Telephone Follow-up Group Research Articles

Comparison of the effect of telephone follow-up with social network follow-up program on self-efficacy and depression in patients undergoing coronary artery bypass graft surgery: A randomized controlled trial

IntroductionCoronary artery bypass graft (CABG) surgery is a common procedure to improve blood flow to the heart muscles, but patients often face challenges during the recovery period. Self-efficacy and depression play crucial roles in patient outcomes. Telephone follow-up and social network follow-up have been introduced as interventions to enhance self-efficacy. This study aims to compare the effectiveness of telephone follow-up and social network follow-up on self-efficacy and depression in CABG patients. MethodThe study is a single-blinded, randomized controlled trial conducted at Shahid Rajaee Heart Hospital in Tehran, Iran. The sample size was determined to be 99 patients who met the inclusion criteria. Data were collected using a demographic questionnaire, Sullivan's cardiac self-efficacy questionnaire, and the Beck Depression Inventory (BDI). Participants were assigned to three groups: control, telephone follow-up, and WhatsApp follow-up using randomization. Data were analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA). ResultsThe results revealed significant improvements in self-efficacy and reductions in depression scores for both the telephone and WhatsApp follow-up groups compared to the control group following the intervention (p < 0.001). Additionally, the mean self-efficacy score was higher and the mean depression score was lower in the WhatsApp follow-up group than in the telephone follow-up group after the intervention (p < 0.001). DiscussionThe findings provide valuable insights for healthcare professionals in choosing appropriate interventions to enhance patients' self-efficacy levels and improve mental health outcomes. Both telephone follow-up and social network follow-up interventions have their own advantages and can be effective in supporting patients' recovery after CABG surgery.

Impact of telephone follow-up on hepatocellular carcinoma patients receiving oral chemotherapy from an ambulatory-care setting.

In recent years, most molecular target drugs have been administered orally, as prescribed at ambulatory services in hospitals and at patients' homes. Telephone follow-up is increasingly being used in clinical practice for patients needing additional support post-discharge and for the prevention of hospital readmissions. The purpose of this study was to clarify the clinical benefits of telephone follow-up while administering oral anticancer drugs. This was a single-center, observational, retrospective study. We evaluated hepatocellular carcinoma patients who received sorafenib or lenvatinib between March 2010 and February 2018. The primary endpoint was the incidence of adverse events. From the total of 130 patients, 83 patients received telephone follow-up and 47 did not. The incidence of hand-foot skin reactions significantly reduced in patients with telephone follow-up (odds ratio (OR) 3.69, 95% confidence interval (CI) 1.16-11.8, p = 0.020). The median durations (ranges) of adherence to oral chemotherapy were 259 days (15-1730) for the telephone follow-up group and 121 days (14-1105) for the no-telephone follow-up group (p < 0.001). Moreover, the disease control rate was significantly higher in the telephone follow-up group (OR 2.52, 95% CI 1.15-5.53, p = 0.020). Remote interventions, such as telephone follow-up, are useful means of managing adverse events in patients receiving oral anticancer drugs and can lead to improved treatment results.

Telephone follow-up contributes to improving adherence and treatment duration in patients with hepatocellular carcinoma treated with lenvatinib.

This study aimed to investigate whether telephone follow-up by clinical pharmacists for unresectable hepatocellular carcinoma (HCC) patients treated with lenvatinib (LEN) contributes to improved adherence and treatment duration for LEN. This retrospective study enrolled 132 patients with HCC who were treated with LEN. The patients were classified into non-telephone follow-up (n=32) or telephone follow-up groups (n=100) [the latter group was further classified into family-pharmacist (FP) telephone follow-up (n=18), or hospital family-pharmacist (HFP) telephone follow-up (n=82) groups]. The progression-free survival (PFS) in the telephone follow-up group was significantly higher than that in the non-telephone follow-up group (PFS 6.1months vs 3.7months, P=0.001, respectively). Although treatment duration was significantly longer in the telephone follow-up group than in the non-telephone follow-up group [median treatment duration: 10.4months vs 4.1months, P=0.001, respectively.], no significant differences were noted between the HFP telephone follow-up group and FP telephone follow-up groups (10.3months vs 13.3months, P=0.543). Self-interruption and adverse-event discontinuation in the HFP-telephone follow-up group were significantly lower than those in the FP-telephone and non-telephone groups (0% vs 11.1% vs 18.8%; P<0.001, 25.6% vs 33.3% vs 53.1%; P=0.022, respectively). Telephone follow-up contributes to prolonged treatment duration for LEN in patients with HCC treated. Moreover, telephone follow-up with an HFP may further improve treatment adherence.

