Telephone Clinic Research Articles

983 Patient’s Satisfaction of Virtual Clinics for Post-Cardiothoracic Surgery Follow Up During COVID

IntroductionWith advances in technology, virtual clinics are becoming increasingly attractive as a tool for outpatient follow up care. During the COVID-19 pandemic, the implementation of virtual outpatient clinics was crucial, for continued service provision despite social distancing guidelines. We aimed to ascertain patient satisfaction with virtual clinics in cardiothoracic surgery.MethodForty patients who attended virtual clinics, post cardiothoracic surgery, were invited to provide feedback by means of a questionnaire. Feedback was gathered by junior doctors.ResultsThirty-four patients (20 had never had a telephone clinic appointment) agreed to provide feedback. Fifty percent of patients had not been seen since their operation. 91.2% (n = 31) of patients felt that the telephone consultation met their expectations/needs. Patient reported advantages of telephone consultations included: less concern regarding exposure to infection, no concern regarding parking, no travel time and less time off work. 79.4% (n = 27) would have preferred a face-to-face appointment. Patient reported disadvantages of telephone consultations were poor reception, felt they weren’t listened to and would have preferred to have been physically examined.ConclusionsPatients were satisfied with telephone clinics for routine follow up post cardiothoracic surgery. However, the majority would have preferred face to face appointments.

829 Is There an Ongoing Role For 'Telephone Triage Clinics' Post COVID-19?

IntroductionCOVID-19 has placed unprecedented demand on services at ELHT and it has become necessary to have telephone clinics to reduce the number of face-to-face clinics. A ‘telephone triage clinic’ was set up for referrals from A&E. Our project evaluated patient and clinician satisfaction on this.MethodWe carried out a retrospective telephone questionnaire with patients over a one-week period during the pandemic. We focussed on overall satisfaction of the consultation and quality of communication. Consultants were also surveyed for their opinion on the clinics.ResultsFrom 30 patients, 77% said they were ‘very satisfied’ with the overall experience. 80% of patients were ‘very satisfied’ with the overall length of the telephone consultation. 50% of patients felt the clinician was only ‘adequately’ able to assess them over the telephone. The consultants were less satisfied with the overall experience of telephone consultation. A common theme was that they felt ED documentation could be improved to help inform ongoing management.ConclusionsOverall, patients were satisfied with the consultations. It has been successful in minimising face to face consultations however some presentations necessitate further evaluation. We need to identify those injuries appropriate for virtual follow up and design a local protocol for these.

P078. Can we safely and effectively manage routine breast pain referrals without face-to-face clinic appointments?

Breast pain is a common primary-care referral to the breast clinic. Telephone clinics were created to manage such referrals at the start of the COVID-19 pandemic to reduce the number of face-to-face clinic appointments in this group, freeing up slots for urgent referrals. The aim was to assess whether the implementation of virtual breast pain clinics are safe and effective in the management of routine referrals for breast pain. A retrospective audit was carried out assessing patients on virtual breast pain clinics over a three month period. Patients were categorised as either fit for discharge after telephone consultations or appointed to a face-to-face clinic. Patients were sent questionnaires to gauge satisfaction with the process. Of 66 patients, 20 (30%) patients were appointed a face-to-face clinic appointment after telephone follow-up. The remaining 70% have been managed by telephone consultation. 51 (77%) of patients have been reassured and discharged. There was a 50% response in satisfaction survey, of which 100% gave positive feedback. One patient reported a lump at initial telephone call requiring a face-to-face clinic review. This was an incorrect referral and she was diagnosed with breast cancer. No other pathology was identified in patients with face-to-face consultations. Telephone clinics for routine breast pain referrals are safe and effective and reduce the number of patients requiring face-to-face clinics. This increases capacity to see urgent referrals which is important given the increased mismatch between urgent referrals and clinic capacity since the onset of the pandemic. Moreover, patients were satisfied with the process.

P025. Patient satisfaction with a telephone-based breast pain clinic

Introduction: With Covid-19 significantly impacting our clinical practice, telephone clinic consultations were established to safely assess and manage new breast pain (BP) referrals outside one-stop clinics. To evaluate patient experience and optimise care, we developed a patient satisfaction questionnaire.

