Nurse Telephone Research Articles

Nurse Telephone Support for Caregivers of Older Adults at Hospital Discharge

Informal caregivers who provide home-based care frequently experience stress and burden that adversely affect their health-related quality of life (HRQOL). To evaluate the efficacy of the Further Enabling Care at Home (FECH+) program for the HRQOL of caregivers of older adults discharged home from the hospital. This multicenter, parallel, 2-group randomized clinical trial, with blinded baseline and outcome measurements, was conducted at 3 hospitals in 2 states in Australia. Recruitment took place between August 2020 and July 2022, and follow-up was performed for 12 months after hospital discharge. Participants were dyads of caregivers and patients. Eligible caregivers were aged 18 years or older who provided informal home-based care at least weekly for a patient aged 70 years or older. Caregivers were enrolled when their patient was discharged from the hospital. Dyads were randomly assigned to either the intervention or control group. Data analysis followed an intention-to-treat approach. Caregivers in the intervention group received the FECH+ program, structured nurse support of 6 telephone calls over 6 months after the patient's discharge plus usual discharge care. Caregivers in the control group received usual care alone. Primary outcome was caregivers' HRQOL 6 months after discharge, which was measured using the Assessment of Quality of Life 8-Dimension (AQOL-8D). Secondary outcomes were caregivers' HRQOL 12 months after discharge as well as preparedness to care (measured using the Preparedness for Caregiving Scale), self-efficacy (measured using the Caregiver Inventory), and levels of strain and distress (measured using the Family Appraisal of Caregiving Questionnaire) at 6 and 12 months after discharge. Baseline and outcome measurements were administered by telephone at 3, 6, and 12 months after discharge. A total of 547 dyads (caregivers: 405 females [74.0%], mean [SD] age, 64.50 [12.82] years; patients: 296 females [54.1%], mean [SD] age, 83.16 [7.04] years for the intervention group and 83.45 [7.20] years for the control group) were included in the intention-to-treat analysis. There was no significant difference in caregivers' HRQOL between the 2 groups at the primary time point of 6 months (difference in AQOL-8D score, 0.01; 95% CI, -0.02 to 0.03; P = .62) after hospital discharge. In this randomized clinical trial, the FECH+ program-a nurse telephone support intervention for caregivers of older adults after hospital discharge-did not significantly improve caregivers' HRQOL at 6 months after discharge compared with usual care. Additional examination is warranted into improving caregivers' HRQOL at the time of their patient's hospital discharge. Australian New Zealand Clinical Trials Registry Identifier: ACTRN12620000060943.

Telemonitoring, Nurse Telephone Coaching Helpful in Post discharge Management of Patients with Heart Failure

According to this study: Noninvasive telemonitoring and nurse telephone coaching improved survival and days out of the hospital in patients who had heart failure and a high comorbidity burden.Patients with multiple other health problems may be the most likely to benefit from this approach.

Postdischarge Noninvasive Telemonitoring and Nurse Telephone Coaching Improve Outcomes in Heart Failure Patients With High Burden of Comorbidity

BackgroundNoninvasive telemonitoring and nurse telephone coaching (NTM–NTC) is a promising postdischarge strategy in heart failure (HF). Comorbid conditions and disease burden influence health outcomes in HF, but how comorbidity burden modulates the effectiveness of NTM–NTC is unknown. This study aims to identify patients with HF who may benefit from postdischarge NTM–NTC based on their burden of comorbidity. Methods and ResultsIn the Better Effectiveness After Transition - Heart Failure trial, patients hospitalized for acute decompensated HF were randomized to postdischarge NTM–NTC or usual care. In this secondary analysis of 1313 patients with complete data, comorbidity burden was assessed by scoring complication and coexisting diagnoses from index admissions. Clinical outcomes included 30-day and 180-day readmissions, mortality, days alive, and combined days alive and out of the hospital. Patients had a mean of 5.7 comorbidities and were stratified into low (0–2), moderate (3–8), and high comorbidity (≥9) subgroups. Increased comorbidity burden was associated with worse outcomes. NTM–NTC was not associated with readmission rates in any comorbidity subgroup. Among high comorbidity patients, NTM–NTC was associated with significantly lower mortality at 30 days (hazard ratio 0.25, 95% confidence interval 0.07–0.90) and 180 days (hazard ratio 0.51, 95% confidence interval 0.27–0.98), as well as more days alive (160.1 vs 140.3, P = .029) and days alive out of the hospital (152.0 vs 133.2, P = .044) compared with usual care. ConclusionsPostdischarge NTM–NTC improved survival among patients with HF with a high comorbidity burden. Comorbidity burden may be useful for identifying patients likely to benefit from this management strategy.