Comparison of the effectiveness of home visits and telephone follow-up on the self-efficacy of patients having undergone coronary artery bypass graft surgery (CABG) and the burden of their family caregivers: A randomized controlled trial

Objective.This study aimed to compare home visits and telephone follow-up effectiveness on patients' self-efficacy undergoing Coronary Artery Bypass Graft Surgery -CABG- and caregivers’ burden.Methods.In this randomized clinical trial, 114 patients undergoing CABG were assigned to the three groups of home visits, telephone follow-up, and control based on the stratified block randomization. The self-management program of the home visit group included four face-to-face 60-minute training sessions once a week, and for the telephone follow-up group, four 30-minute telephone counseling sessions twice each week for a month. The control group received routine care. Data were collected using the cardiac rehabilitation self-efficacy questionnaire and the caregiver burden scale before and after the intervention.Results.Before the study, there were no statistically significant differences between the three groups in terms of the means of self-efficacy and caregiver burden scores. However, there was a statistically significant difference between the home visit and control groups (p<0.001) and between the telephone follow-up and control groups (p<0.001) after the intervention, with increased self-efficacy and reduced caregiver burden reported. In contrast, there was no significant difference between the home visit and telephone follow-up groups regarding self-efficacy and caregiver burden scores.Conclusion.Both methods of self-management education have similar effectiveness in increasing self-efficacy and reducing the caregiver burden after discharge for patients who have undergone CABG.

Comparison of the effectiveness of home visits and telephone follow-up on the self-efficacy of patients having un-dergone coronary artery bypass graft surgery (CABG) and the burden of their family caregivers: A randomized con-trolled trial.

This study aimed to compare home visits and telephone follow-up effectiveness on patients' self-efficacy undergoing Coro-nary Artery Bypass Graft Surgery -CABG- and caregivers' burden. In this randomized clinical trial, 114 patients undergoing CABG were assigned to the three groups of home visits, telephone follow-up, and control based on the stratified block randomization. The self-management program of the home visit group included four face-to-face 60-minute training sessions once a week, and for the telephone follow-up group, four 30-minute telephone counseling sessions twice each week for a month. The control group received routine care. Data were collected using the cardiac rehabilitation self-efficacy questionnaire and the caregiver burden scale before and after the interven-tion. Before the study, there were no statistically significant differences between the three groups in terms of the means of self-efficacy and caregiver burden scores. However, there was a statistically significant difference between the home visit and control groups (p<0.001) and between the telephone follow-up and control groups (p<0.001) after the intervention, with in-creased self-efficacy and reduced caregiver burden reported. In contrast, there was no significant difference between the home visit and telephone follow-up groups regarding self-efficacy and caregiver burden scores. Both methods of self-management education have similar effectiveness in increasing self-efficacy and reducing the care-giver burden after discharge for patients who have undergone CABG.

Telephonic Postoperative Follow-up During a Pandemic: Cohort Study

Introduction: According to the available scientific evidence It is unknown whether replacing clinic follow-up visits with telephone follow-up for low-risk elective and non-elective surgeries is safe. Nonetheless;using telemedicine has become one of the most needed and used methods during this pandemic to avoid COVID-19 disease spreading among surgical teams and patients. Methods: A retrospective cohort study was performed. We compared the frequency of needing of any health assistance, adverse event and readmissions after been discharged and during the first 30 postoperative days, between two groups of patients, the first one with exclusive telephone follow-up vs the traditional face-to-face visit. Results: We registered the data from 324 patients who underwent elective and non-elective low-risk surgeries between May 1st and December 1st 2020. The overall health assistance rate during the first 30 days after been discharged home was 11,54%. The telephone follow-up group we registered only 18 adverse events compared with 29 for the traditional visit group this was statistical significant. We found 13 consults for telephonic follow-up group and 14 for traditional visit this was statistical significant as well. We also found difference between the two groups in matter of readmissions in favor of telephonic follow-up. All these differences were statistically significant. Conclusion: No standardized postoperative management algorithm exists for patients undergoing surgery during a pandemic. We propose the telephonic follow-up based on our findings, as a safe and effective approach. Future studies are needed to validate the current proposal.

