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At least 721 records · Page 40Linked to original sources
PubMed2003

The relationship between use of NHS Direct and deprivation in southeast London: an ecological analysis.

BACKGROUND: Little is known about the utilization of NHS Direct by disadvantaged groups, in spite of the service aiming to be 'accessible to all'. This study investigates the relationship between use of NHS Direct and deprivation in one predominantly disadvantaged area. METHODS: Ward-level call rates to NHS Direct South East London over a 6 month period were calculated using postcode data. Jarman and Townsend scores were used as a proxy of deprivation in each ward. We performed negative binomial regression to investigate the relationship between deprivation score and rate of calls to NHS Direct. RESULTS: There was a significant, non-linear (quadratic) effect of deprivation score on call rates; call rates were lower in both the most affluent and most deprived wards. CONCLUSION: Calls to NHS Direct rise with increasing deprivation until, at extreme levels of deprivation, they subsequently decline. This challenges assumptions that NHS Direct is not utilized in deprived areas.

Hotlines↗
PubMed2003

Early warning and NHS Direct: a role in community surveillance?

BACKGROUND: NHS Direct is a nurse-led telephone help line that covers the whole of England and Wales. NHS Direct derived data are being used for community surveillance, the purpose of which is to detect a local or national increase in symptoms reported by callers. The system has the potential to identify an increase in symptoms reported by callers about people in the prodromal stages of illness caused by the deliberate release of a biological or chemical agent. There are no other community surveillance projects existing on a national scale that utilize electronic daily data. METHODS: We describe the surveillance system and calls to NHS Direct between December 2001 and July 2002. Confidence limits have been constructed for 10 key algorithms at each site and control charts devised for five of these algorithms at sites covering the key urban areas. RESULTS: Daily reporting has been achieved from NHS Direct sites in England and Wales. High levels of activity in specific algorithms at both national and regional levels have been detected. A sustained national increase in calls about fever occurred in January 2002. CONCLUSION: Although the project is still at an early stage, daily analysis of NHS Direct data has the potential to detect symptoms in the community that could be related to deliberate releases of chemical or biological agents or to outbreaks of disease. For this surveillance to act as an 'early warning' of illness resulting from a microbiological or chemical cause, the NHS Direct surveillance needs to be fully integrated into an appropriate public health response (which may require diagnostic samples to be taken from callers).

Adolescent↗
PubMed2004

NHS Direct derived data: an exciting new opportunity or an epidemiological headache?

NHS Direct, a national telephone helpline for health advice, was established in 1998 to provide health information and advice to callers and refer them to an appropriate service. This article briefly describes the nature of the NHS Direct call record and discusses issues relevant to the use of the data for disease surveillance and epidemiological purposes. Clinical decision support software [the NHS Clinical Assessment System (NHS CAS)] is used by NHS Direct to collect callers' demographic details and direct them to the appropriate level of care. Data relating to NHS Direct calls provide a timely snapshot of symptoms occurring in the community and are summarized in 'off the shelf' NHS CAS reports. Adapting the system to provide customized data extracts requires considerable development work. When interpreting NHS Direct derived data, particular attention should be given to the age distribution of callers, NHS Direct demand surges, call 'networking' and changes to the NHS CAS clinical algorithms. An increasingly rich source of baseline data, growing body of published work, and a more 'bedded down' NHS Direct service will further our understanding and acceptance of the value of the NHS Direct call record.

Age Factors↗
PubMed1993

Increasing awareness of arthritis--the public's response.

Six hundred and fifty telephone calls in response to a television programme about arthritis have been analysed for their content. Social and psychological isolation, lack of pain control and fears of side effects from tablets were the main concerns of callers. It is suggested that disease-orientated telephone help lines should be considered, and that future initiatives in public education should target some of the concerns expressed in this survey.

Adolescent↗
PubMed2000

Rheumatology telephone helplines: an activity analysis. South and West of England Rheumatology Consortium.

BACKGROUND: Anecdotal evidence suggests that the services offered by rheumatology telephone helplines in the UK vary widely between NHS Trusts because of the lack of national or European guidelines. OBJECTIVE: To conduct an activity analysis of six NHS Trust rheumatology telephone helplines in the south and west of England. METHODS: Serial data were collected on the first 100 calls received on or after 1 January 1999 by six rheumatology helplines in the south and west of England. Background information was gathered on the management, availability, setting and purpose of each helpline. Data on the time taken to manage these calls and patient satisfaction were not collected. RESULTS: Patients with rheumatoid arthritis were the major users and no significant differences were found in the outcome of their calls between centres, but wide variations were revealed in the management of the helplines, the populations they serve and the services they offer. CONCLUSION: The rheumatology helpline services in six NHS Trusts in the south and west of England were shown to be the same in name only. They lacked uniformity in the delivery of care and accessibility to relevant patient groups. The geographical variation in service delivery may result in patient dissatisfaction and confusion if a number of hospitals are attended over the course of a patient's chronic disease. Further research is required to identify the helpline needs of the broader rheumatology population, patient satisfaction, outcomes and system costs, and to progress towards the development of national and European guidelines.

