scholarly journals Converting From Face-to-face to Postal Follow-up and Its Effects on Participant Retention, Response Rates and Errors: Lessons from the EQUAL study in the UK.

Author(s):  
Emer Regina Gates ◽  
Barnaby Hole ◽  
Samantha Hayward ◽  
Nicholas C Chesnaye ◽  
Yvette Meuleman ◽  
...  

Abstract BackgroundProspective cohort studies are challenging to deliver, with one of the main difficulties lying in retention of participants. The need to socially distance during the COVID-19 pandemic has added to this challenge. The pre-COVID-19 adaptation of the European Quality (EQUAL) study in the UK to a remote form of follow-up for efficiency provides lessons for those who are considering changing their study design.MethodsThe EQUAL study is an international prospective cohort study of patients ≥65 years of age with advanced chronic kidney disease. Initially, patients were invited to complete a questionnaire (SF-36, Dialysis Symptom Index and Renal Treatment Satisfaction Questionnaire) at research clinics every 3-6 months, known as “traditional follow-up” (TFU). In 2018, all living patients were invited to switch to “efficient follow-up” (EFU), which used an abbreviated questionnaire consisting of SF-12 and Dialysis Symptom Index. These were administered centrally by post. Response rates were calculated using returned questionnaires as a proportion of surviving invitees, and error rates presented as the average percentage of unanswered questions or unclear answers, of total questions in returned questionnaires. Response and error rates were calculated 6-monthly in TFU to allow comparisons with EFU.ResultsOf the 504 patients initially recruited, 236 were still alive at the time of conversion to EFU; 111 of these (47%) consented to the change in follow-up. In those who consented, median TFU was 34 months, ranging from 0 to 42 months. Their response rates fell steadily from 88% (98/111) at month 0 of TFU, to 20% (3/15) at month 42. The response rate for the first EFU questionnaire was 60% (59/99) of those alive from TFU. With this improvement in response rates, the first EFU also lowered errors to baseline levels seen in early follow-up, after having almost trebled throughout traditional follow-up.ConclusionsOverall, this study demonstrates that administration of shorter follow-up questionnaires by post rather than in person does not negatively impact patient response or error rates. These results may be reassuring for researchers who are trying to limit face-to-face contact with patients during the COVID-19 pandemic.

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Mia Rodziewicz ◽  
Terence O'Neill ◽  
Audrey Low

Abstract Background/Aims  Rheumatology departments were required to switch rapidly from face-to-face (F2F) to remote consultations during the COVID-19 pandemic in the UK. We conducted a patient satisfaction survey on the switch to inform future service development. Methods  All patients [new (NP), follow-up (FU)] were identified between 1st to 5th June 2020. Patients who attended or did not attend (DNA) a pre-booked F2F consultation or cancelled were excluded. Of the remainder, half the patients was surveyed by phone using a standardised questionnaire and the other half was posted the same questionnaire. Both groups were offered the opportunity to complete the survey online. Patients were surveyed on the organisation and content of the consultation, whether they were offered a subsequent F2F appointment and future consultation preference. Results  233 consultations were scheduled during the study period. After 53 exclusions (34 pre-booked F2F, 16 DNA, 3 cancellations), 180 eligible consultations were surveyed (85 via mailshot, 95 by telephone). 75/180 patients (42%) responded within 1 month of the telephone consultation (20 NP, 47 FU, 8 missing). The organisation of the switch was positively perceived (Table). Patients were highly satisfied with 4 of the 5 consultation domains but were undecided whether a physical assessment would have changed the outcome of the consultation (Table). After the initial phone consultation, 7 of 20 NP and 19 of 47 FU were not offered subsequent F2F appointments at the clinicians’ discretion. Of those not offered subsequent F2F appointments, proportionally more NP (3/7, 43%) would have liked one, compared to FU (5/19, 26%). Reasons included communication difficulties and a desire for a definitive diagnosis. 48/75 (64%) would be happy for future routine FU to be conducted by phone “most of the time" or "always”; citing patient convenience and disease stability. Caveats were if physical examination was required or if more serious issues (as perceived by the patient) needed F2F discussion. Conclusion  Patients were generally satisfied with telephone consultations and most were happy to be reviewed again this way. NPs should be offered F2F appointments for first visits to maximise patient satisfaction and time efficiency. P071 Table 1:Median age, yearsFemale; n (%)Follow-up; n (%)All eligible for survey; n = 18056122 (68)133 (74)Sent mailshot; n = 855459 (69)65 (76)Surveyed by phone; n = 955663 (66)68 (72)Responder by mail; n = 166911 (69)13 (82)Responder by phone; n = 525437 (71)34 (65)Responder by e-survey; n = 7495 (71)UnknownOrganisation of the telephone consultation, N = 75Yes, n (%)No, n (%)Missing, n (%)Were you informed beforehand about the phone consultation?63 (84)11 (15)1 (1)Were you called within 1-2 hours of the appointed date and time?66 (88)6 (8)3 (4)Domains of the consultation, N = 75Strongly disagree, n (%)Disagree, n (%)Neutral, n (%)Agree, n (%)Strongly agree, n (%)Missing, n (%)During the call, I felt the clinician understood my problem3 (4)1 (1)1 (1)20 (27)49 (65)1 (1)During the call, I had the opportunity to ask questions regarding my clinical care1 (1)02 (3)16 (21)55 (73)1 (1)A physical examination would have changed the outcome of the consultation16 (21)18 (24)20 (27)11 (15)10 (13)0The clinician answered my questions to my satisfaction2 (3)06 (8)18 (24)49 (65)0At the end of the consultation, the clinician agreed a management plan with me3 (4)2 (3)6 (8)24 (32)39 (52)1 (1)Future consultations, N = 75Never, n (%)Sometimes, n (%)Most of the time, n (%)Always, n (%)Missing, n, (%)In the future, would you be happy for routine FU to be conducted by phone?5 (7)20 (27)16 (21)32 (43)2 (3) Disclosure  M. Rodziewicz: None. T. O'Neill: None. A. Low: None.