Effects of a mobile health diabetes self-management program on HbA1C, self-management and patient satisfaction in adults with uncontrolled type 2 diabetes: a randomized controlled trial

PurposeThis study aimed to examine the effects of a three-month mobile health diabetes self-management program (MHDSMP) on glycemic control, diabetes self-management (DSM) behaviors and patient satisfaction in adults with uncontrolled type 2 diabetes (T2DM) in Thailand.Design/methodology/approachThis was a three-arm, parallel-group, randomized controlled trial among 129 adults with uncontrolled T2DM who attended the medical outpatient department in a medical center. The participants were randomly assigned to the three study groups (n = 43 per group), including MHDSMP, telephone follow-up (TF) and usual care (UC). MHDSMP encompassed four components, including DSM engagement, DSM mobile application, motivational text messages and telephone coaching. Outcomes were evaluated at three-month end-of-study by using HbA1C and response to the Summary of Diabetes Self-Care Activities (SDSCA) and the Client Satisfaction Questionnaire (CSQ-8). Data were analyzed by using descriptive statistics and multivariate analysis of covariance (MANCOVA).FindingsThe findings revealed that at the end-of-study, HbA1C decreased from 7.80 to 7.17% (p &lt; 0.001) in MHDSMP group, from 7.72 to 7.65% (p = 0.468) in TF group, and from 7.89 to 7.72% (p = 0.074) in UC group. Significantly higher SDSCA and CSQ-8 scores were also observed in MHDSMP compared to TF and UC groups (F = 12.283, F = 19.541, F = 8.552, p &lt; 0.001, respectively).Originality/valueThis study demonstrated that MHDSMP adjunct with usual care is beneficial for patient outcomes in adults with uncontrolled T2DM in Thailand, compared to TF and UC groups.

A Mobile Health App for the Collection of Functional Outcomes After Inpatient Stroke Rehabilitation: Pilot Randomized Controlled Trial.

BackgroundMonitoring the functional status of poststroke patients after they transition home is significant for rehabilitation. Mobile health (mHealth) technologies may provide an opportunity to reach and follow patients post discharge. However, the feasibility and validity of functional assessments administered by mHealth technologies are unknown.ObjectiveThis study aimed to evaluate the feasibility, validity, and reliability of functional assessments administered through the videoconference function of a mobile phone–based app compared with administration through the telephone function in poststroke patients after rehabilitation hospitalization.MethodsA randomized controlled trial was conducted in a rehabilitation hospital in Southeast China. Participants were randomly assigned to either a videoconference follow-up (n=60) or a telephone follow-up (n=60) group. We measured the functional status of participants in each group at 2-week and 3-month follow-up periods. Half the participants in each group were followed by face-to-face home visit assessments as the gold standard. Validity was assessed by comparing any score differences between videoconference follow-up and home visit assessments, as well as telephone follow-up and home visit assessments. Reliability was assessed by computing agreements between videoconference follow-up and home visit assessments, as well as telephone follow-up and home visit assessments. Feasibility was evaluated by the levels of completion, satisfaction, comfort, and confidence in the 2 groups.ResultsScores obtained from the videoconference follow-up were similar to those of the home visit assessment. However, most scores collected from telephone administration were higher than those of the home visit assessment. The agreement between videoconference follow-up and home visit assessments was higher than that between telephone follow-up and home visit assessments at all follow-up periods. In the telephone follow-up group, completion rates were 95% and 82% at 2-week and 3-month follow-up points, respectively. In the videoconference follow-up group, completion rates were 95% and 80% at 2-week and 3-month follow-up points, respectively. There were no differences in the completion rates between the 2 groups at all follow-up periods (X21=1.6, P=.21 for 2-week follow-up; X21=1.9, P=.17 for 3-month follow-up). Patients in the videoconference follow-up group perceived higher confidence than those in the telephone follow-up group at both 2-week and 3-month follow-up periods (X23=6.7, P=.04 for 2-week follow-up; X23=8.0, P=.04 for 3-month follow-up). The videoconference follow-up group demonstrated higher satisfaction than the telephone follow-up group at 3-month follow-up (X23=13.9; P=.03).ConclusionsThe videoconference follow-up assessment of functional status demonstrates higher validity and reliability, as well as higher confidence and satisfaction perceived by patients, than the telephone assessment. The videoconference assessment provides an efficient means of assessing functional outcomes of patients after hospital discharge. This method provides a novel solution for clinical trials requiring longitudinal assessments.Trial Registrationchictr.org.cn: ChiCTR1900027626; http://www.chictr.org.cn/edit.aspx?pid=44831&htm=4.

