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Telephone Consultation as a Substitute for Routine Out-patient Face-to-face Consultation for Children With Inflammatory Bowel Disease: Randomised Controlled Trial and Economic Evaluation.

Akobeng AK, O'Leary N, Vail A, Brown N, Widiatmoko D, Fagbemi A, Thomas AG - EBioMedicine (2015)

Bottom Line: We aimed to assess the effectiveness and cost consequences of telephone consultation compared with the usual out-patient face-to-face consultation for young people with IBD.We found no suggestion of inferiority of telephone consultation compared with face-to-face consultation with regard to improvements in QOL scores, and telephone consultation reduced consultation time and NHS costs.Telephone consultation is a cost-effective alternative to face-to-face consultation for the routine outpatient follow-up of children and adolescents with IBD.

View Article: PubMed Central - PubMed

Affiliation: Royal Manchester Children's Hospital, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK ; Department of Paediatric Gastroenterology, Royal Manchester Children's Hospital, Central Manchester NHS Foundation Trust, Manchester, UK ; Sidra Medical and Research Centre, Doha, Qatar.

ABSTRACT

Background: Evidence for the use of telephone consultation in childhood inflammatory bowel disease (IBD) is lacking. We aimed to assess the effectiveness and cost consequences of telephone consultation compared with the usual out-patient face-to-face consultation for young people with IBD.

Methods: We conducted a randomised-controlled trial in Manchester, UK, between July 12, 2010 and June 30, 2013. Young people (aged 8-16 years) with IBD were randomized to receive telephone consultation or face-to-face consultation for 24 months. The primary outcome measure was the paediatric IBD-specific IMPACT quality of life (QOL) score at 12 months. Secondary outcome measures included patient satisfaction with consultations, disease course, anthropometric measures, proportion of consultations attended, duration of consultations, and costs to the UK National Health Service (NHS). Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02319798.

Findings: Eighty six patients were randomised to receive either telephone consultation (n = 44) or face-to-face consultation (n = 42). Baseline characteristics of the two groups were well balanced. At 12 months, there was no evidence of difference in QOL scores (estimated treatment effect in favour of the telephone consultation group was 5.7 points, 95% CI - 2.9 to 14.3; p = 0.19). Mean consultation times were 9.8 min (IQR 8 to 12.3) for telephone consultation, and 14.3 min (11.6 to 17.0) for face-to-face consultation with an estimated reduction (95% CI) of 4.3 (2.8 to 5.7) min in consultation times (p < 0.001). Telephone consultation had a mean cost of UK£35.41 per patient consultation compared with £51.12 for face-face consultation, difference £15.71 (95% CI 11.8-19.6; P < 0.001).

Interpretation: We found no suggestion of inferiority of telephone consultation compared with face-to-face consultation with regard to improvements in QOL scores, and telephone consultation reduced consultation time and NHS costs. Telephone consultation is a cost-effective alternative to face-to-face consultation for the routine outpatient follow-up of children and adolescents with IBD.

Funding: Research for Patient Benefit Programme, UK National Institute for Health Research.

No MeSH data available.


Related in: MedlinePlus

Dot-plot of all observed IMPACT QOL scores at baseline and 12 month follow-up with medians in each group at each time-point.
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f0010: Dot-plot of all observed IMPACT QOL scores at baseline and 12 month follow-up with medians in each group at each time-point.

Mentions: A summary of all observed outcomes and the treatment effect estimates is given in Table 2. The median (IQR) of the QOL score in the face-to-face group was 106 (95, 116) and 113 (105, 125) in the telephone group. Fig. 2 illustrates all observed QOL scores at baseline and 12 month follow-up. The specified ANCOVA model estimated a mean (95% CI) QOL score of 102.5 (96.5, 108.4) in the face-to-face group and 108.2 (101.6, 114.7) in the telephone group. The treatment effect estimate (95% CI) was then 5.7 (− 2.9, 14.3) units on the IMPACT QOL scale (P = 0.19) in favour of the telephone consultation group.