P148. Virtual phone call or video consultations: Patient and clinician preference during COVID-19

In response to COVID-19 and social distancing guidelines, healthcare services have evolved. Telehealth has been a part of this change and many services have introduced virtual telephone clinics. The HSE recently approved a video conferencing tool, 'Attend Anywhere', and although available it is not widely used. We have received positive feedback from patients, but only a few studies provide information on patient and clinician satisfaction of virtual consultations. We aim to validate this by assessing preferences towards virtual telephone and video consultations.

Impact of a pharmacist-led substance use disorder transitions of care clinic on postdischarge medication treatment retention

BackgroundThe Veterans Health Administration (VHA) has made significant improvements in increasing prescribing of medication treatment for opioid use disorder (MOUD) and medication treatment for alcohol use disorder (MAUD); however, several barriers to treatment retention remain. In an effort to improve MOUD/MAUD retention, a Veterans Affairs (VA) facility established a pharmacist-led substance use disorder (SUD) transitions of care telephone clinic for patients discharged from an inpatient hospitalization on MOUD/MAUD, including buprenorphine/naloxone (BUP/NAL) and extended-release (ER) naltrexone injections. Pharmacists within the clinic assess aspects of treatment retention such as medication tolerability, perceived barriers to continuing treatment, status of current prescriptions, and appointment coordination. ObjectivesThe primary objective of this study was to evaluate the impact of a pharmacist-led SUD transitions of care telephone clinic on MOUD/MAUD retention following inpatient initiation in patients with opioid use disorder (OUD) and/or alcohol use disorder (AUD). Secondary objectives included subanalyses of clinic impact on MOUD/MAUD retention based on study medication or diagnoses, health care utilization, and characterization of pharmacist interventions. MethodsThe study identified patients for inclusion from inpatient units at a VA hospital. The study included patients if they were >18 years of age, had a diagnosis of AUD and/or OUD, and were initiated on ER naltrexone or BUP/NAL during admission and continued at discharge from August 1, 2018, to December 31, 2019. The study excluded patients if they declined clinic involvement, transferred facilities, moved beyond the VA catchment area, or were unable to be reached for initial contact after 3 telephone attempts. The intervention group included patients enrolled in the pharmacist-led SUD transitions of care telephone clinic, while the control group included patients initiated on MOUD/MAUD during admission who were eligible but not referred for clinic enrollment. Results/conclusionsThe study identified a total of 150 patients for inclusion (n = 54 intervention group; n = 96 control group). The study observed a statistically significant difference for the primary endpoint of combined 1- and 3-month MOUD/MAUD retention rates as measured by a continuous, multiple-interval measure of medication acquisition (CMA) of ER naltrexone and BUP/NAL for the intervention group vs. control group (1-month: 77.3% vs. 56.8%, p = 0.004; 3-month: 71.4% vs. 48%, p = 0.0002). When analyzed by study medication, we also observed a statistically significant improvement in continuous use of ER naltrexone for those enrolled in the clinic (1-month: 71.4% vs. 45.9%, p = 0.01; 3-month: 66.7% vs. 34.4%, p = 0.0003). The study did not observe any statistically significant improvements for BUP/NAL (1-month: 87.1% vs. 75.8%, p = 0.13; 3-month: 79.4% vs. 68.5%, p = 0.24) or establishment with a BUP/NAL clinic (90.5% vs. 80% patients established, p = 0.46). Likewise, the study did not observe any statistically significant differences for combined emergency department (ED) visits (1-month: 24.1% vs.17.1% patients with ED visit, p = 0.40; 3-month: 31.5% vs. 29.2% patients with ED visit, p = 0.85) or hospitalizations (1-month: 9.3% vs. 14.6% re-hospitalization, p = 0.45; 3-month: 14.8% vs. 26% re-hospitalization, p = 0.15) for those in the intervention group vs. the control group. Overall, the study observed statistically and clinically significant improvements in MOUD/MAUD retention rates for patients enrolled in a pharmacist-led SUD transitions of care telephone clinic.