Towards reduction of preventable hospital readmission: Older people and family members' views on planned self-management of care at home.

To reduce the likelihood of preventable readmissions, the aim was to investigate how older people (with their family members) managed their chronic health conditions at home following hospital discharge. The objectives explored older people and their family members' perspectives on how discharge plans assisted self-management of their chronic conditions, their recognition of deterioration and when to seek treatment/re-attend hospital. Chronic conditions have challenged older adults' self-management, particularly after hospital discharge and can impact on preventable readmission. Few studies have examined patients' and their family members' perspectives on the management of their conditions at home after hospitalisation. A qualitative exploratory design known as Interpretive Description was utilised. Purposeful sampling involved 27 community-dwelling older adults; nineteen were discharged patients with one or more chronic health conditions. Eight nominated family members were also recruited to enhance understanding of the older persons' self-management at home. Interviews were undertaken and thematic data analysis followed the COREQ guidelines. Five themes emerged: (1) Post-Discharge Advice; (2) Managing at Home; (3) Recognition and Response to Deterioration; (4) Community Care and Support; and (5) The "Burden" on Others of Post-Discharge Care. Older people sought a clear plan for self-management at home prior to discharge. This plan should contain potential signs of deterioration and guidance on future action. We found that support given to older people from family and friends was critical to prevent readmission. In addition, their local General Practitioner and Pharmacist played an essential part in the support of their care. For some, social support services were also important. Nurse telephone follow-up in the week following discharge was mostly absent. However, this strategy would be strongly recommended. To mitigate against preventable readmission, we recommend the above strategies to assist the older person at home with self-management of their chronic conditions.

The Effect of Nurse Telephone Consultation After Coronary Artery Bypass on the Autonomy Level of Elderly Patients: A Quasi-Experimental Study

The Effect of Nurse Telephone Consultation After Coronary Artery Bypass on the Autonomy Level of Elderly Patients: A Quasi-Experimental Study

Effectiveness of a nurse-led telephone follow-up in the therapeutic management of patients receiving oral antineoplastic agents: a randomized, multicenter controlled trial (ETICCO study).

The use of oral cancer drugs (OAD) has increased over the last two decades. The objective of this study was to measure the impact of a nurse-led telephone follow-up in the therapeutic management of patients treated with an OAD regarding toxicity, medication adherence and quality of life. A randomized, multicenter, controlled trial was conducted. All consecutive over 18-year-old patients, treated in medical oncology, radiotherapy, or hematology departments, receiving OAD for any cancer were invited to participate to the study. A total of 183 patients treated for solid or hematological cancers with an OAD were randomly assigned to receive a nurse-led telephone follow-up or standard care for 24 weeks. Data were collected between 2015 and 2018. Nurse telephone follow-up did not improve the global score toxicity in the intervention group. However, telephone calls directed by trained nurses induced a significant decrease in number of patients with grade 3 adverse events throughout the follow-up [OR 0.45 (IC à 95%) (0.23, 0.9)](P = 0.03). There was no significant difference in quality of life and medication adherence between groups at any follow-up time point. In this first French real-life study, the advice provided by qualified nurses via phone calls improved the management of grade 3 toxicities but failed to demonstrate an improvement of all grades of toxicities. More prospective studies are needed to confirm the impact of telephone calls on the toxicities related to OAD. Clinical trial registration is NCT02459483. Protection committee SUD-ESTI registration is 2015-A00527-42 on 13 April 2015. National Agency for the Safety of Medicines and Health Products registration is 150619-B on the 27 may 2015.

