A survey of chronic pain telephone consultations during COVID-19 at an inner-city secondary care center.
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ABSTRACT:
SUBMITTER: Berwick RJ
PROVIDER: S-EPMC8250122 | biostudies-literature | 2021 Jul
REPOSITORIES: biostudies-literature
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A survey of chronic pain telephone consultations during COVID-19 at an inner-city secondary care center.
Berwick Richard J RJ Herron Katie K Kee Tsang Hoo H
Pain practice : the official journal of World Institute of Pain 20210430 6
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Project description:BackgroundThe impact of telephone consultations between pain specialists and primary care physicians regarding the care of patients with chronic pain is unknown.ObjectivesTo evaluate the impact of telephone consultations between pain specialists and primary care physicians regarding the care of patients with chronic pain.MethodsPatients referred to an interdisciplinary chronic pain service were randomly assigned to either receive usual care by the primary care physician, or to have their case discussed in a telephone consultation between a pain specialist and the referring primary care physician. Patients completed a numerical rating scale for pain, the Pain Disability Index and the Short Form-36 on referral, as well as three and six months later. Primary care physicians completed a brief survey to assess their impressions of the telephone consultation.ResultsEighty patients were randomly assigned to either the usual care group or the standard telephone consultation group, and 67 completed the study protocol. Patients were comparable on baseline pain and demographic characteristics. No differences were found between the groups at six months after referral in regard to pain, disability or quality of life measures. Eighty percent of primary care physicians indicated that they learned new patient care strategies from the telephone consultation, and 97% reported that the consultation answered their questions and helped in the care of their patient.DiscussionMost primary care physicians reported that a telephone consultation with a pain specialist answered their questions, improved their patients' care and resulted in new learning. Differences in patient status compared with a usual care control group were not detectable at six-month follow-up.ConclusionsWhile telephone consultations are clearly an acceptable strategy for knowledge translation, additional strategies may be required to actually impact patient outcomes.
| S-EPMC4676497 | biostudies-literature
Project description:There are no studies describing the nature and quality of telephone consultations for critically ill children despite being an important part of pediatric intensive care. We described pediatric telephone consultations to a PICU in Ontario, Canada in 2011 and 2012. Of 203 consultations, 104 patients (51.2%) were admitted to the PICU; this was associated with weekend consultations ( p = 0.005) and referral hospital location ( p = 0.036). Frequency of interruptions was 1 in every 3.2 (2.0, 5.7) minutes and not associated with call content. Twenty-one percent of consults had limited discussion of vital signs. Our study described our center's remote critical care consultation program and outcomes.
| S-EPMC6687452 | biostudies-literature
Project description:Consultations on telephone are ever increasing especially in primary healthcare. Currently the estimated total number consultations in England rose from 224.5 million to 243.1 million in 1995/1996 to 303.9 million to 313.6 million in 2008/2009, out of which 3% of consultations in 1995/1996 were telephone consultations which increased to 12% in 2008/2009. Literature search was done on published articles on tele-healthcare which resulted in devising a telephone consultation model. An audit was carried out in urban Cambridge family practice over the period of one year after implementing this telephone consultation model. Following proposed consultation model by healthcare staff, it has improved patient satisfaction survey from 75% to 94%, face to face consultation rate was reduced by 1.6%, home visits were reduced by 2.9% however the direct economic saving could not be determined. Further research is required to assess the detailed economic analysis of using effective telephone consultation in healthcare. The data shown in this article is related to primary care in the UK, but its concept can be replicated by any country in Europe or rest of the world providing primary healthcare to public.
| S-EPMC4652702 | biostudies-literature
Project description:BackgroundApproximately 20% of patients experience chronic pain after total knee replacement (TKR). The impact of chronic pain after TKR on primary care services in the UK is currently unknown. The aim of this study was to compare primary care consultations and pain medicine prescriptions between patients with and without chronic pain after TKR.MethodsData from 5,055 patients who received TKR between 2009 and 2016 with anonymised linked data from the Clinical Practice Research Datalink Gold (CPRD) and English Hospital Episode Statistics (HES) Patient Reported Outcome Measures (PROMs) programme were analysed. The exposure time was from 10 years pre-operative to eight years post-operative. Patients with a score ≤ 14 on the Oxford Knee Score pain component scale at 6 months post-operative were classified as having chronic pain after TKR. Primary care consultations and prescribed pain medicines were quantified, and costs calculated based on national cost data.Results721 patients (14%) had chronic pain after TKR. The prevalence and costs of primary care consultations and pain medicine prescriptions per year were consistently higher for patients with chronic pain after TKR compared with those without chronic pain after TKR; these differences were observed both before and after surgery. There was a substantial and sustained increase in the cost of opioid prescriptions after surgery for patients with chronic pain after TKR, peaking at seven years post-operative.ConclusionsIncreased primary care consultations and pain medicine prescriptions associated with chronic pain after TKR represent a considerable financial cost to primary care services. Evaluation of interventions to reduce the risk of developing this pain condition and improve the early management of pain after TKR are needed to improve outcomes for patients and reduce costs to healthcare services.