P070 Tele-consultations from the patient’s perspective: during the pandemic and beyond

Background/Aims The current COVID-19 pandemic has challenged healthcare systems worldwide stimulating a transformation of NHS services to cope with increased acute demand, while aiming to minimise viral transmission. A significant proportion of rheumatology patients are considered ‘clinically extremely vulnerable’ and are at increased risk of COVID-19. With this in mind, alongside national guidance from the British Society for Rheumatology and the National Institute of Clinical Excellence we adapted our services in response to COVID by mostly suspending face-to-face appointments for follow up patients, instead relying on telephone or virtual consultations with a face-to-face appointment if necessary in order to minimise risk to our patients. We aimed to evaluate our use of telephone consultations during the pandemic and gain understanding of our patients views of telephone consultations longer term. Methods We retrospectively surveyed rheumatology patients under active follow-up at the royal Wolverhampton trust who had a telephone consultation with a rheumatology consultant over a 4-week period (11/5/20- 4/6/20). Patients were invited to participate via a SMS text message containing an embedded web-link to the survey. Results were analysed using SPSS version 26. Results Surveys were sent to 1,213 patients; 306 (25.2%) patients completed the survey. Responders were mostly female; the predominant diagnosis was inflammatory arthritis. Ages included: 1 (0.3%) patient 16-29 years, 46 (15.0%) 30-49, 180 (58.8%) 50-69, and 79 (25.8%) aged >70 years. Regarding their telephone consultation, 86.6% of responders were satisfied with the consultation. During the current pandemic 81.4% of responders were pleased to have a telephone consult rather than face-to-face; 57.2% of responders would be happy for their next routine appointment to be a telephone clinic. A significantly higher proportion of patients <50 years preferred telephone consultations when compared to older patients (Chi2 [DF = 3]= 10.075, P = 0.018) and more younger patients had access to a smartphone than those in the older cohort (Chi2 [DF 3]= 20.919, P = <0.001). Conclusion Overall, the short-term switch to telephone consultation was well received by our cohort. The majority of patients were satisfied with their telephone consultation and most were pleased to have a telephone consult rather than a face-to-face appointment in the current pandemic. Just over half would be happy for their next routine appointment to be a telephone consultation, however, a significantly higher proportion of younger patients prefer telephone consultations compared to older patients and a greater number of younger patients have access to a smartphone compared to older patients. Further planning is required to ensure patients in older and other vulnerable groups are not excluded should telephone clinics become a more permanent fixture. Disclosure N. Cleaton: None. S. Raizada: None.

P066 Telephone clinics: what are our patients saying?

Background/Aims Telemedicine has not previously been a regular part of routine rheumatology services.Our department adopted telephone clinics during the COVID-19 pandemic. We assessed patient satisfaction by conducting a feedback survey. Our aim was to obtain a patient perspective on remote consultations and on preferred future follow up options including video or face-to-face consultations. Methods The cohort included 160 rheumatology patients who had a telephone consultation between May and mid-June 2020. All patients consented to receive a further phone call by a different member of the team. Patients had to answer a questionnaire about recent consultation and to rate this on a scale of 1-5. Other questions included whether all their queries were answered; clear action plan made; perceived benefits or disadvantages of telephone consultation; and views about future follow up and any additional comments. Results 71.9% of 160 patients were females while 28.1 % males. Mean age 58.6 yrs. More than half of the patients (60.6%) had a diagnosis of inflammatory arthritis, followed by connective tissue disease (19.3%), other diagnosis (8.1% ) & vasculitis (5.6%). 94.4 % of the patients in this study were return appointments-the remainder new. Feedback results revealed 92.5% patients were satisfied with their consultation with mean score of 4.3/5 (5=best,1= worst). More than 80% agreed that all their queries were answered and a clear action plan was formed during consultation. However ,71.2% would want a face to face consultation if given choice while 54 % happy to have further follow up over the phone. 65% of patients preferred not to have video consultation. Subgroup analysis showed that majority of patients who would accept video consultation were aged between 30-39. Most common benefits described were noted to be convenience; reduced time of work; travel time and safety during pandemic, whilst difficulty in describing symptoms; hearing problems; and severity of disease were disadvantages raised, but numbers were small in our cohort. Conclusion Telephone clinics were the mainstay during the COVID-19 pandemic.The large majority of the rheumatology patients in our cohort were highly satisfied with this form of consultation. However, interestingly the majority (71% ) would still prefer face-to-face consultation as follow up in the future. Regular follow up in carefully selected patient groups can successfully be performed by telephone clinics with good patient satisfaction. This would help increase capacity within the clinic setting. Disclosure M. Abdullah: None. N. Heng: None. S. Noor: None. U. Ahmed: None. C. Lavery: None. S. Bawa: None.