2004 ◽  
Vol 185 (6) ◽  
pp. 460-464 ◽  
Author(s):  
Natalie D. Veen ◽  
Jean-Paul Selten ◽  
Diede Schols ◽  
Winfried Laan ◽  
Hans W. Hoek ◽  
...  

BackgroundNo study outside the UK has examined the diagnostic stability of psychotic disorders in a population-based sample.AimsTo determine diagnostic stability in a Dutch population-based psychosis incidence cohort, to examine the frequencies of diagnostic shifts to and from schizophrenic disorders and to report the revised relative risks of schizophrenic disorders for immigrants.MethodA 30-month follow-up study assessed the cohort (n=181) by means of face-to-face diagnostic interviews.ResultsDiagnostic stability of schizophrenic disorders was high (91%), but lower for other psychotic disorders. At follow-up, the initial diagnosis was adjusted to schizophrenic disorder more often than that the reverse occurred. Almost half (49%) of the patients who were not initially diagnosed as having a schizophrenic disorder received this diagnosis at follow-up. The relative risks for most immigrant groups were stable.ConclusionsSchizophrenic disorders are underdiagnosed, rather than overdiagnosed, at first presentation.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Chaudhry ◽  
J Abiola

Abstract Introduction The Covid-19 pandemic has had a global impact on healthcare. As a result, changes have been made to healthcare provision. In the UK, the focus was changed to urgent and emergency treatment only, and therefore a shift from face-to-face consultations to video and telephone consultations was implemented. Our aim was to look at the telephone consultations in our oral and maxillofacial (OMF) department to identify their effectiveness. Method A search was carried out using the electronic patient record for patients booked for consultations in the OMF clinics from the 23rd of March to the 1st of May 2020. Trauma clinics and ad-hoc clinics were excluded. Results 21 clinic codes were found as suitable for inclusion. 185 consultations were booked during the 6-week period. Of these, 165 were via telephone and 20 face-to-face. A total of 75 consultations resulted in discharge and 110 required further follow up or further investigation. Of the 75 patients discharged, 73 of these were via telephone. The main reason for discharge was delivery of benign biopsy results. Conclusions Covid-19 will have long term impacts on healthcare provision. If implemented correctly, virtual consultations carry the potential in making healthcare more accessible.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Carol Norman ◽  
Lilia Ragad ◽  
Anupama Nagarajakumar ◽  
Maryam Alam Khan ◽  
Michal Uhercik ◽  
...  

