Respiratory Diseases
Conditions
Keywords
outpatients
Brief summary
Consultations with patients by hospital consultants are organised today in a manner which is barely dissimilar from that offered 30 or 40 years ago. Whilst some attempts to improve this process, such as Choose and Book, shorter waiting times and patients' receiving a copy of the correspondence sent to their general practitioner (GP) have improved the situation, there has been little radical change and little thought given to the patient experience. The investigators wish to investigate whether patients' experience of attending respiratory outpatient clinics can be improved by a pre-clinic telephone call with a specialist thereby reducing the number of attendances at the hospital for appointments and investigations and improving overall patient satisfaction.
Detailed description
This study will investigate whether taking a new patient's history over the telephone permits better selection and arrangement of investigations prior to or synchronous with the first face to face consultation, with the potential to reduce the number of visits the patient has to make to the hospital. Patients will be offered an initial telephone consultation by post and may opt-in or out of the study. Those having a telephone consultation would have this booked for a specific time and date and the patient would be sent an appropriate information leaflet regarding this. After the telephone consultation patients receive a summary of the consultation and details of any investigations and appointments booked by the research nurse. Patients who did not respond to the initial invitation letter within seven days or who declined to participate would be sent a routine appointment. All patients would asked to complete the MISS-21 questionnaire.
Interventions
alternative to face to face consultation for new referrals
OTHERNo intervention
no alternative to face to face consultation
Sponsors
The Dunhill Medical Trust
Imperial College London
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All new adult general respiratory referrals from primary care
Exclusion criteria
* Follow-up patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient Satisfaction of the Alternative Consultation | First clinic appointment (Month 0) and Follow-up appointment (6 months | Patient Satisfaction assessed by MISS scale, Medical interview satisfaction score. The score 0-7, 0 means dissatisfaction, higher scores indicate higher satisfaction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Required Investigations | 0-6 months | reduction in number of required investigations |
Countries
United Kingdom
Participant flow
Pre-assignment details
Patients' who attending respiratory outpatient clinics
Participants by arm
| Arm | Count |
|---|---|
| Respond to Study Invitation - Agree to Alternative Consultatio participants agreed to have an alternative consultation i.e. telephone consultation for their first hospital appointment | 49 |
| Respond to Study Invitation - Declined/ Non-responders Participants declined or did not respond to the invitation to participate in the study | 51 |
| Comparator - Choose and Book participants in this group booked their appointment through the choose and book system | 57 |
| Total | 157 |
Baseline characteristics
| Characteristic | Respond to Study Invitation - Declined/ Non-responders | Comparator - Choose and Book | Total | Respond to Study Invitation - Agree to Alternative Consultatio |
|---|---|---|---|---|
| Age, Continuous | 57.4 years STANDARD_DEVIATION 16.7 | 50.9 years STANDARD_DEVIATION 17 | 56.7 years STANDARD_DEVIATION 15.8 | 62 years STANDARD_DEVIATION 13.7 |
| Race and Ethnicity Not Collected | — | — | 0 Participants | — |
| Region of Enrollment United Kingdom | 51 participants | 57 participants | 157 participants | 49 participants |
| Sex: Female, Male Female | 28 Participants | 28 Participants | 83 Participants | 27 Participants |
| Sex: Female, Male Male | 23 Participants | 29 Participants | 74 Participants | 22 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 49 | 0 / 51 | 0 / 57 |
| other Total, other adverse events | 0 / 49 | 0 / 51 | 0 / 57 |
| serious Total, serious adverse events | 0 / 49 | 0 / 51 | 0 / 57 |
Outcome results
Primary
Patient Satisfaction of the Alternative Consultation
Patient Satisfaction assessed by MISS scale, Medical interview satisfaction score. The score 0-7, 0 means dissatisfaction, higher scores indicate higher satisfaction.
Time frame: First clinic appointment (Month 0) and Follow-up appointment (6 months
Population: Incomplete data and those that had an alternative consultation did not need a follow up appointment
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Agree to the Alternative Consultation | Patient Satisfaction of the Alternative Consultation | first clinic appointment | 5.85 score on a scale | Standard Deviation 0.73 |
| Declined the Alternative Study Invitation | Patient Satisfaction of the Alternative Consultation | first clinic appointment | 5.67 score on a scale | Standard Deviation 0.68 |
| Declined the Alternative Study Invitation | Patient Satisfaction of the Alternative Consultation | follow-up appointment | 5.47 score on a scale | Standard Deviation 0.53 |
| Comparator | Patient Satisfaction of the Alternative Consultation | first clinic appointment | 5.26 score on a scale | Standard Deviation 0.7 |
| Comparator | Patient Satisfaction of the Alternative Consultation | follow-up appointment | 5.36 score on a scale | Standard Deviation 0.98 |
Secondary
Number of Required Investigations
reduction in number of required investigations
Time frame: 0-6 months
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Agree to the Alternative Consultation | Number of Required Investigations | Planned investigations | 147 number of investigation |
| Agree to the Alternative Consultation | Number of Required Investigations | Completed investigations | 145 number of investigation |
| Declined the Alternative Study Invitation | Number of Required Investigations | Planned investigations | 117 number of investigation |
| Declined the Alternative Study Invitation | Number of Required Investigations | Completed investigations | 105 number of investigation |
| Comparator | Number of Required Investigations | Planned investigations | 128 number of investigation |
| Comparator | Number of Required Investigations | Completed investigations | 116 number of investigation |