Telephone Clinic Research Articles

The utility of digital rectal examination after radical radiotherapy for prostate cancer

The aim of the current study was to determine the utility of routine digital rectal examination (DRE) after radical radiotherapy for prostate cancer. Between 1990 and 1999, 899 patients with clinically localised prostatic adenocarcinoma (T1-4, N0/Nx, M0/Mx) underwent neoadjuvant androgen deprivation and radical radiotherapy at the Royal Marsden Hospital. Patients were followed with serum prostate-specific antigen (PSA) test and DRE carried out at 6-monthly intervals for the first 2 years, and then annually. At a median follow-up of 5 years, 39 out of 899 cases (4.3%) had local recurrence detected on DRE. DRE failed to detect any local recurrences in the absence of a rising PSA. The lowest serum PSA concentration at the time of clinically detectable local recurrence was 1.7 ng/ml. These findings question the standard model of follow-up after radiotherapy for prostate cancer, and suggest that alternatives, such as telephone clinics, should be considered.

28. Adjunctive lithium and a follow-up telephone clinic: the benefits for patients receiving RAI for thyrotoxicosis

s of the 31st Annual Meeting of the British Nuclear Medicine Society, Manchester, UK, 29 April to 1 May 2003 - THYROID/PARATHYROID

Randomized controlled trial comparing couple satisfaction with appointment and telephone follow-up consultation after unsuccessful IVF/ICSI treatment

Couples undergoing in vitro fertilization and intracytoplasmic sperm injection (IVF/ICSI) at Aberdeen Maternity Hospital come from a wide geographical area. Increasingly, telephone discussions after unsuccessful treatment have replaced appointments for those who do not live locally. The aim of this study was to compare patient satisfaction with telephone follow-up discussions versus clinic appointments. Couples were separated into those undergoing their first treatment cycle (100 couples) and those undergoing their second or subsequent treatment cycle (85 couples), and then randomized to either a telephone or appointment follow-up. Satisfaction was assessed by a postal questionnaire and analysis conducted on an ‘intention to treat’ basis. An overall response rate of 91% was achieved. Analysis indicated no statistically significant difference between telephone and appointment groups with regard to the degree of satisfaction. However, there was an association between the type of follow-up and the duration of discussion (P<0.001): telephone follow-up discussions were significantly shorter than appointment follow-ups. There is the potential for significant savings in costs, both to the service and to patients, by providing telephone follow-up consultations. The savings may be achieved without compromising patient satisfaction as long as clinic appointments remain available as an option for those couples who prefer them.

Acceptability of a Telephone Clinic to Patients: Results of a Questionnaire Study

Acceptability of a Telephone Clinic to Patients: Results of a Questionnaire Study

Evaluation of a Nurse-Led Telephone Clinic in the Follow-up of Patients with Malignant Glioma

The aim of this study was to evaluate nurse-led telephone follow-up (NTF) for patients with high-grade glioma as an alternative to conventional clinic follow-up (CCF) and to assess patient satisfaction with this approach.Patients who were completing primary therapy for high-grade glioma and were suitable for CCF were offered the alternative of nurse-led telephone follow-up. NTF was arranged by the nurse at mutually agreed times. Assessment was by open discussion and a semistructured questionnaire, together with the Barthel Activities of Daily Living Index. Formal medical assessment in the clinic was arranged at 4-month intervals or earlier if indicated. Twenty-two patients were asked to complete a satisfaction questionnaire.Between February 1996 and October 1997, 43 patients with high-grade glioma, one with primitive neuroectodermal tumour and one with oligoastrocytoma agreed to be monitored by NTF. Their median survival from diagnosis was 16 months (95% confidence interval 13–23 months). At the time of analysis, the median time of follow-up by the telephone clinic was 6 months (range 2–21), with symptomatic progressive disease the reason for discontinuation of NTF in all patients. Two-hundred and fifty-four telephone calls were made, of which 234 were routine and 20 non-routine, being initiated by the patients or their carers. NTF was considered as a sufficient replacement for CCF during the stable phase of the disease. There were 41 unscheduled clinic visits, of which 31 were at the time of progression and usually initiated at NTF. The majority of unplanned visits were due to a change in symptoms and would not have been avoided with CCF carried out at the same time intervals. Patient satisfaction was high, with a median satisfaction score of 9, (range 3.6–10) on a scale of 0–10.NTF provides an alternative approach to conventional hospital attendance and moves the emphasis away from cancer surveillance to a more patient centred supportive model. It can be carried out without apparent detriment to the patient and is associated with high satisfaction rating.