P072 Tele-rheumatology: outcomes from the COVID-19 pandemic

Background/Aims The COVID-19 pandemic resulted in significant disruption to outpatient services, with hospital resources redirected to acute medical and critical care units. Social distancing measures meant that routine face-to-face outpatient appointments needed to be cancelled or reimagined. Telemedicine offered an attractive solution. Telemedicine uses technology to increase access to healthcare and has been used internationally in remote clinical settings, the National Health Service’s ‘111’ as well as in the National Aeronautics and Space Administration (NASA). Methods The University Hospital Lewisham Rheumatology Department organised outpatient review of new and follow-up patients via a consultant-supervised registrar telephone clinic 5 days a week during the first-wave of the COVID-19 pandemic. 278 patients had a telephone consultation with the registrar over a 3-month period (30 March to 30 June 2020): 197 new and 81 follow-up patients. Results Of the 197 new patient referrals: 2% required urgent face-to-face review (new inflammatory arthritis); 31% were provided with future routine clinic appointments and 44% were discharged: 35 patients without the need for any further investigations and 52 patients following subsequent investigations (e.g. phlebotomy and radiology). Patients were provided with management advice, links to online resources and referred to allied health professionals as indicated, e.g. physiotherapy. Patients were effectively discharged following telephone consultation if the history was sufficient to exclude a condition requiring secondary care management and if relevant community investigations were negative (including inflammatory markers and immunology). 62 of the 197 newly referred patients were offered a routine follow-up appointment. 36 of these patients were reviewed in person when COVID-19 restrictions eased. Of these 36 patients, 20 were subsequently discharged, diagnoses included: chronic pain (5), osteoarthritis (3), mechanical joint pain (6). 11 patients remained for follow up, diagnoses included: Sjögren’s syndrome (2) and palindromic rheumatism (1). 5 patients did not attend. Conclusion The strengths of this model were: the ability to continue to provide an outpatient rheumatology service; provide safe and effective management for new and follow-up patients; provide patient specific advice pertaining to COVID-19 and to support patients and primary care clinicians. The weaknesses of this model were the use of a single practitioner. Video consultation was not available when this model was implemented, but should add further to subsequent services. Our experience with the tele-rheumatology model suggests that a telephone triage system, coupled with relevant investigations prior to referral could lead to an effective virtual management strategy with potential beyond the COVID-19 pandemic. It also has great promise with regards to managing chronic conditions in clinical remission with video or telephone consultations, utilising virtual disease activity scores (ePROMS now available via the BSR) and satellite monitoring of blood tests and urinalysis. As technology continues to advance, we should explore ways to modernise the outpatient services. Disclosure S. Patel: None. P. Lutalo: None. G. Yanni: None. L. Pollard: None.

Factors associated with pain resolution in those with knee pain: the MOST study

To determine how many persons with knee pain have subsequent pain resolution and what factors are associated with resolution, focusing especially on types of physical activity. Using data from MOST, an NIH funded longitudinal cohort study of persons with or at risk of knee osteoarthritis, we studied participants who at baseline reported knee pain on most days at both a telephone interview and clinic visit. We defined pain resolution if at 30 and 60 month exams, they reported no knee pain on most days and compared these participants to those who reported persistent pain later. In logistic regression analyses, we examined the association of baseline risk factors including demographic factors, BMI, depressive symptoms, isokinetic quadriceps strength and both overall physical activity (using the PASE survey) and specific activities including walking, gardening, and different intensities of recreational activities with pain resolution. Of 1,304 participants with knee pain on most days at baseline, 265 (20.3%) reported no knee pain at 30 and 60 months. Lower BMI and stronger quadriceps were associated with higher odds of pain resolution while overall physical activity was not. Of activities, walking decreased the odds of pain resolution (adjOR=0.86 (95% CI 0.76, 0.98)), but gardening (adjOR=1.59 (1.16, 2.18)) and moderate intensity recreational activities ((adjOR=1.24 (1.05, 1.46)) increased it. Pain resolution is common in those with knee pain. Factors increasing the odds of pain resolution include lower BMI, greater quadriceps strength and gardening and moderately intensive recreational activities.

