in similar systems operating in developed countries when evaluated with basis on the representativeness and reliability of the estimates and on costs. The cost per concluded interview was eight times lower than the cost usually seen in similar systems in developed countries and four to eight times lower than the cost of traditional household surveys undertaken in the city of Sao Paulo.

Adult↗
PubMed2002

Effect of telephone follow-up on the physical well-being dimension of quality of life in patients with cancer.

OBJECTIVE: To evaluate the effect of telephone follow-up on the physical well-being dimension of health-related quality of life in patients with cancer. DESIGN: Randomized, controlled trial. SETTING: Public teaching hospital. PATIENTS: One hundred fifty patients with cancer who were discharged to home from the hospital. INTERVENTION: Patients received a telephone follow-up call 48-72 hours after discharge. Information was solicited regarding drug-related (and other) problems. Problems were addressed, and advice and support were given. MEASUREMENTS AND MAIN RESULTS: Analysis of variance revealed no differences in the physical well-being dimension of health-related quality of life between patients who received telephone follow-up and a control group who did not. Sixty-eight percent of the follow-up group and 40% of the control group (p = 0.007) reported having had at least one contact with a health professional. CONCLUSION: One possible explanation for the lack of effect of the intervention is that high-risk patients in the control group received a similar intervention from other health care professionals. We suggest that telephone follow-up be coordinated among health professionals.

Adult↗
PubMed1978

Quality assessment of a telephone care system utilizing non-physician personnel.

An approach to providing medical care by telephone is described and its content and quality assessed by means of an outcome study. Pediatric health assistants have been trained to evaluate, triage and offer home management advice in lieu of an office visit for medical problems presented by parents via telephone. During a four-week study period, data were collected on all calls (N = 2520) using a telephone encounter form. Fifty-nine per cent of all calls involved requests for care of illness, 30 per cent of which were independently handled by the health assistant. Quality of care was evaluated for those cases who received advice in home management by means of a seven day follow-up interview with parents (N = 247). Access, parent satisfaction, residual symptoms, and the need for further care were ascertained. Greater than 90 per cent of parents expressed satisfaction and 92 per cent of problems had resolved. Results indicate that this telephone care system can effectively sort out and advise parents in home management for the many minor problems which occur in a pediatric practice, thereby increasing time for direct contact with patients.

Adolescent↗
PubMed1979

A comparison of mail, telephone, and home interview strategies for household health surveys.

The method of data collection in household health surveys can be a major determinant of cost and data quality. A survey strategy can comprise mail, telephone, or home interview methods, individually or in combination to follow up non-respondents. The purpose of this study in Montreal was to compare cost and data quality of various strategies. Strategies which began with mail or telephone contact, followed by the two other methods, provided response rates as high as a home interview strategy (all between 80 and 90 per cent), for one-half the cost of home interviews when used as the sole method. The telephone response rate was higher than the mail response rate. Comparing different follow-up approaches to strategies beginning with mail or telephone, it proved less costly, and equally effective, to use home interviewing as a last resort for persistent non-respondents. Validity of response (comparing individual responses with records of a government health insurance data bank) and willingness to answer sensitive questions were greatest in mail strategy.

Canada↗
PubMed1983

Personal versus telephone surveys for collecting household health data at the local level.

Personal and telephone interview surveys were conducted simultaneously during 1981 in the same area (four counties in the area of Tampa Bay, Florida) and utilizing the same interview schedule. Following completion of the surveys, validity checks were made with the medical providers reported by a subsample of respondents to each mode. The telephone survey yielded a lower response rate but cost less than half the personal interview. There was some evidence of nonresponse bias in the telephone survey, and some relatively minor differences in responses were found between the two modes, but there was no conclusive evidence that the response differences resulted from mode effects. Telephone respondents appeared to be somewhat more accurate in their reporting of visits to medical providers, although accuracy comparisons must be interpreted with caution in view of the disparate success experienced for the two modes in securing permission forms for the release of medical record information.

Adolescent↗
PubMed1989

Validity of telephone surveys in assessing cigarette smoking in young adults.

Self-reports of cigarette smoking in a sample of young adults, aged 17 to 21 (n = 359) obtained by telephone were validated by home interview and saliva cotinine measurement. While most subjects were in agreement for their reported behaviors, the telephone methodology underestimated cigarette smoking rates by 3 to 4 per cent. Reported quitting by telephone was an unstable category with 35 per cent of quitters reporting smoking on home interview. Reliance on telephone methods alone may underestimate smoking behavior. Validation of surveys, preferably by biochemical methods, is recommended.

Adolescent↗
PubMed1999

Estimating the proportion of homes with functioning smoke alarms: a comparison of telephone survey and household survey results.