| S-EPMC9172077 | biostudies-literature
Project description:ObjectiveThe objective of this study was to evaluate the efficacy of a telephone-delivered, home-based cognitive-behavioral intervention for chronic low back pain in comparison to a matched supportive care (SC) treatment.MethodsParticipants (N=66) were patients with chronic back pain that were randomized to either an 8-week Cognitive-Behavioral Therapy (CBT) or a SC condition matched for contact frequency, format, and time. Participants completed validated measures of improvement in back pain disability, pain severity, and overall improvement.ResultsIntent-to-treat analyses at posttreatment showed that the treatment groups not show significantly different improvements in back pain disability (mean changes, -2.4 and -2.6 for CBT and SC, respectively; Cohen d, 0.49 and 0.55, respectively) or reductions in pain severity (mean changes, -0.9 and -1.4 for CBT and SC respectively; Cohen d, 0.50, and 0.90, respectively). Participants rated their overall improvement levels at 31% (CBT) versus 18.5% (SC).DiscussionResults from this clinical trial suggest that home-based, telephone-delivered CBT and SC treatments did not significantly differ in their benefits for back pain severity and disability, and may warrant further research for applications to hospital settings. Major limitations included recruitment difficulties that underpowered primary analyses, the lack of objective improvement measures, and the absence of a usual care/untreated control group for comparisons.
| S-EPMC5832497 | biostudies-literature
Project description:BackgroundThe use of information technology, including internet- and telephone-based resources, is becoming an alternative and supporting method of providing many forms of services in a healthcare and health management setting. Telephone consultations provide a promising alternative and supporting service for face-to-face general practice care. The aim of this review is to utilize a systematic review to collate evidence on the use of telephone consultation as an alternative to face-to-face general practice visits.MethodsA systematic search of MEDLINE, CINAHL, The Cochrane Library, and the International Clinical Trials Registry Platform was performed using the search terms for the intervention (telephone consultation) and the comparator (general practice). Systematic reviews and randomized control trials that examined telephone consultation compared to normal face-to-face consultation in general practice were included in this review. Papers were reviewed, assessed for quality (Cochrane Collaboration's 'Risk of bias' tool) and data extracted and analysed.ResultsTwo systematic reviews and one RCT were identified and included in the analysis. The RCT (N = 388) was of patients requesting same-day appointments from two general practices and patients were randomized to a same-day face-to-face appointment or a telephone call back consultation. There was a reduction in the time spent on consultations in the telephone group (1.5 min (0.6 to 2.4)) and patients in the telephone arm had 0.2 (0 to 0.3) more follow-up consultations than the face-to-face group. One systematic review focused on telephone consultation and triage on healthcare use, and included one RCT and one other observational study that examined telephone consultations. The other systematic review focused on patient access and included one RCT and four observational studies that examined telephone consultations. Both systematic reviews provided narrative interpretations of the evidence and concluded that telephone consultations provided an appropriate alternative to telephone consultations and reduced practice work load.ConclusionThere is a lack of high level evidence for telephone consultations in a GP setting; however, current evidence suggests that telephone consultations as an alternative to face-to-face general practice consultations offers an appropriate option in certain settings.Systematic review registrationPROSPERO CRD42015025225.
| S-EPMC5496327 | biostudies-literature
Project description:ObjectivesDuring the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation.MethodsWe carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool.ResultsSurveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were <50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (<50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P < 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%).ConclusionMost patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients >50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.
| S-EPMC7798592 | biostudies-literature
Project description:During the COVID-19 pandemic, remote consultations became a new norm for paediatric outpatient clinics. The objective of this survey was to find patients' perspective on telephone consultations. 200 patients, who had remote consultations since April 2020, were surveyed and their responses were analysed. Almost half (98/200) of the patients or their parents preferred remote consultations mixed with face-to-face consultations; only a fifth (40/200) preferred exclusively face-to-face consultations; and approximately a third (62/200) preferred exclusively remote consultations. In conclusion, remote consultations are becoming a popular choice for patients, although there are limitations, especially in the context of safeguarding.
| S-EPMC7722828 | biostudies-literature
Project description:BackgroundRefugees and asylum seekers experience language barriers in general practice. Qualitative studies have found that responses to language barriers in general practice are ad hoc with use of both professional interpreters and informal interpreters (patients' relatives or friends). However, the scale of the issues involved is unknown. This study quantifies the need for language assistance in general practice consultations and examines the experience of, and satisfaction with, methods of language assistance utilized.MethodsData were collected by telephone survey with general practitioners in a regional health authority in Ireland between July-August 2004. Each respondent was asked a series of questions about consulting with refugees and asylum seekers, the need for language assistance and the kind of language assistance used.ResultsThere was a 70% (n = 56/80) response rate to the telephone survey. The majority of respondents (77%) said that they had experienced consultations with refugees and asylum seekers in which language assistance was required. Despite this, general practitioners in the majority of cases managed without an interpreter or used informal methods of interpretation. In fact, when given a choice general practitioners would more often choose informal over professional methods of interpretation despite the fact that confidentiality was a significant concern.ConclusionThe need for language assistance in consultations with refugees and asylum seekers in Irish general practice is high. General practitioners rely on informal responses. It is necessary to improve knowledge about the organisational contexts that shape general practitioners responses. We also recommend dialogue between general practitioners, patients and interpreters about the relative merits of informal and professional methods of interpretation so that general practitioners' choices are responsive to the needs of patients with limited English.
| S-EPMC2637872 | biostudies-literature