Endometrial cancer patients' preferences for follow-up after treatment: A cross-sectional survey.

Alternatives to hospital follow-up (HFU) following treatment for cancer have been advocated. Telephone follow-up (TFU) and patient-initiated follow-up are being implemented but it is unclear if these approaches will meet the preferences and needs of patients. This study aimed to explore the preferences of endometrial cancer patients and their levels of satisfaction with HFU and nurse-led TFU. A cross-sectional survey design was utilised and a questionnaire was administered to 236 patients who had participated in a randomised controlled trial comparing HFU with TFU for women diagnosed with Stage I endometrial cancer (ENDCAT trial). 211 (89.4%) patients returned the questionnaire; 105 in the TFU group and 106 in the HFU group. The TFU group were more likely to indicate that appointments were on time (p<0.001) and were more likely to report that their appointments were thorough (p=0.011). Participants tended to prefer what was familiar to them. Those in the HFU group tended to prefer hospital-based appointments while the TFU group tended to prefer appointments with a clinical nurse specialist, regardless of locality. To provide patient centred follow-up services we need to ensure that patient preferences are taken into account and understand that patients may come to prefer what they have experienced. Patient initiated approaches may become standard and preferred practice but TFU remains a high-quality alternative to HFU and may provide an effective transition between HFU and patient-initiated approaches.

Effect of Postoperative Telephone Calls on Patient Satisfaction and Scar Satisfaction After Mohs Micrographic Surgery.

Mohs micrographic surgery is considered the gold standard for high-risk nonmelanoma skin cancer. Postoperative telephone follow-up (TFU) is linked to higher patient satisfaction; however, there are no randomized, blinded studies examining whether TFU after Mohs surgery improves patient satisfaction. To perform a randomized single-blinded prospective survey study examining whether patient satisfaction or scar satisfaction varied between Mohs patients who received a postoperative call and patients who did not. Patients were enrolled into "post-op call" or "no post-op call" groups. Both arms completed surveys at suture removal and 3-month follow-up visits. One hundred four subjects were enrolled, and demographics, the number of Mohs stages, and type of repair were controlled. At suture removal, both arms reported similar overall high satisfaction on the 5-point Likert scale (4.90 "call arm" vs 4.88 "no-call arm", p = .80). Patient and Observer Scar Assessment Scale (POSAS) scores were 3.37 in the "call arm" versus 3.81 in the "no-call arm", p = .31. At 3-month follow-up, results were similar. High overall satisfaction was reported in both arms. The TFU group reported higher overall satisfaction, but this difference was not significant. Scar satisfaction did not vary statistically between the arms, but POSAS scores in the call arm trended favorably.

Efficacy of Telephone Follow-Up in Children Tonsillectomy with Day Surgery.

Day surgery for tonsillectomy has become more and more popular in China. However, many parents face difficulties to cope up with the pain and side effects after surgery. The present study was aimed to examine the efficacy of telephone follow-up on children's post-discharge recovery after tonsillectomy. In this prospective study, the sample consisted of 863 children randomly assigned to receive clinic visit after discharge or 1 to 14d' telephone follow-up after discharge. During the follow-up, the research nurse or parents assessed each child's status, identified problems, and provided needed follow-up care. Key outcomes were pain intensity, postoperative complication, and unanticipated contact with the health care system. Compared with clinical visit, children in telephone follow-up group presented with less pain in early stage after surgery and better food and drink intake. The prevalence of hemorrhage, nausea, vomiting, fever and dizziness had no difference between the groups. Telephone follow-up also reduced unanticipated healthcare services. The present study suggested that a follow-up telephone call is a safe and cost-effective method of postoperative management for pediatric patients who have undergone tonsillectomy.