Perspectives of health care use and access to care for individuals living with inflammatory bowel disease in rural Canada.

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gastrointestinal tract with no known cure. Management of IBD is complex and requires those with IBD to have lifelong interactions with the healthcare system. Individuals with IBD who live in rural areas are at risk of poorer health outcomes due to their limited access to care. This study examined healthcare utilization and access to care for rural adults with IBD. The research questions explored in this study were: What are the care experiences of healthcare providers (HCPs) and persons living with IBD in rural areas? What are the enablers and barriers to optimal IBD care in rural environments? What strategies are necessary to enhance care delivery for these individuals with IBD? This patient-oriented research initiative involved patient and family advisors as active and equal team members in decision-making throughout the project. This article reports on the qualitative findings of a larger mixed-methods study. The setting was one western Canadian province. Fourteen individuals with IBD living in rural areas and three HCPs working in rural areas participated. Interview data were analyzed using thematic analysis. Three themes were identified: communication, stressors and support systems, and coordination of care. Communication with and between HCPs was challenging due to the distance to access care. Participants described challenges related to rural HCPs' lack of IBD-related knowledge. Virtual communication, such as telehealth and phone clinics, was infrequently used yet highly recommended by participants. Individuals with IBD described various stressors and feelings of isolation while living in rural environments, and both participant groups described the need for additional formal and informal support systems to ease these stressors. Coordination of care was considered essential to optimal health outcomes, but individuals frequently experienced gaps in care. Lack of local services such as outpatient clinics, hospitals, laboratory testing, infusion clinics, and pharmacies meant individuals with IBD frequently had to travel to access care. Some participants reported bypassing existing local services, instead preferring the expedited, specialist care within larger centers. Most participants described challenges associated with living in rural areas and suggested health system improvements. Access to multidisciplinary care teams, including IBD physicians and nurses, psychologists, and dieticians, for individuals in rural areas is encouraged, as is the use of virtual care delivery options such as telehealth, online clinics, telephone clinics or advice lines, web-based video-conferencing, and email communication to increase access to care. Continued efforts to recruit and retain rural HCPs with knowledge of IBD are deemed necessary to provide continuity of care within rural environments. Strengthening formal and informal support systems and enhancing psychosocial supports in rural communities are warranted to ensure optimal wellbeing. Online strategies to provide individual and group education related to IBD are strongly recommended. Facilitating access to care in rural areas can increase disease remission, decrease direct and indirect care costs, and promote quality of life in individuals with IBD.

AB033. SOH21AS156. Virtual phone call or video consultations: patient and clinician preference during COVID-19

Background: In response to COVID-19 and social distancing guidelines, healthcare services have evolved. Telehealth has been a part of this change and many services have introduced virtual telephone clinics. The HSE recently approved a video conferencing tool, ‘Attend Anywhere’, and although available it is not widely used. We have received positive feedback from patients, but only a few studies provide information on patient and clinician satisfaction of virtual consultations. We aim to validate this by assessing preferences towards virtual telephone and video consultations.

A standardized telephone interview with validated questionnaires for very long-term evaluation of women lost to follow-up after a stress urinary incontinence procedure.

Telephone interviews including questionnaires have been used to obtain very long-term (>10-year) follow-up after stress urinary incontinence (SUI) procedures in women otherwise lost to follow-up (LTF). For questionnaires validated for office use, our goal was to evaluate recent telephone vs last clinic scores in a long-term study. For women with >10 years of follow-up after anterior vaginal wall suspension (AVWS) for bothersome SUI associated with an anterior compartment prolapse, questionnaire scores from their last clinic encounter were compared with their scores from a standardized telephone interview at long-term follow-up. The validated questionnaires were Urinary Distress Inventory 6-Short Form (UDI-6), International Incontinence Questionnaire 7-Short Form (IIQ-7), and Quality of Life (QoL). Eighty-four women underwent a telephone interview (median follow-up: 13.8 years, interquartile range [IQR]: 12.2-17) after AVWS. The median difference between telephone and clinic visit was 10.2 years (IQR: 6.1-12.2). The clinic UDI-6 total score remained low but was higher than the phone score (mean difference 1.2, P= .0023). The UDI-6 Q2, Q3, Q5, IIQ-7, and QoL scores did not significantly differ between clinic and phone. For "incontinent" AVWS patients (UDI-6 Q3 ≥ 2), there was a larger difference between clinic and phone UDI-6 total score (P< .0001), while "dry" patients (UDI-6 Q3 ≤ 1) responded similarly. In women who would otherwise be LTF after anti-incontinence native tissue repair AVWS, UDI-6 total score varied slightly between last clinic and long-term follow-up phone interviews, but QoL and IIQ-7 remained similar.