OBJECTIVES: This study determined the proportion of homes with functioning smoke alarms in a low-income area experiencing a high rate of residential fire-related injuries. METHODS: An on-site survey of households was conducted to confirm the results of a telephone survey. RESULTS: In the telephone survey, 71% of households reported having functioning smoke alarms. In the household survey, 66% of households reported having functioning alarms; however, when the alarms were tested, the percentage dropped to 49%. CONCLUSIONS: Telephone surveys may overestimate the presence of functioning smoke alarms in some populations. Thus, the use of telephone surveys to establish baseline measures could significantly affect the evaluation of smoke-alarm giveaway programs.

Accidents, Home↗
PubMed2000

Maintaining mammography adherence through telephone counseling in a church-based trial.

OBJECTIVES: This study assessed the effectiveness of telephone counseling in a church-based mammography promotion intervention trial. METHODS: Thirty churches were randomized to telephone counseling and control conditions; telephone interview data were used in assessing intervention effects on mammography adherence. Separate analyses were conducted for baseline-adherent participants (maintaining adherence) and baseline-nonadherent participants (conversion to adherence). RESULTS: Year 1 follow-up data indicated that the telephone counseling intervention maintained mammography adherence among baseline-adherent participants and reduced the nonadherence rate from 23% to 16%. CONCLUSIONS: Partnerships between the public health and faith communities are potentially effective conduits to promote maintenance of widely endorsed health behaviors such as regular cancer screening.

Black or African American↗
PubMed1982

A feasibility trial of a bureau-based telephone service for the deaf.

In the autumn of 1980, a 6-week experimental trial of a telephone service for deaf people was carried out with the financial support of NRD, British Telecom, RNID and in collaboration with the Electronics Department at Southampton University. The trial involved 25 deaf people with speech who were supplied with Prestel TV sets which allowed them to receive text from an operator at the bureau who set up the call connections and transcribed the speech of the hearing caller into text. The text was transmitted via the telephone network and displayed on the participant's Prestel receiver. The deaf callers used their telephones in the normal fashion to make their replies. Although the trial had its fair measure of problems, particularly at the start, the experiment proved to be successful. This paper describes the system used for the trial, the trial itself and also attempts to evaluate the requirements of a bureau-based telephone service for the deaf.

Activities of Daily Living↗
PubMedDate not supplied

Telephone versus in-person clinical and health status assessment interviews in patients with bipolar disorder.

We evaluated the correspondence between in-person- and telephone interview-derived data on affective symptoms, health-related quality of life, disability days, and medication compliance in patients with bipolar disorder. Twenty-eight outpatients with DSM-III-R-documented bipolar disorder were randomly assigned to an initial in-person or telephone interview. An average of 4.0 days later, they were reassessed by the other interview method. Results indicate good to excellent agreement between telephone and in-person interviews on measures of mania (intraclass correlation coefficient (ICC) = 0.92) and depression symptoms (ICC = 0.90), suicide risk (kappa = 0.80), and alcohol use (kappa = 0.61), scores on the Medical Outcomes Study 36-item Short-Form Health Survey (ICCs = 0.66-0.92), and medication compliance (ICCs = 0.50-0.66). Measures of bed disability days (ICC = 0.34) and restricted activity days (ICC = 0.66) showed less agreement. Telephone interviews are feasible and reliable for collecting data on psychiatric and other health-related outcomes in bipolar disorder patients.

Adult↗
PubMed1992

Telephone therapy: call for help.

1. Many disabled people are unable to take advantage of community resources because they cannot leave their homes, but the telephone can provide a link to psychotherapeutic services. 2. In both telephone and office therapy, the therapist orients members to the group, suggests an arena in which goals might be established, encourages verbalizations, sharing of concerns, strategies for solving problems, and assesses the psychodynamics of the therapeutic situation. 3. Psychotherapy via telephone can provide significant benefits to people who formerly were barred from services. Telephone therapy requires the therapist's commitment to the challenge of mastering a new technique and to altering fee structures to allow those on fixed incomes to be served.

Persons with Disabilities↗
PubMed1998

Self-administered psychotherapy for depression using a telephone-accessed computer system plus booklets: an open U.S.-U.K. study.

