BackgroundEvidence for the use of telephone consultation in childhood inflammatory bowel disease (IBD) is lacking. We aimed to assess the effectiveness and cost consequences of telephone consultation compared with the usual out-patient face-to-face consultation for young people with IBD.MethodsWe conducted a randomised-controlled trial in Manchester, UK, between July 12, 2010 and June 30, 2013. Young people (aged 8–16 years) with IBD were randomized to receive telephone consultation or face-to-face consultation for 24 months. The primary outcome measure was the paediatric IBD-specific IMPACT quality of life (QOL) score at 12 months. Secondary outcome measures included patient satisfaction with consultations, disease course, anthropometric measures, proportion of consultations attended, duration of consultations, and costs to the UK National Health Service (NHS). Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02319798.FindingsEighty six patients were randomised to receive either telephone consultation (n = 44) or face-to-face consultation (n = 42). Baseline characteristics of the two groups were well balanced. At 12 months, there was no evidence of difference in QOL scores (estimated treatment effect in favour of the telephone consultation group was 5.7 points, 95% CI − 2.9 to 14.3; p = 0.19). Mean consultation times were 9.8 min (IQR 8 to 12.3) for telephone consultation, and 14.3 min (11.6 to 17.0) for face-to-face consultation with an estimated reduction (95% CI) of 4.3 (2.8 to 5.7) min in consultation times (p < 0.001). Telephone consultation had a mean cost of UK£35.41 per patient consultation compared with £51.12 for face-face consultation, difference £15.71 (95% CI 11.8–19.6; P < 0.001).InterpretationWe found no suggestion of inferiority of telephone consultation compared with face-to-face consultation with regard to improvements in QOL scores, and telephone consultation reduced consultation time and NHS costs. Telephone consultation is a cost-effective alternative to face-to-face consultation for the routine outpatient follow-up of children and adolescents with IBD.FundingResearch for Patient Benefit Programme, UK National Institute for Health Research.

SUMMARY Aims:To explore patients' and staffs' perceptions of a pilot service which dispatched a nurse and paramedic to low-priority ambulance calls. Methods.Patients' opinions of both pilot and standard service groups were obtained through qualitative questionnaire data and individual interviews. Staffs' perceptions were explored via two focus groups. Study participants.Questionnaires were sent to a convenience sample of 128 patients attended by the pilot service and 128 patients receiving the standard service. Initially 19 questionnaire participants agreed to be interviewed.Focus group participants (n=11) included nurses and paramedics involved in the pilot service.

Injury sustained through falling is a significant risk for the elderly and a significant burden on the health service.

Purpose Despite the importance of pharmaceutical products in everyday life, particularly after the coronavirus outbreak in early 2020, only a few studies have attempted to analyse consumer behaviour with regard to halal pharmaceutical products. Therefore, this study aims to investigate the factors influencing purchase intention for halal pharmaceutical products among Indonesian Muslims. Design/methodology/approach This study uses a theory of planned behaviour approach, in which religiosity and knowledge of halal product variables are added to attitude, subjective norms and perceived behavioural control variables. Primary data were collected from 225 Indonesian Muslims in Jakarta, the capital city of Indonesia and analysed using structural equation modelling. Findings The study found that the intention to purchase halal pharmaceutical products is positively affected by attitude, religiosity, knowledge of halal products and perceived behavioural control. However, the influence of the subjective norm variable was found to be insignificant in this study. Research limitations/implications It is possible to improve the empirical model by including more explanatory variables and investigating the mediating effect of the variables. The study could also be scaled up to reach more respondents in different regions and countries. These additional aspects would provide better insights into the behaviour of consumers when considering halal pharmaceutical products. Practical implications The findings suggest the importance of designing and implementing appropriate strategies and campaigns to enhance knowledge of halal products, of positive attitudes and of better resources/opportunities to consume halal pharmaceutical products. The industry needs to highlight its products’ halal and tayyib aspects through proper branding and promotion strategies. The government and other stakeholders could also implement education campaigns to increase halal products and halal literacy knowledge. These are ultimately expected to enhance the effectiveness of halal regulations and meet Muslim consumer expectations in the country. Originality/value Despite the importance of halal pharmaceutical products, this area has received limited attention in the academic literature. Thus, this study attempts to elaborate on consumer behaviour in this niche area.

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