Aged↗
PubMed2003

It ain't over till it's over: the case for offering relapse-prevention interventions to former smokers.

Most people who attempt to quit tobacco smoking eventually relapse. Although treatment strategies have been developed to prevent smoking relapse, they tend to be available only to the small proportion of smokers who enroll in intensive smoking cessation treatments. It is argued that freestanding relapse-prevention interventions could be offered to persons who recently ceased smoking, whether they used a formal treatment program or quit on their own. A line of research is described demonstrating that a series of relapse-prevention booklets mailed to recent quitters significantly reduces smoking relapse. Moreover, the intervention seems to be highly cost-effective. If disseminated widely, such an approach has the potential to make a significant public health impact.

Clinical Trials as Topic↗
PubMed2003

Quitlines in North America: evidence base and applications.

Quitlines provide a model for the translation of research findings to public health application. Quitlines are currently in operation in more than half of US states, in Canada, and in multiple countries globally. Overall, when implemented correctly, quitlines have been shown to be efficacious and effective. Multiple quitline models are in use, but there is no evidence on the relative effectiveness of one over the other. Differences have been demonstrated for the efficacy of quitlines for specific applications, with the strongest evidence base for application as a primary intervention or as follow-up for hospitalized patients and particularly for cardiac patients. The evidence base for both reactive and proactive services is reviewed, and future directions to continue to advance the field are discussed.

Adolescent↗
PubMedDate not supplied

Linking people with traumatic brain injury to services: successes and challenges in Colorado.

People with traumatic brain injury (TBI)-related disability often need services and other types of support to return to productive lives; thus, improving access to available TBI services is a priority for a variety of states' agencies, such as Human Services and Public Health. Although infrastructure and resources vary from state to state, each can benefit by learning about how other states link people with TBI to services. In this report, we summarize Colorado's experience in exploring and developing better ways to link state residents with TBI to services. Recommendations for improving the system of linking people to services in Colorado included the following: (1) expanding the population targeted for linkage to services beyond those who are hospitalized; (2) improving access to information about available services; and (3) increasing the availability of services.

Brain Injuries↗
PubMed1994

Responses to telephone inquiries made to craniofacial treatment teams.

This report is a follow-up to an earlier research project concerning composition and function of self-identified teams listed in the ACP-CFA 1990 Membership-Team Directory. We address the types of responses provided by personnel answering telephones for teams listed in a recent Directory. Sixty of the 228 teams listed in the continental United States were randomly selected and divided into 2 groups of 30 each. One group was telephoned by an ACP-CFA member who is the parent of a patient with cleft palate; the other group was telephoned by a graduate student in speech-language pathology. Data indicate that Directory listing does not assure access to information pertinent to cleft lip, palate, and craniofacial anomalies; different type and manner of responses were made to the 2 callers; and inadequate information was often provided by the personnel who answer the telephones. Implications include the need for more training of personnel in responding to telephone inquiry and cautious use of the directory listings as a resource for referral.

Chi-Square Distribution↗
PubMedDate not supplied

Impact of a continuing education activity on the quality of telephone interventions by nurses in an adult asthma client base.

The objectives of this study were to evaluate the effect of a continuing education activity on the clinical evaluation and advice provided by nurses working for a telephone triage service with an asthmatic client base, and to measure the number of referrals to Asthma Education Centers (AECs). The results suggest a positive impact on the quality of the telephone intervention in the short term, but this was not sustained over time. Few patients were referred to an AEC.

Adult↗
PubMedDate not supplied

Meeting the need for public education about dementia.

Research continues to advance the knowledge of pathophysiology and development of effective methods for treating patients with Alzheimer disease and other dementias. Dissemination of information is likely to be slowest among the general population, who may be the first to recognize dementia symptoms but may also be reticent to discuss concerns because of fear, embarrassment, and/or inadequate knowledge. The feasibility of providing public education and access to dementia resources was studied using a toll-free interactive voice response (IVR) telephone system. Public interest in this service and willingness to use this technology were evaluated in a 1-month study conducted in a predominantly rural upper Midwest county (population of 102,565). One hundred ninety-three calls were received during November 1999, with an average length of 9 minutes and 29 seconds. One in six calls lasted 15 minutes or longer. One third of the calls were received outside typical business hours (8:00 AM to 6:00 PM). Concern for a parent or grandparent was the most frequent reason (50.6%) given for the call. Self-concern was indicated by 24.7% of the callers. Callers provided positive feedback. Such IVR technology may provide a cost-effective bridge to the "digital divide" existing among elderly, lower socioeconomic status, and rural populations underrepresented as computer and Internet users.

Aged↗