CN42 Nurse and pharmacist-delivered gynaecology telephone clinic: Maintenance therapies patient and staff survey

CN42 Nurse and pharmacist-delivered gynaecology telephone clinic: Maintenance therapies patient and staff survey

MP27-20 CAN A SIMPLE PHONE CALL IMPROVE POST-URETEROSCOPY OUTCOMES IN PATIENTS WITH PSYCHIATRIC DISEASE? 6.3.6

INTRODUCTION AND OBJECTIVE: A recent publication from our institution demonstrated that among the 12.6% of patients that return to the emergency department (ED) within 30 days of ureteroscopy (URS) for stone disease, approximately 60% have a history of psychiatric disease (PD). Small-scale quality improvement studies have suggested that postoperative nursing telephone calls reduce unplanned care encounters after URS for all patients. We sought to determine if a postoperative phone call by a urology nurse targeted to this high-risk group would reduce the rate of post-URS ED returns. METHODS: PD was defined as having a DSM-5 psychiatric diagnosis, a prescription for a psychoactive medication, or documentation by a clinician regarding the diagnosis and management of either. Our cohort was identified by prospectively screening the medical record of all patients undergoing URS for stone disease between August 2018 and August 2019. Patients with a history of chronic pain syndromes or substance abuse were excluded. Patients who met inclusion criteria were called by urology triage nurses between postoperative days 1-4. Nurses reviewed a standardized script with the patient and then used a templated form to document information regarding symptomatology and medication usage. Information regarding ED presentation was obtained by chart review, and outcomes were compared with our previously published retrospective population. RESULTS: At 12-months follow-up, 42% of 360 patients undergoing URS were identified as having PD. The overall 30-day ED return rate following URS for stone disease was 10.8%, and 56% of the patients who returned had PD. PD patients had an ED return rate of 14.4% (previously 16.7%), and 56% of these visits resulted in admission (previously 36%). The proportion of PD patients returning to the ED with a chief complaint of pain was 32%, whereas previously it was 46%. CONCLUSIONS: PD is a risk factor for post-op ED presentation and is prevalent in patients undergoing URS. Our findings demonstrate that phone calls targeted to these patients may lead to a reduction in 30-day ED returns for reasons that do not require admission, such as pain. Compared with our published retrospective data, the findings of this study reflected an overall reduction in ED returns for PD patients following initiation of postoperative phone calls. Source of Funding: NA

The Effect of Case Management on Improving the Quality of Life of Breast Cancer Patients in Chemotherapy

Objective: The study attempts to explore the effect of case management on improving the quality of life of breast cancer patients in chemotherapy. Methods: We selected 138 patients who were pathologically diagnosed with breast cancer and were receiving chemotherapy in our department, and averagely divided them into control group and observation group. The control group was given usual nursing care and telephone follow-up after discharge while in the observation group, case management model was employed besides the intervention the control group received. After that, we observed the quality of life and the total incidence of adverse reactions (myelosuppression, gastrointestinal discomfort, skin reaction, allergic reaction, infusion tube related complications, etc.) of the two groups. We used the quality of life questionnaire made by the European Organization for Research and Treatment of Cancer (EORCTQLQ-C30) to evaluate the quality of life of the two groups and compared that between the two groups before and after intervention. Results: During chemotherapy, the score on somatic function, role function, emotional function, social function, cognitive function and general health of the observation group was higher than that of the control group (P<0.05). Besides, the total incidence of adverse reactions of the observation group (30.43%) was significantly lower than that of the control group (53.62%) (χ2=7.614, P=0.000). Conclusions: Case management for breast cancer patients in chemotherapy can reduce adverse reactions caused by chemotherapy and increase treatment compliance so as to improve the quality of life of patients.

Nurse Telephone Counseling Services as a "Gatekeeper" in an Internet-Based Digital Doctor Reception: A Mixed Questionnaire Survey.

