Feasibility Of Telephone Follow-up Research Articles

Commentary: No-test medication abortion: A sample protocol for increasing access during a pandemic and beyond

Author(s): Raymond, Elizabeth; Grossman, Daniel; Mark, Alice; Upadhyay, Ushma; Dean, Gillian; Creinin, Mitchell; Coplon, Leah; Perritt, Jamila; Atrio, Jessica; Taylor, DeShawn; Gold, Marji | Abstract: No abstract

Value and Feasibility of Telephone Follow-Up in Ethiopian Surgical Patients.

Background: Surgical site infections (SSIs) represent a major cause of morbidity and mortality in Ethiopia. Lack of post-discharge follow-up, including identification of SSIs, is a barrier to continued patient care, often because of financial and travel constraints. As part of a surgical quality improvement initiative, we aimed to assess patient outcomes at 30 days post-operative with a telephone call. Patients and Methods: We conducted mobile telephone follow-up as part of Lifebox's ongoing Clean Cut program, which aims to improve compliance with intra-operative infection prevention standards. One urban tertiary referral hospital and one rural district general hospital in Ethiopia were included in this phase of the study; hospital nursing staff called patients at 30 days post-operative inquiring about signs of SSIs, health-care-seeking behavior, and treatments provided if patients had any healthcare encounters since discharge. Results: A total of 701 patients were included; overall 77% of patients were reached by telephone call after discharge. The rural study site reached 362 patients (87%) by telephone; the urban site reached 176 patients (62%) (p < 0.001). Of the 39 SSIs identified, 19 (49%) were captured as outpatient during the telephone follow-up (p < 0.001); 22 (34%) of all complications were captured following discharge (p < 0.001). Telephone follow-up improved from 65%-78% in the first half of project implementation to 77%-89% in the second half of project implementation. Conclusion: Telephone follow-up after surgery in Ethiopia is feasible and valuable, and identified nearly half of all SSIs and one-third of total complications in our cohort. Follow-up improved over the course of the program, likely indicating a learning curve that, once overcome, is a more accurate marker of its practicability. Given the increasing use of mobile telephones in Ethiopia and ease of implementation, this model could be practical in other low-resource surgical settings.

Feasibility of Telephone Follow-Up after Critical Care Discharge.

Background: Critical care has evolved from a primary focus on short-term survival, with greater attention being placed on longer-term health care outcomes. It is not known how best to implement follow-up after critical care discharge. Study aims were to (1) assess the uptake and feasibility of telephone follow-up after a critical care stay and (2) profile overall physical status and recovery during the sub-acute recovery period using a telephone follow-up assessment. Methods: Adults who had been admitted to critical care units of St. James’s Hospital, Dublin, for >72 h were followed up by telephone 3–9 months post discharge from critical care. The telephone assessment consisted of a battery of questionnaires (including the SF-36 questionnaire and the Clinical Frailty Scale) and examined quality of life, frailty, employment status, and feasibility of telephone follow-up. Results: Sixty five percent (n = 91) of eligible participants were reachable by telephone. Of these, 80% (n = 73) participated in data collection. Only 7% (n = 5) expressed a preference for face-to-face hospital-based follow-up as opposed to telephone follow-up. For the SF-36, scores were lower in a number of physical health domains as compared to population norms. Frailty increased in 43.2% (n = 32) of participants compared to pre-admission status. Two-thirds (n = 48) reported being >70% physically recovered. Conclusion: Results showed that telephone follow-up is a useful contact method for a typically hard-to-reach population. Deficits in physical health and frailty were noted in the sub-acute period after discharge from critical care.

Feasibility of telephone follow-up after medical abortion

Background This study was conducted to assess the feasibility of using telephone calls combined with high-sensitivity urine pregnancy testing as a primary method of follow-up after medical abortion. Methods We enrolled 139 women up to 63 days of gestation to receive mifepristone 200 mg orally and misoprostol 800 mcg vaginally or buccally, per their choice. Participants were contacted by phone one week after mifepristone administration and interviewed using standardized questions. If the subject or clinician thought the pregnancy was not expelled, the subject returned for an ultrasound examination. Otherwise, subjects performed high-sensitivity home urine pregnancy testing 30 days after the mifepristone and were called within 3 days of the test. Those with positive pregnancy tests returned for an ultrasound examination. Those with negative tests required no further follow-up. Results Six of the 139 (4.3%, 95% CI 1.6–9.1%) subjects presented prior to Phone Call 1 for an in-person visit. All 133 (100%, 95% CI 97.8–100%) subjects eligible for their first telephone follow-up were contacted. Eight of the 133 (6.1%, 95% CI 2.6–11.5%) women were asked to return for evaluation and all did so (100%, 95% CI 63.1–100%). Eight of the 133 women eligible for the 30 day phone call presented for an interim visit prior to the call. After 30 days, 116 of the 117 (99.1%, 95% CI 97.5–100%) eligible subjects were contacted. One subject was not reached for the day 30 phone call. Twenty-seven of the 116 (23.3%, 95% CI 15.6–31.0%) subjects had a positive pregnancy test and required follow-up. Two of these subjects (7.4%, 95% CI 1.0–24.2%) did not return for in-person follow-up. Two of the 116 (1.7%, 95% CI 0.2–6.1%) subjects had inconclusive pregnancy tests and were asked to return for follow-up. One of these subjects (50%, 95% CI 1.2–98.7%) did not return. Complete follow-up was achieved in 135 of the 139 subjects (97.1%, 95% CI 94.3–99.9%). None of the 26 women evaluated for a positive or inconclusive pregnancy test had a gestational sac or continuing pregnancy. Conclusion Telephone follow-up combined with urine pregnancy testing after medical abortion is a feasible alternative to routine ultrasonography or serial serum hCG measurements.

The feasibility of telephone follow-up after medical abortion

The feasibility of telephone follow-up after medical abortion