Telephone Consultation as a Substitute for Routine Out-patient Face-to-face Consultation for Children With Inflammatory Bowel Disease: Randomised Controlled Trial and Economic Evaluation.

Akobeng AK, O'Leary N, Vail A, Brown N, Widiatmoko D, Fagbemi A, Thomas AG - EBioMedicine (2015)

Dot-plot of all observed IMPACT QOL scores at baseline and 12 month follow-up with medians in each group at each time-point.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4588430&req=5

f0010: Dot-plot of all observed IMPACT QOL scores at baseline and 12 month follow-up with medians in each group at each time-point.
Mentions: A summary of all observed outcomes and the treatment effect estimates is given in Table 2. The median (IQR) of the QOL score in the face-to-face group was 106 (95, 116) and 113 (105, 125) in the telephone group. Fig. 2 illustrates all observed QOL scores at baseline and 12 month follow-up. The specified ANCOVA model estimated a mean (95% CI) QOL score of 102.5 (96.5, 108.4) in the face-to-face group and 108.2 (101.6, 114.7) in the telephone group. The treatment effect estimate (95% CI) was then 5.7 (− 2.9, 14.3) units on the IMPACT QOL scale (P = 0.19) in favour of the telephone consultation group.

Bottom Line: We aimed to assess the effectiveness and cost consequences of telephone consultation compared with the usual out-patient face-to-face consultation for young people with IBD.We found no suggestion of inferiority of telephone consultation compared with face-to-face consultation with regard to improvements in QOL scores, and telephone consultation reduced consultation time and NHS costs.Telephone consultation is a cost-effective alternative to face-to-face consultation for the routine outpatient follow-up of children and adolescents with IBD.

View Article: PubMed Central - PubMed

Affiliation: Royal Manchester Children's Hospital, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK ; Department of Paediatric Gastroenterology, Royal Manchester Children's Hospital, Central Manchester NHS Foundation Trust, Manchester, UK ; Sidra Medical and Research Centre, Doha, Qatar.

ABSTRACT

Background: Evidence for the use of telephone consultation in childhood inflammatory bowel disease (IBD) is lacking. We aimed to assess the effectiveness and cost consequences of telephone consultation compared with the usual out-patient face-to-face consultation for young people with IBD.

Methods: We conducted a randomised-controlled trial in Manchester, UK, between July 12, 2010 and June 30, 2013. Young people (aged 8-16 years) with IBD were randomized to receive telephone consultation or face-to-face consultation for 24 months. The primary outcome measure was the paediatric IBD-specific IMPACT quality of life (QOL) score at 12 months. Secondary outcome measures included patient satisfaction with consultations, disease course, anthropometric measures, proportion of consultations attended, duration of consultations, and costs to the UK National Health Service (NHS). Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT02319798.

Findings: Eighty six patients were randomised to receive either telephone consultation (n = 44) or face-to-face consultation (n = 42). Baseline characteristics of the two groups were well balanced. At 12 months, there was no evidence of difference in QOL scores (estimated treatment effect in favour of the telephone consultation group was 5.7 points, 95% CI - 2.9 to 14.3; p = 0.19). Mean consultation times were 9.8 min (IQR 8 to 12.3) for telephone consultation, and 14.3 min (11.6 to 17.0) for face-to-face consultation with an estimated reduction (95% CI) of 4.3 (2.8 to 5.7) min in consultation times (p < 0.001). Telephone consultation had a mean cost of UK£35.41 per patient consultation compared with £51.12 for face-face consultation, difference £15.71 (95% CI 11.8-19.6; P < 0.001).

Interpretation: We found no suggestion of inferiority of telephone consultation compared with face-to-face consultation with regard to improvements in QOL scores, and telephone consultation reduced consultation time and NHS costs. Telephone consultation is a cost-effective alternative to face-to-face consultation for the routine outpatient follow-up of children and adolescents with IBD.

Funding: Research for Patient Benefit Programme, UK National Institute for Health Research.

No MeSH data available.


Related in: MedlinePlus