Evaluation of a Nurse-Led Telephone Clinic in the Follow-up of Patients with Malignant Glioma

Evaluation of a Nurse-Led Telephone Clinic in the Follow-up of Patients with Malignant Glioma

Health system factors contributing to breastfeeding success.

To identify and characterize health care system factors that contribute to successful breastfeeding in the early postpartum period. A prospective 8-week cohort study of 522 women at five area hospitals who had a vaginal delivery of a healthy, full-term single child and who intended to breastfeed. Mothers and infants had free access to each other for breastfeeding during the hospital stay. Data were obtained through chart review and surveys. In-person postpartum interviews in the hospital and 4- and 8-week telephone interviews were used to determine participants' perceptions of breastfeeding support by hospital personnel, home visit nurses, and family and friends. The hospital in-person interview with each mother was conducted before discharge to confirm maternal interest and intent to breastfeed. Questions were asked regarding breastfeeding information and support provided by medical and nursing personnel. Mothers were asked to rate the quality of information, as well as the degree of support they received for breastfeeding. Mothers also were asked to rate their hospital breastfeeding experience. A second interview was conducted by telephone 4 weeks after birth. The focus of this interview was to ascertain the rating of their breastfeeding experience, the quality of their interactions with health care professionals, and whether supplemental formula was being provided to the infant. If supplemental formula was being provided, the mothers were asked to quantify the volume and frequency of supplementation. A final telephone interview was conducted when the infants were 8 weeks of age. This interview determined the continuance or cessation of breastfeeding and information about formula supplementation, as in the 4-week interview. Mothers were given a journal and asked to note all telephone calls, clinic visits, and home nurse visits that related to breastfeeding issues and concerns. Demographic data examined included maternal age, marital status, highest level of education reached, race, employment, insurance coverage, and length of stay in the hospital. Pregnancy characteristics included prenatal care, parity, and gravity. Infant characteristics included gestational age and birth weight. Other factors examined included maternal rating of the support received from the infant's father for the decision to breastfeed, the time the infant spent in the mother's hospital room, and whether the infant was breastfed in the delivery room. The women were mostly white (90%), educated (82% had some college education), married, older (mean maternal age of 29.3 years), and insured (92% commercial). The primary outcome of interest was success at breastfeeding. Success was determined based on each mother's initial estimate of the planned duration of breastfeeding. Of the participants, 76% breastfed successfully for at least as long as they had initially planned. Seventeen percent of the mothers had stopped breastfeeding at the time of the 4-week interview, and 29% had stopped by the 8-week interview. Of the infants' fathers, 97% were reported by the mothers to be supportive of the decision to breastfeed. Once discharged, 98% of mothers expected to have help with the household chores. Eighty percent rated their hospital breastfeeding experience as good or very good. However, only 56% rated hospital breastfeeding support as good or very good, and only 44% spoke with a lactation consultant while in the hospital. Of those who spoke with the lactation consultant, 85% felt more confident afterward. Hospital nurses talked with 82% of women, and 97% of these found this helpful. Seventy-four percent reported receiving a home nursing visit after discharge, and of these, 82% found it helpful. Successful mothers were significantly more likely to report that the visiting nurse watched them breastfeed and asked how it was going. Mothers were more likely to call or visit family and friends with concerns about breastfeeding than

Lack of Effect of Intraarticular Corticosteroids for Chronic Pain in the Cervical Zygapophyseal Joints

BARNSLEY, LESLIE; LORD, SUSAN M.; WALLIS, BARBARA J.; BOGDUK, NIKOLAI Author Information

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