Comparison of the effects of two transitional nursing models in patients with post-stroke depression

Objective To explore the comparison of clinical outcomes of two transitional nursing mode intervention in patients with post-stroke depression. Methods From August 2015 to April 2017, a total of 126 patients with post-stroke depression in Suzhou Municipal Hospital were selected as the research subjects. All the subjects were randomly divided into telephone follow-up group (n=61) and home interview group (n=65) , and were followed up once a month for one year. The intervention outcome was compared with Modified Rankin Scale (mRS) , Barthel Index (BI) and Hamilton Depression Scale (HAMD) . Results After being followed up for 1 year, the scores of mRS, BI and HAMD were (1.82±0.89) , (81.55±13.81) and (9.21±5.12) respectively in the home interview group. Those scores in the telephone follow-up group were (2.37±1.59) , (68.24±26.25) and (15.41±6.52) . The differences between the two groups were statistically significant (t=4.07, 5.96, 3.59; P<0.05) . Conclusions The transitional nursing model of home interview mode can alleviate the degree of depression in patients with post-stroke depression, and is helpful to the recovery of post-stroke depression patients with limb function. Key words: Stroke; Depression; Transitional nursing; Telephone follow-up; Home interview

Clinical Outcomes of Telemonitoring for Patients on Warfarin after Discharge from Hospital.

Objective To evaluate the impact of telephone follow-up service on clinical outcomes in patients on warfarin when discharged from hospital. Methods This randomized controlled trial was conducted at a general hospital in Thailand. Patients aged ≥20 years who were prescribed warfarin when discharged were eligible to participate in this study. They were randomly allocated, using a computer generated random number, to receive either telephone follow-up intervention or usual care. Participants in the intervention group received telephone follow-up by hospital pharmacists for three months. During each telephone call, pharmacists performed medicine use reviews and addressed any problems identified. Key Findings A total of 50 patients participated in this study. The proportion of international normalized ratio (INR) values in the target range for the telephone follow-up group (36/79, 45.6%) was higher than that in the usual care group (19/79, 24.1%), p=0.005. The mean time in the therapeutic range (TTR) in the telephone follow-up group was also higher than that in the usual care group (49.8±34.3 versus 28.0±27.5, p=0.017). All patients in the usual care group experienced one or more out-of-range INR values (25/25, 100%) compared to 21 out of 25 (84%) in the telephone follow-up group, p=0.037. There was no difference between the two groups in the incidence of complications or adverse events associated with warfarin. Conclusions The telephone follow-up service in recently discharged patients helps them achieve and maintain their INR target. This anticoagulant supportive service should be promoted to patients receiving warfarin therapy after discharge. This trial is registered with TCTR20180614006 (Thai Clinical Trials Registry).

Telephone-delivered lifestyle support with action planning and motivational interviewing techniques to improve rehabilitation outcomes.

In this randomized controlled trial, we evaluated the effectiveness of a telephone-delivered intervention based on the Health Action Process Approach (HAPA) after discharge from inpatient rehabilitation to address behavior change, emotional status, and glycemic control in patients with Type 2 diabetes. In a German rehabilitation center, 249 patients with Type 2 diabetes were separated into randomized groups, either a 12-month telephone follow-up support group or the usual care group. The counselor identified personal target areas and intervention modules and developed with the patient an individualized action plan for the telephone support. To enhance motivational processes, they used motivational interviewing techniques. Counselors called patients monthly to support the implementation of the personal plans into the patients' daily routines and to screen for emotional problems. Assessments measured exercise, diet, medication adherence, psychological variables, body mass index, HbA1c, and cardiovascular risk. Twelve months after inpatient rehabilitation, the telephone group's rate of physical activity rose by 26% compared with the usual care group's 10%. Patients in the intervention group exhibited greater improvements in terms of their illness burden, psychological well-being, and depression. HbA1c fell in the telephone group but increased in the usual care group (-0.68% vs. 0.12%). The intervention group's cardiovascular risk fell, whereas the usual care group's rose (-0.57 vs. 0.23). A theory-based telephone-delivered follow-up intervention utilizing motivational interviewing techniques and focusing on personalized action planning demonstrated improvements in patients' level of activity and health status 12-months postrehabilitation discharge and may be a beneficial supplement to rehabilitation programs. (PsycINFO Database Record

Smartphone Application WeChat for Clinical Follow-up of Discharged Patients with Head and Neck Tumors: A Randomized Controlled Trial.