Assessment of the Efficacy of Telephone Medicine Consultations in Trauma and Orthopaedics During COVID-19 Using the Ashford Clinic Letter Score.

During the coronavirus disease 2019 (COVID-19) pandemic, our aim was to protect staff and patients, therefore, face-to-face clinics were converted to telephone clinics. We retrospectively compared two groups of patients: those seen in traditional clinics pre-COVID-19 and those who had telephone clinics during the pandemic. The mean Ashford Clinic Letter Score (ACLS) for the face-to-face clinic letters was 6.7, and the letters from both groups of telemedicine appointments scored better; the first group scoring 7.1 and the second 7.45. The pandemic allowed us to show that telephone clinics are effective and can be superior to traditional clinics in a specific set of patients.

Role of parent-initiated digital imaging in paediatric clinical practice

Parent-initiated digital photographs are being increasingly provided to clinicians and allied health professionals (AHPs) by parents as a complement to the history of their child’s clinical illness (figure 1). This...

Establishing a nurse-led thyroid cancer follow-up clinic

Thyroid cancer is a complex disease requiring management by a large multidisciplinary team. The number of patients with a diagnosis of thyroid cancer is significantly increasing year-on-year, and traditional models of consultant-led follow up are no longer sustainable. Although nurse-led cancer follow-up clinics are becomining increasingly common, thyroid cancer nurse-led follow-up clinics are rare. An excellent understanding of the disease, treatment and management of risk of disease recurrence is essential for safe patient care, and is discussed in this article. The clinic discussed uses the skill set of head and neck nurse specialists, including psychological support, coping strategies for long-term side effects of treatment and non-medical prescribing. A patient survey of the service revealed high levels of patient satisfaction and a desire to continue face-to-face consultations rather than telephone clinics.

Virtual fracture liaison clinics in the COVID era: an initiative to maintain fracture prevention services during the pandemic associated with positive patient experience.

SummaryWe introduced virtual fracture liaison clinics during the COVID-19 pandemic in order to support clinical care while DXA services were down-turned. We observed that virtual FLS clinics are effective in delivering fracture risk assessment, health promotion, and clinical management and are well received by patients with positive patient experience.IntroductionWe examined the impact of virtual FLS telephone clinics, as an alternative to face-to-face clinics during the COVID-19 lockdown.MethodsPatients presenting with low trauma fracture were recruited according to standard criteria. A structured telephone clinic appointment was offered, which included fracture risk and health promotion assessment and a treatment plan. Risk factors, demographics, fracture type, FRAX scores, and outcomes were analysed. We assessed patient experience with an anonymised patient survey.ResultsClinical outcomes from virtual clinics were assessed (77F/33M; mean age 65.7 years). The mean 10-year observed fracture risk for major osteoporotic fracture was 18.2% and 7.0% for hip fracture. We observed high ‘attendance’ rates at 79%; however, a significant number were still not available for telephone review (11%) or cancelled their appointment (10%). A recommendation for bisphosphonate treatment was made in 54% of the cohort based on National Osteoporosis Guidelines Group (NOGG) criteria. Follow-up DXA assessment is planned for 64%, according to fracture risk and NOGG guidance. We received 60 responses from the initial patient survey. Ninety percent rated their overall experience of service at 4 or 5 (very good to excellent). Ninety-eight indicated they would recommend the service to others.ConclusionsVirtual clinics are effective in delivery of fracture risk assessment and clinical management with positive patient experience. While a significant proportion will require DXA follow-up to complete the clinical assessment, virtual clinics have mitigated delays in fracture prevention interventions during the COVID-19 pandemic.

