Preclinic telephone consultations: an observational cohort study

Abstract

-Patients referred to secondary care for specialist respiratory review frequently undergo multiple hospital attendances for investigations and consultations. This study evaluated the potential of a preclinic telephone consultation and subsequent coordination of tests and face-to-face consultations to reduce hospital visits. Total hospital attendances were recorded for three cohorts (participants, non-participants and comparators) for 6 months from first specialist contact. Patients completed the medical interview satisfaction scale-21 (MISS-21). The study showed that a preclinic telephone consultation can significantly reduce hospital visits over a fixed period without reducing patient satisfaction. In total, 20.8% of the participant group had three or more hospital attendances compared with 42.9% of the non-participant group (pϭ ϭ0.001) and 44.7% of the comparator group (pϭ ϭ0.002). Participants had fewer follow up visits and lower rates of non-attendance/late rearrangement of appointments. This service reduces unnecessary hospital visits, seems to improve patient compliance and may save costs associated with non-attendance and follow up consultations.

Green respiratory health care: Time for us all to act

“…A respiratory green task force might address methods by which we might reduce unnecessary travel to hospitals and more clinical follow‐up could and should be done by telephone, e‐mail, use of the internet or video calls . For example, taking the history from new patients before first face‐to‐face consultation in a respiratory medicine department has been shown to permit better requesting of investigations with a reduction in overall number of patient attendances at hospital . A new emphasis on motivating our patients, on shared decision‐making and supporting them better as they self‐manage their own condition would also reduce unnecessary travel and attendance at hospitals .…”

“…9 For example, taking the history from new patients before first face-to-face consultation in a respiratory medicine department has been shown to permit better requesting of investigations with a reduction in overall number of patient attendances at hospital. 10 A new emphasis on motivating our patients, on shared decision-making and supporting them better as they self-manage their own condition would also reduce unnecessary travel and attendance at hospitals. 11,12 Attention could also be focused on risk stratification strategies.…”

Teleophthalmology and COVID-19: the patient perspective

“…18,19 Although telephone consultations are more novel to the secondary care setting, they are serving this purpose just as well. 20,21 On the other hand, video consultations have the added benefit of conveying visual information. This allows remote examinations to be largely useful and credible, especially for new patients.…”

Telemedicine and virtual respiratory care in the era of COVID-19

“…Whilst historically less widely adopted in hospitals than primary care practice (until the pandemic mandated a move to remote consulting), observational studies have shown the potential utility of telephone consultations to replace follow-up consultations, [61,62] and also as a preliminary contact to streamline future hospital consultations. [63] A telephone call to take a history and arrange necessary investigations prior to the first respiratory outpatient attendance reduced the need for follow-up appointments. [63] Post-discharge telephone follow-up has been tried in a range of conditions (though not specifically respiratory), but whilst appreciated by patients, benefits in terms of reduced complications or readmissions have not been clearly demonstrated.…”