Objective: A large number of different types of digital innovations for health and medical care have been developed in Sweden under the concept of eHealth. Employees’ interest is of great importance in determining the success of different new digital interventions and technologies. Purpose: In this study, we aimed to elucidate the nurses’ experiences as a first “gatekeeper” in an Internet-based Digital Doctor Reception (DDR) concept. Methods: Our 16 informants were recruited among nurses who participated in a DDR pilot project that was completed in April 2019. A mixed questionnaire survey was used to elucidate the nurses’ experiences of collaboration & challenges, technical functionality, and DDR as an activity. The results were descriptively summarized with index values (IVs, 0-1.0), supplemented with a 10-point Likert-type scale that estimated satisfaction and views regarding personal experiences. Results: Collaboration and challenges were experienced as fairly good (IV, 0.58), and technical functionality was experienced as good (IV, 0.80). The experience of DDR as an activity was described positively with an IV of 0.75. The overall experience of the concept (IV, 0.68), corresponds well to the median satisfaction value of 6.5 (interquartile range, 6-9). Content analysis identified 2 main categories: “Facilitators in using DDR experienced by nurses” and “Barriers in using DDR experienced by nurses.” Nurses generally felt positive about participating in the development of an eHealth service. However, they suggested that DDR triaging should take place at the health care center level. The nurses also observed that certain patient groups were excluded from the DDR concept, and sometimes experienced this new way of triaging as less challenging. Conclusion: The informants in our study generally described satisfaction and an overall good experience with the DDR concept. However, some informants felt that the concept was sometimes more stressful and less challenging compared with normal working methods.

Nurse telephone education for promoting a treat-to-target approach in recently diagnosed rheumatoid arthritis patients: A pilot project.

The aim of the present study was to implement a nurse telephone education programme for patients with recently diagnosed rheumatoid arthritis (RA) that promotes shared decision-making and a treat-to-target approach. This was a pilot project of newly diagnosed adult RA patients conducted between November 2015 and December 2016. A rheumatology clinic nurse telephoned patients to offer disease education. A toolkit was mailed to patients. Measures included call attempts, call time, a qualitative description of free-text notes and the proportion of patients who adhered to their next clinic visit. Data were analysed descriptively and qualitatively. Twenty-six patients participated in the nurse calls. Most patients were female (65%), with a median age of 54years (range 22-78years). Median call length was 14.5min, with a range of 8-23min. Qualitative notes indicated that patients overwhelmingly supported the nurse calls. Nineteen patients (73%) were adherent to their follow-up visit. This preliminary project successfully implemented an educational programme that included a nurse-facilitated, RA-specific, telephone call and toolkit. This educational programme could be a model for similar educational efforts by other clinics.

Transitional care interventions reduce unplanned hospital readmissions in high-risk older adults

BackgroundAcute hospital services account for the largest proportion of health care system budgets, and older adults are the most frequent users. As a result, older people who have been recently discharged from hospital may be at greater risk of readmission. This study aims to evaluate the comparative effectiveness of transitional care interventions on unplanned hospital readmissions within 28 days, 12 weeks and 24 weeks following hospital discharge.MethodThe present study was a randomised controlled trial (ACTRN12608000202369). The trial involved 222 participants who were recruited from medical wards in two metropolitan hospitals in Australia. Participants were eligible for inclusion if they were aged 65 years and over, admitted with a medical diagnosis and had at least one risk factor for readmission. Participants were randomised to one of four groups: standard care, exercise program only, Nurse Home visit and Telephone follow-up (N-HaT), or Exercise program and Nurse Home visit and Telephone follow-up (ExN-HaT). Socio-demographics, health and functional ability were assessed at baseline, 28 days, 12 weeks and 24 weeks. The primary outcome measure was unplanned hospital readmission which was defined as any hospital admission for an unforeseen or unplanned cause.ResultsParticipants in the ExN-HaT or the N-HaT groups were 3.6 times and 2.6 times respectively significantly less likely to have an unplanned readmission 28 days following discharge (ExN-HaT group HR 0.28, 95% CI 0.09–0.87, p = 0.029; N-HaT group HR 0.38, 95% CI 0.13–1.07, p = 0.067). Participants in the ExN-HaT or the N-HaT groups were 2.13 and 2.63 times respectively less likely to have an unplanned readmission in the 12 weeks after discharge (ExN-HaT group HR 0.47, 95% CI 0.23–0.97, p = 0.014; N-HaT group HR 0.38, 95% CI 0.18–0.82, p = 0.040). At 24 weeks after discharge, there were no significant differences between groups.ConclusionMultifaceted transitional care interventions across hospital and community settings are beneficial, with lower hospital readmission rates observed in those receiving more transitional intervention components, although only in first 12 weeks.Trial registrationAustralian and New Zealand Clinical Trial Registry (ACTRN12608000202369).