Background:Nowadays, social media tools such as short message service, Twitter, video, and web-based systems are more and more used in clinical follow-up, making clinical follow-up much more time- and cost-effective than ever before. However, as the most popular social media in China, little is known about the utility of smartphone WeChat application in follow-up. In this study, we aimed to investigate the feasibility and superiority of WeChat application in clinical follow-up.Methods:A total of 108 patients diagnosed with head and neck tumor were randomized to WeChat follow-up (WFU) group or telephone follow-up (TFU) group for 6-month follow-up. The follow-ups were delivered by WeChat or telephone at 2 weeks, 1, 2, 3, and 6 months to the patients after being discharged. The study measurements were time consumption for follow-up delivery, total economic cost, lost-to-follow-up rate, and overall satisfaction for the follow-up method.Results:Time consumption in WFU group for each patient (23.36 ± 6.16 min) was significantly shorter than that in TFU group (42.89 ± 7.15 min) (P < 0.001); total economic cost in WFU group (RMB 90 Yuan) was much lower than that in TFU group (RMB 196 Yuan). Lost-to-follow-up rate in the WFU group was 7.02% (4/57) compared with TFU group, 9.80% (5/51), while no significance was observed (95% confidence interval [CI]: 0.176–2.740; P = 0.732). The overall satisfaction rate in WFU group was 94.34% (50/53) compared with 80.43% (37/46) in TFU group (95% CI: 0.057–0.067; P = 0.034).Conclusions:The smartphone WeChat application was found to be a viable option for follow-up in discharged patients with head and neck tumors. WFU was time-effective, cost-effective, and convenient in communication. This doctor-led follow-up model has the potential to establish a good physician-patient relationship by enhancing dynamic communications and providing individual health instructions.Trial Registration:Chinese Clinical Trial Registry, ChiCTR-IOR-15007498; http://www.chictr.org.cn/ showproj.aspx?proj=12613.

Adherencia al tratamiento en la insuficiencia cardiaca y las tecnologías de la información y la comunicación

MotivationTo determine the efficacy of the use of information and communication technologies in the treatment adherence of patients with heart failure that were assisted at the Heart Failure Unit of Bogotá. MethodsA clinical trial was conducted with pre-, post-test and control group. Three randomised groups of 37 participants each were conformed, two of which received an intervention during two months based in the use of information and communication technology; group 1 received telephone follow-up plus text messages, group 2 telephone follow-up plus emails and group 3, which was the control group, received the usual nurse follow-up at a Heart Failure Unit. ResultsThe three defined study groups significantly modified their average adherence levels; groups 1 and 2 the increase is attributable to the intervention with the use of information and communication technologies, likewise, adherence of the control group participants who received the usual care at a Heart Failure Unit also showed a significant increase. ConclusionThe use of information and communication technologies, such as the telephone follow-up associated to text messages and emails, rose the adherence to the pharmacological and non-pharmacological treatment in patients with heart failure by motivating and monitoring patients.

Economic evaluations of psychosocial interventions in cancer: a systematic review.

Although the effectiveness of many psychosocial interventions for people with cancer has been established, one barrier to implementation in routine clinical care is a lack of data on cost-effectiveness. We conducted a systematic review to assess the cost-effectiveness of psychosocial interventions for improving psychological adjustment among people with cancer. A systematic review of the literature, study appraisal and narrative synthesis. Eight studies involving 1668 patients were identified. Four of these reported outcomes in a cost per quality adjusted life year (QALY) framework. Six studies reported psychosocial interventions to be cost-effective for improving health-related quality of life, mood, pain, distress or fear of cancer progression, compared with usual care. Of the six psychosocial interventions identified as cost-effective, three were cognitive-behavioural therapy-based interventions, one was a nurse-delivered telephone follow-up plus educational group programme, one was a group-based exercise and psychosocial intervention and one was a series of 10 face-to-face or telephone-based individual support sessions delivered by a nurse. The quality of studies assessed according to the Consensus Health Economic Criteria-list criteria was good overall; however, some studies were limited by their choice of outcome measure and omission of important categories of costs. Several psychosocial interventions, particularly those based on cognitive-behavioural therapy, have been demonstrated to represent good value for money in cancer care. Future research should include a clear definition of the economic question, inclusion of all relevant costs, and consideration of utility-based quality of life measures for QALY estimation. Copyright © 2016 John Wiley & Sons, Ltd.

An observational study of a team management approach for first-line XELOX therapy in patients with advanced/recurrent colorectal cancer: The SMILE study (the study of metastatic colorectal cancer to investigate impact of learning effect).