OBJECTIVE: To evaluate the efficacy and acceptability of a self-help program for mild-to-moderate depression that combined treatment booklets and telephone calls to a computer-aided Interactive Voice Response (IVR) system. METHOD: In an open trial, 41 patients from Boston, Massachusetts; Madison, Wisconsin; and London, England, used COPE, a 12-week self-help system for depression. COPE consisted of an introductory videotape and 9 booklets accompanied by 11 telephone calls to an IVR system that made self-help recommendations to patients based on information they entered. RESULTS: All 41 patients successfully completed the self-assessment in the booklets and telephone calls; 28 (68%) also completed the 12-week self-help program. Hamilton Rating Scale for Depression (HAM-D) and Work and Social Adjustment scores improved significantly (41% and 42% mean reduction in the intent-to-treat sample, respectively, p < .001). Eighteen (64%) of the 28 completers were considered responders on the basis of > or = 50% reduction in their HAM-D scores. There was a higher percentage of completers in the pooled U.S. sites (82% vs. 43%), and U.S. completers improved more than those in the United Kingdom (73% vs. 43% were responders). Most (68%) of the calls were made outside usual office hours, Monday-Friday, 9:00 a.m. to 5:00 p.m. Expectation of effectiveness and time spent making COPE calls (more treatment modules) correlated positively with improvement over 12 weeks. Mean call length for completers was 14 minutes. CONCLUSION: A self-help system comprised of a computer-aided telephone system and a series of booklets was used successfully by people with mild-to-moderate depression. These preliminary results are encouraging for people who cannot otherwise access ongoing, in-person therapy.

Adult↗
PubMed1998

Emergency department telephone advice.

OBJECTIVE: To evaluate telephone advice given in an emergency department. DESIGN: Prospective, observational study. SETTING: A community-based emergency department in a semi-rural/outer metropolitan setting, between August and November 1995. PARTICIPANTS: All people telephoning the emergency department for medical advice. METHODS: Details of all calls, callers and patients were recorded. Within 72 hours, a follow-up call was initiated seeking replies to a series of standardised questions. MAIN OUTCOME MEASURES: Number, timing and duration of calls; appropriateness of the advice given; compliance with the advice; and callers' satisfaction with the service. RESULTS: Over the four-month period, 1682 calls were received, 58% between 4pm and midnight. There were 33 telephone calls per 100 emergency department attendances. The mean call duration was 3.9 minutes (range, 0.25-25 minutes); 49% of patients were less than 14 years old, and 72% of callers phoned because of spontaneous illness. The advice given was considered inappropriate in only 1.4% of calls. Follow-up calls were made to 1132 people (67%), revealing a non-compliance rate of only 6.9% and a high level of caller satisfaction, with 99% of callers affirming a need for such a service. CONCLUSIONS: The provision of telephone advice by emergency department staff is rated highly by the community and compliance with the advice is strong. Paediatric problems, arising as a result of spontaneous illness, predominate and there is a large bias towards after-hours use of the service. Experienced staff provide better advice.

Adolescent↗
PubMed1995

Taming your telephone.

In this modern age of communications, with computers, FAX machines, and the videoconference, the decision-making process has been accelerated. Use of the telephone has become more important and intensive. The physician executive must constantly strive to hone the edge of his or her skills to increase productivity and soften the stress of each day. In the 1990s and in the era of health care reform, the physician executive will face increasing pressures and demands. Telephone skills will become increasingly important to organizations and to physician executives' peace of mind. This article considers some fundamental aspects of telephone usage: (1) reasons for provider behavior, (2) the value of the phone as a negotiating tool, (3) suggestions for phone efficiency, (4) guidelines for a successful telephone encounter, and (5) pitfalls.

Efficiency, Organizational↗
PubMed1999

Is telephone counselling a useful addition to physician advice and nicotine replacement therapy in helping patients to stop smoking? A randomized controlled trial.

BACKGROUND: The authors evaluated the incremental efficacy of telephone counselling by a nurse in addition to physician advice and nicotine replacement therapy in helping patients to stop smoking. METHODS: The trial was conducted at the University of Ottawa Heart Institute. A total of 396 volunteers who smoked 15 or more cigarettes daily were randomly assigned to either of 2 groups: usual care (control group) and usual care plus telephone counselling (intervention group); the groups were stratified by sex and degree of nicotine dependence. Usual care involved the receipt of physician advice on 3 occasions, self-help materials and 12 weeks of nicotine replacement therapy. Telephone counselling was provided by a nurse at 2, 6 and 13 weeks after the target quit date. Point-prevalent quit rates were determined at 52 weeks after the target quit date. RESULTS: The point-prevalent quit rates at 52 weeks did not differ significantly between the control and intervention groups (24.1% v. 23.4% respectively). The quit rates did not differ significantly at the secondary measurement points of 4, 12 and 26 weeks. INTERPRETATION: Brief physician assistance, along with nicotine replacement therapy, can help well-motivated smokers to quit. Three additional sessions of telephone counselling by a nurse were ineffective in increasing quit rates. This form of assistance may be useful in the absence of physician advice or when self-selected by patients.

Adult↗