Estimating Weekly Call Volume to a National Nurse Telephone Triage Line in an Influenza Pandemic.

Telephone nurse triage lines, such as the Centers for Disease Control and Prevention's (CDC) Flu on Call®, a national nurse triage line, may help reduce the surge in demand for health care during an influenza pandemic by triaging callers, providing advice about clinical care and information about the pandemic, and providing access to prescription antiviral medication. We developed a Call Volume Projection Tool to estimate national call volume to Flu on Call® during an influenza pandemic. The tool incorporates 2 influenza clinical attack rates (20% and 30%), 4 different levels of pandemic severity, and different initial "seed numbers" of cases (10 or 100), and it allows variation in which week the nurse triage line opens. The tool calculates call volume by using call-to-hospitalization ratios based on pandemic severity. We derived data on nurse triage line calls and call-to-hospitalization ratios from experience with the 2009 Minnesota FluLine nurse triage line. Assuming a 20% clinical attack rate and a case hospitalization rate of 0.8% to 1.5% (1968-like pandemic severity), we estimated the nationwide number of calls during the peak week of the pandemic to range from 1,551,882 to 3,523,902. Assuming a more severe 1957-like pandemic (case hospitalization rate = 1.5% to 3.0%), the national number of calls during the peak week of the pandemic ranged from 2,909,778 to 7,047,804. These results will aid in planning and developing nurse triage lines at both the national and state levels for use during a future influenza pandemic.

Continuing nursing of tuberculosis in China: a bibliometric analysis

Objective To investigate the current status and problems of continuing nursing of tuberculosis in China based on bibliometric analysis. Methods Literatures related to continuing care of tuberculosis published before 2017 were searched according to CNKI and Wanfang database. The NoteExpress software was used to decrease ridding unbalance. A database was established in Excel to analyse the annual number of published papers, authors' regions and institutions, the source of journals, citation, funding, and research contents. Results A total of 81 periodical literatures were included in this study. Articles regarding tuberculosis continuing care were firstly published in 2008 and increasingly published after 2011. The first authors came from 19 provinces, 2 municipality cities and 3 autonomous regions. Approximately 80.2% of the published papers were contributed from comprehensive hospitals. The top four periodicals with good published article volume included: Journal of Qilu Nursing, International Journal of Nursing, China Healthcare & Nutrition, Chinese Journal of Modern Nursing. Approximately 92.6% of the published papers had been cited less than 10 times. Only 8.6% studies were fund programs. Most of the studies were experimental and quasi-experimental studies. The evaluation parameters of clinical experiments were mainly compliance and functional indexes. The continuing nursing intervention included telephone follow-up, online information platforms, outpatient follow-up, and home visits. Conclusions Published literatures on continuing care of tuberculosis is widely increased in recent years. However, the problems such as unbalanced source distribution, limited citation, inadequate funding, and low quality of study design and methods need further development. Furthermore, the connection between hospital and community service should be enhanced to promote the hospital-community-family service mode. Key words: Bibliometrics; Tuberculosis; Continuing nursing

Cost-Effectiveness Analysis in Telehealth: A Comparison between Home Telemonitoring, Nurse Telephone Support, and Usual Care in Chronic Heart Failure Management