554 Background: Although oral chemotherapies such as XELOX are widely favored for convenience and flexibility, these have several disadvantages such as drug non-compliance and delayed discovery of adverse events. So we designed a multicenter, prospective, observational study to evaluate the efficacy of supportive interventions in first-line XELOX for colorectal cancer (CRC) patients (pts). Methods: CRC pts undergoing first-line XELOX (+Bevacizumab) therapy practicing one or more of supportive interventions as follows: 1) a telephone follow-up (TF), 2) instruction on dosage and administration by a pharmacist, 3) skin care instruction by a nurse, and 4) pts education by a doctor were eligible. The objective was to evaluate the incident rate of grade 2 or worse hand-foot syndrome (HFS), QoL, safety, and efficacy. QoL was assessed at baseline, 2, 4, 5 and 8 cycles after the treatment started, using the Hospital Anxiety and Depression Scale (HADS) and the Mental adjustment to cancer scale (MAC). Results: From April 2011 to September 2012, 80 pts were enrolled from 14 institutes. The characteristics were as follows: male/female: 46/34, age median: 63 (36-75), and supportive intervention 1)/2)/3)/4): 36/68/73/78. The incidence of grade 2 or worse HFS during 6 months were 11.1% (n=4) for those received TF (n=36), and 20.5% (n=9) for those received other intervention except TF (n=44). Relative dose intensity (RDI) was 75.7% (TF+/-: 77.7/74.3%) in oxaliplatin and 77.5% (TF+/-: 80.2/75.3%) in capecitabine, respectively. Although a tendency of the QoL score improvement about anxiety, fighting spirit and helplessness in a TF group was observed during the periods from start of therapy to 4 courses, there were no significant differences compared to other interventions except TF. Conclusions: We confirmed that HFS incidence was mitigated in a TF group. In regard to QoL, although we could not show the statistical differences due to some limitations of this study such as small sample size and non-randomized, it was indicated that TS had the potential to improve several QoL about anxiety, fighting spirit, and helplessness. Clinical trial information: UMIN000007185.

Effect of telephone follow-up on self-management skills for Miles patients

Objective To investigate whether telephone follow-up can help to improve Miles operation patient self-management capabilities,to improve quality of life and to improve patients' satisfaction.Methods The Miles operation patients were randomly divided into telephone follow-up group and conventional group.Both groups were given general surgical care; and telephone follow-up group was given support for lifestyle of outside,psychological and social competence weekly by full-time nurses through telephone follow-up.Patients in the two groups were investigated by self-management questionnaire 6 months later.Results Self-management skills of telephone follow-up group were significantly better than those of the conventional group (t =6.48,P ＜ 0.05 ).The score of postoperative adaptive capacity in follow-up group was (50.45 ±4.87) and (43.19 ±5.76) in conventional group; the score of self-management skills of patients had positive correlation with colostomy and adaptive capacity,social support,self-esteem score and cognitive symptoms management (r =0.45,0.39,0.37,0.33;P ＜0.0l ) ; The physician-patient and nurse-patient satisfaction after 6 months' intervention was 99.2％ in follow-up group and 94.2％ in conventional group,with significant difference (x2 =4.56,P ＜ 0.05).Conclusions Telephone follow-up can significantly improve self-management capacity,improve quality of life of Miles operation patients,and improve care and service satisfaction. Key words: Follow-up studies; Self-care; Miles operation

Does telephone follow-up improve blood pressure after minor stroke or TIA?

hypertension is a common risk factor for stroke/transient ischaemic attack (TIA) and there is good evidence that blood pressure (BP) control prevents recurrent stroke. We investigated whether telephone follow-up (TFU) improved risk factor management in hypertensive patients after stroke/TIA. we conducted a randomised controlled trial and assigned hypertensive patients within 1 month of stroke or TIA to receive usual care (n = 27) or usual care plus regular TFU (n = 29). Primary outcome was the difference in 12 h ambulatory systolic BP change from baseline to 6 months (DeltaSBP) in both groups. TFU at 7 days, 1, 2 and 4 months included patient-focussed education and goal setting. mean baseline BP was 145/83 mm Hg (standard deviation (SD) 21/14). There was no significant difference in DeltaSBP over 6 months with TFU. Median DeltaSBP was 0 mm Hg (interquartile range 19.5) in the TFU group and 3.0 mm Hg (20) fall in the usual care group (P = 0.29). Post hoc analysis showed that statin use increased from baseline to 6 months (P = 0.02) and cholesterol was significantly lower at 6 months in all patients (mean reduction 0.95 mmol/l; P < 0.001). our study found TFU that promoted patient-led management of risk factors did not improve BP control over 6-month follow-up in primary care after stroke/TIA.