Cancer patient experience of telephone clinics implemented in light of COVID-19.

IntroductionDue to the pandemic of COVID-19 a number of National Health Service (NHS) Trusts in the UK adopted telephone consultations for patients who were shielding. As the pandemic continues to affect these services an evaluation was conducted to determine whether telephone consultations implemented during the pandemic should be maintained long term. The objective was to evaluate this new service and to understand patient experience.MethodsThis study was conducted via a telephone survey. Staff working in the Macmillan centres across the Trust called patients to survey them about their experience of telephone consultations. Data were collected 23/06/20 – 17/07/20. A mix of eight open and closed questions were asked. Data were collected on an Excel spreadsheet and patient identifiable information was anonymised.Results55 patients accepted to participate in this study. Out of 55, 39 patients rated the phone consultation they had as either 4 or 5 out of 5. When asked if they would like to continue with phone clinics 33 said they would. The majority of consultations were conducted by doctors (43/55). Patients commented they had received great support from their healthcare professionals and they felt that phone consultations were safer in the current climate. Three of the patients felt the calls were rushed and others found it difficult to discuss pain management, sides effects and post-surgery issues.ConclusionsThis evaluation provides a brief snapshot of the experience cancer patients are having with phone clinics. A re-evaluation will take place once video consultations are implemented.

Patient's perspectives of living with a precancerous condition: Monoclonal gammopathy of undetermined significance (MGUS).

The aim of this study was to investigate patient experiences of living with monoclonal gammopathy of undetermined significance (MGUS). Living with a premalignant condition such as MGUS may elicit negative psychosocial effects including increased anxiety and fear of progression to cancer. To date, no study utilising qualitative methodology has explored the lived experiences of MGUS patients. Data was collected via two focus groups and six telephone interviews. MGUS patients (n=14) were recruited via nurse-led haematology telephone-clinics in Northern Ireland. Interviews were transcribed verbatim and the data subjected to thematic analysis. Thematic analysis identified 3 overarching themes; (1) The psychosocial impact of an MGUS diagnosis, (2) Knowledge of MGUS and (3) Experiences of MGUS health services. Patients with MGUS reported experiencing poor psychological adjustment to their condition particularly at the point of diagnosis and approaching follow-up appointments. Feelings of isolation, poor information-provision, increased uncertainty and limited psychosocial support for MGUS patients were also reported. Patients did however reflect positively on their experience of being followed up via nurse-led telephone clinics. Provision of patient friendly information guides at diagnosis, and additional psychosocial support services such as nurse-led telephone clinics and coordinated patient groups may help MGUS patients adjust better to their diagnosis and in doing so improve quality of life in this patient population.

Differences in patient satisfaction with virtual telephone clinics in a tertiary referral centre for otolaryngology during and after lockdown measures during the SARS-Cov2 pandemic.

IntroductionThe SARS-Cov2 pandemic has caused considerable disruption to provision of routine outpatient care. This pandemic has necessitated a more modern and innovative approach to clinics, which could potentially change outpatient organisation and improve efficiency in the long term. Telephone clinics are the most practical way to deliver healthcare at a distance.AimThe purpose of the present study was to assess patient satisfaction with a virtual telephone clinic in a tertiary referral centre for otolaryngology first during the height of the SARS-Cov2 pandemic, and subsequently at a physical follow-up appointment after easing of “lockdown” measures.MethodsPatients were enrolled prospectively via a telephone interview over a 1-week period during the height of the “lockdown” measures, and subsequently at a physical appointment when measures eased.ResultsOverall, patients responded very positively in the anonymised questionnaire at the time of their virtual appointment. However, at a subsequent physical appointment, there was a reduction in overall favourable responses from patients. While patients still thought virtual clinics were a good idea and convenient in the context of SARS-Cov2, we noted a reduction in satisfaction in other key aspects of their care. Notably, patients were less likely to think that virtual clinics were able to properly address their condition.ConclusionWhile virtual clinics remain a useful tool during the height of lockdown measures during the SARS-Cov2 pandemic, we did note a significant reduction in favourable responses to virtual appointments over physical ones upon easing of lockdown measures. Patients remained cautious in suggesting that outpatient appointments may be replaced by virtual clinics.