ObjectivesTo assess the cost effectiveness of home telemonitoring (HTM) and nurse telephone support (NTS) compared with usual care (UC) in the management of patients with chronic heart failure, from a third-party payer’s perspective. MethodsWe developed a Markov model with a 20-year time horizon to analyze the cost effectiveness using the original study (Trans-European Network–Home-Care Management System) and various data sources. A probabilistic sensitivity analysis was performed to assess the decision uncertainty in our model. ResultsIn the original scenario (which concerned the cost inputs at the time of the original study), HTM and NTS interventions yielded a difference in quality-adjusted life-years (QALYs) gained compared with UC: 2.93 and 3.07, respectively, versus 1.91. An incremental net monetary benefit analysis showed €7,697 and €13,589 in HTM and NTS versus UC at a willingness-to-pay (WTP) threshold of €20,000, and €69,100 and €83,100 at a WTP threshold of €80,000, respectively. The incremental cost-effectiveness ratios were €12,479 for HTM versus UC and €8,270 for NTS versus UC. The current scenario (including telenurse cost inputs in NTS) yielded results that were slightly different from those for the original scenario, when comparing all New York Heart Association (NYHA) classes of severity. NTS dominated HTM, compared with UC, in all NYHA classes except NYHA IV. ConclusionsThis modeling study demonstrated that HTM and NTS are viable solutions to support patients with chronic heart failure. NTS is cost-effective in comparison with UC at a WTP of €9000/QALY or higher. Like NTS, HTM improves the survival of patients in all NYHA classes and is cost-effective in comparison with UC at a WTP of €14,000/QALY or higher.

Therapeutic Effects of Nurse Telephone Follow-up for Lung Cancer Patients in Turkey.

Patients with lung cancer can encounter many difficulties as they adjust to the side effects of chemotherapy treatments. The aim of this study is to determine the therapeutic effects of nurse telephone follow-up for lung cancer patients. In this quasi-experimental study, the sample consisted of 60 patients with lung cancer assigned to an intervention group (n = 30) and a control group (n = 30). The control group participants were sequentially enrolled first and then the intervention group participants were enrolled. The data were collected using the Patient Information Form, Eastern Cooperative Oncology Group Performance Status, the Edmonton Symptom Assessment Scale, and the Functional Living Index-Cancer. The Nursing Care Guide was created by the nurse researchers' team and given to both the intervention and control groups. Telephone follow-up calls were conducted with intervention patients within the first week after their chemotherapy session. The Kolmogorov-Smirnov, Pearson χ, Fisher exact, Mann-Whitney U, and Friedman test and descriptive statistics were used to evaluate the data. Patients in the intervention group demonstrated significantly better adjustment to the symptoms secondary to chemotherapy and higher social functioning quality of life scores compared with reported scores in the control group. Nurse telephone follow-up can reduce chemotherapy-related symptoms for lung cancer patients and improve participants' social functioning. Nurse telephone follow-up is an acceptable and feasible form of patient contact and is a convenient and efficient way to offer patients the support and continuity of care they need.

Specialised Nursing-based Transitional Care in Elderly Patients with Chronic Diseases

The purpose of this study is to explore the influence of transitional care by specialty nurses (SN) for elderly patients with dementia. A total of 104 patients with dementia suffering from various diseases of the elderly were invited to participate in this research project in the Department of Internal Medicine in Shenzhen People's hospital from September 2015 to February 2016. Using purposive sampling, the patients were assigned into two groups: the control group and the observation group. Patients in both groups were evaluated before discharge. Patients in the control group were given only routine nursing care and telephone follow-up in the first month after discharge. Patients in the observation group were given transitional care on the top of the usual care offered. The unscheduled readmission rate, compliance behavior and incidence of complications for those discharged with tubes after discharge were compared between the groups. The results showed that the unscheduled readmission rate of patients in the observation group decreased, compliance behavior improved and the incidence of complications for those discharged with indwelling catheters (IDC) was reduced. There were statistically significant differences in data between the groups. Transitional care led by specialized nurses can lower the readmission rate, reduce complications, and improve compliance behavior, which results in a quick recovery for patients after discharge.

