Implementation of podiatry telephone appointments for people with rheumatic and musculoskeletal diseases

J L Palmer,B Alcacer‐Pitarch,H J Siddle,A C Redmond

doi:10.1186/s13047-020-00441-9

Abstract

BackgroundFoot health problems are common in the general population, and particularly so in people with rheumatic and musculoskeletal disorders (RMD). Several clinical guidelines state that people with RMDs should have access to foot health services, although service capacity is often limited. The current COVID-19 pandemic has increased the need for alternative ways to provide patient care. The aim of this clinical audit was to review a newly implemented telephone follow-up appointment service conducted within the Rheumatology Podiatry Department in Leeds, UK.MethodsFifty-eight patients attending the Rheumatology Podiatry Department at Leeds Teaching Hospitals NHS Trust were contacted by telephone approximately 6–8 weeks following initial intervention. During the telephone consultation, all patients were asked pre-defined questions relating to their symptoms, intervention efficacy, the need for further appointments and their preference for the type of consultation. To assess the cost of the telephone consultation the number of attempts needed in order to make successful contact, the duration of the call and the number of telephone follow-up appointments completed in a working day were also recorded.ResultsTwenty-five patients (43%) were successfully contacted within the 6–8 weeks stipulated time frame and were included in the analysis. Of the 25 contacted, twelve (48%) patients were successfully contacted on the first attempt. Ten (40%) were successfully contacted on the second attempt. The remaining three patients (12%) required 3 or more attempts to make successful contact. Telephone consultations were estimated not to last longer than 10 min, including notes screening and documentation. Eleven patients (44%) reported an improvement in their symptoms, thirteen (52%) reported no change and one patient (4%) reported their symptoms to be worse.ConclusionTelephone follow-up consultations may be a potentially cost-effective alternative to face-to-face appointments when implemented in a Rheumatology Podiatry Department, and provide an alternative way of providing care, especially when capacity for face-to-face contact is limited. The potential cost saving and efficiency benefits of this service are likely to be enhanced when telephone consultations are pre-arranged with patients.

Highlights

Foot health problems are common in the general population, and so in people with rheumatic and musculoskeletal disorders (RMD)
High rates of disabling foot pain are seen in people with osteoarthritis (9.6%) and systemic sclerosis (67%) [5, 6]
In the United Kingdom (UK) there are generic and disease specific national and local guidelines recommending that people with RMDs and foot problems should have access to foot health services, including the Arthritis and Musculoskeletal Alliance (ARMA) and the UK Podiatry Rheumatic Care Association (PRCA) Standards of Care for People with Musculoskeletal Health Problems [7, 8]

Summary

Introduction

Foot health problems are common in the general population, and so in people with rheumatic and musculoskeletal disorders (RMD). In the UK there are generic and disease specific national and local guidelines recommending that people with RMDs and foot problems should have access to foot health services, including the Arthritis and Musculoskeletal Alliance (ARMA) and the UK Podiatry Rheumatic Care Association (PRCA) Standards of Care for People with Musculoskeletal Health Problems [7, 8]. The recommended telephone service aims to provide patients with timely access to advice related to their care as well as part of an ongoing assessment process, while minimising hospital visits These local guidelines are in-keeping with NICE guidance which states that people with RA should have the opportunity for review appointments that suit their individual needs [9]

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Discussion

Conclusion