Results of Postdischarge Nursing Telephone Assessments: Persistent Symptoms Common Among Pulmonary Resection Patients

After hospital discharge, patients may have questions or complaints that surface or remain inadequately addressed. However, the dominant concerns and indications for further intervention among recently discharged patients after pulmonary resection have not been well described. The aims of this study were to characterize dominant concerns of pulmonary resection patients after discharge and to elucidate any relevant risk factors for their development. A single-institution, retrospective review was conducted of all patients who underwent pulmonary resection over a 12-month period and included records of standardized, nurse-initiated follow-up phone calls to discharged patients. Records of postdischarge telephone calls were reviewed, and data collected pertaining to complaints requiring counseling over the phone or escalation to higher care level. Demographic, operative, and hospital data were examined by multivariate analyses to assess predictors of need for counseling or escalation of care. In all, 523 patients underwent pulmonary resection during the study, and 245 (46.8%) had nursing-documented telephone conversations at 4.6 days (±0.18) days after discharge. Among those reached, 81 (33.1%) had problems requiring counseling during the call; 31 (12.7%) reported concerns requiring escalation of care, handled by subsequent telephone call for 7 (22.6%), clinic appointment for 22 (71.0%), oremergency room referral for 2 (6.5%). Age, sex, race,and residential proximity to the hospital did not predict need for counseling nor escalation of care. Patient complaints after pulmonary resection were frequent, with most problems resolved by telephone counseling. Despite highly prevalent concerns, predictors of need for counseling or care escalation were not identified, suggesting ongoing utilityin the practice of telephoning all patients. Further, this study serves as a needs assessment, highlightingthe importance of patient education and discharge planning.

The Cost-Effectiveness Analysis of Philips Motiva Telehealth System: A Comparison Between Home Telemonitoring, Nurse Telephone Support And Usual Care In Chronic Heart Failure

markdownabstractObjectives The clinical effectiveness of Motiva Monitor platform was established in the previous study (TEN-HMS). Patients randomly assigned to receive Usual Care had higher one year mortality (45%) than patients assigned to receive Nurse Telephone Support (27%) or Home Telemonitoring (29%) (p=0.032). Our intention is to provide insights in the cost-effectiveness of Motiva telehealth system by modeling the intervention and running the analysis on top of the reported data. Methods Effectiveness was established by mining the EuroQol-5D from the original database, while the information on costs came from the literature and the manufacturer of the equipment. Direct healthcare costs considered ER visits, GP, Specialist, Hospitalist and Nurse time and resources utilization. The induced (indirect) costs were not considered in the analysis. The approximation of the cost of medical consumption came from the Netherlands only, although the original study was run in three European countries. We assumed the payer perspective for our analysis. Results The results clearly show, within the parameters of our model, the increased effectiveness of Home Telemonitoring and Nurse Telephone Support in comparison to the Usual Care. The deterministic results show ICERs of € 14.842 and € 12.547 per QALY (discounted at 1.5% a year) for HTM and NTS respectfully. Probabilistic results show that NTS was the most effective strategy in health systems that pay more than €12.500 per QALY. In the subgroup analysis HTM dominated both NTS and UC at the threshold of €16.500 in NYHA IV group of Chronic Heart Failure patients. Conclusions Home telemonitoring by Motiva Monitor system reduces mortality and lowers the in-hospital length of stay. On the quality of life dimensions, Home Telemonitoring was similarly effective as the Nurse Telephone Support, but with more costs. The cost-effectiveness analysis shows that both NTS and HTM dominate the Usual Care at WTP of €15.000.

Nurse telephone support at home during chemotherapy

An innovative scheme has been operational since 2013 at the Institut Claudius Regaud in Toulouse, aimed at patients undergoing chemotherapy. After an initial consultation, patients receive regular telephone support at home from expert nurses between treatments. The scheme helps to improve patient management and reinforce the community-hospital link.