Abstract Aims Prior to March 2020, at Princess Royal University Hospital (PRUH), Kings College NHS Foundation Trust, almost daily face to face benign/malignant breast clinic follow ups occurred. On March 23rd 2020 the UK went into official COVID-19 pandemic lockdown. The effect on elective follow up practice was swift with cancellation, triaging and replacement of face-to-face by telephonic/virtual consultations. We compared the change of follow up pattern, pre and post COVID-19. Could this effect the future of consultations at PRUH? Methods A comparison of all patients attending PRUH breast unit outpatients in January 2020 (preCOVID-19) for follow up, with those attending in April 2020 (postCOVID-19). Data collection from clinic lists and electronic patient records, with Excel version 16 analysis. Results 343 patient follow up consultations 01/2020. 53 patient follow up consultations 04/2020. Malignant cases: January 65%, April 60% Benign/B3 cases: January 35%, April 20% Summary follow up types. Conclusions Impact of COVID has been widespread in our practice. Our results show a significant reduction in face-to-face appointments, to allow social distancing. Further evaluation of this model will show its sustainability. Patient satisfaction will have to be assessed, with a view to a full move to video/telephone consultation where indicated.


2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i37-i37
Author(s):  
E R Bodger ◽  
K Ibrahim ◽  
H C Roberts

Abstract Introduction People with Parkinson’s (PwP) and their caregivers often report poor diagnosis experiences and a lack of information, support and control over Parkinson’s. First Steps is a two-day course delivered by volunteers with Parkinson’s, which aims to help those newly diagnosed and their caregivers face the future positively and take control of Parkinson’s. This study aimed to capture the views and experiences of participants and volunteer hosts of First Steps, and evaluate if it meets those aims. Methods Using purposive sampling, twelve participants comprising four PwP, five caregivers and three volunteer hosts were recruited. Face-to-face, semi-structured interviews were conducted, audio-recorded, transcribed verbatim and analysed thematically. Results Course participants found First Steps informative, supportive, and helpful in feeling more positive about Parkinson’s. Participants were reassured by the hosts having Parkinson’s, despite prior concerns regarding seeing people who might have more advanced Parkinson’s. Some found First Steps more relatable than other support services and reported that the course complemented clinician-led courses as the content was aimed at caregivers as well as PwP, with variation in information delivery techniques. Among the PwP and caregivers, two thirds reported a lack of control over Parkinson’s and some felt First Steps had improved their control. Hosts felt they had control over Parkinson’s and perceived their role to be both challenging and rewarding. Conclusions First Steps was perceived as a helpful course, offering information and support for those newly diagnosed and their caregivers in a positive and non-clinical environment. Volunteer hosts felt more control over Parkinson’s than other participants, but there was evidence that the course helped some experience more control. Suggested course improvements included: additions to the presentation content with more emphasis on taking control, and offering group follow up sessions. This will inform current expansion across the UK.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9020-9020
Author(s):  
P. Hopwood ◽  
M. Nankivell ◽  
C. Pugh ◽  
D. Gilligan ◽  
M. Nicolson ◽  
...  

9020 Aim: To evaluate QL during the first 2 years follow-up in patients randomised to receive 3 cycles of platinum-based chemotherapy (CT-S) prior to surgical resection of NSCLC compared to those receiving surgery alone (S). Methods: A total of 519 patients were entered into the LU22 trial from 70 centres in the UK, The Netherlands, Germany and Belgium. All patients were asked to complete the SF-36 QL questionnaire prior to randomisation and at 6 and 12 months then annually to 5 years. The scores from the SF-36 questionnaire were combined into 8 domains and also summarised as physical component summary (PCS) and mental component summary (MCS). The 6,12 and 24 month PCS and MCS scores were analysed using multivariable regression to identify prognostic factors and investigate the difference between the regimens. Results: 82% patients completed QL at baseline, and compliance at 6, 12 and 24 months was 59%, 60% and 67% respectively. Median age was 63 (range 25 to 79 years) and 72% were male. At 6 months patients in the S group reported somewhat better functioning in all domains except general health and mental health, but no differences were seen at 12 or 24 months. The regression analyses indicated that better physical health outcomes (PCS) were predicted by baseline PCS and MCS at all follow-up points (all p<0.05), whereas longer time since surgery predicted better PCS at 6 months (p<0.05), and younger age predicted better PCS at 24 months (p=0.07). For mental health, better MCS was predicted at all time points by baseline MCS (p<0.05). In addition, female gender (p=0.07), and PCS (p<0.05), were predictors at 6 months, and younger age predicted better MCS at 24 months (p<0.01). Treatment regimen had no effect on QL at any time point. At 1 and 2 years more than 50% patients considered their health comparable to others, and 45% were generally optimistic about their future health. Conclusions: Over 2 years follow-up, QL was not adversely affected by pre-operative chemotherapy and there were no significant differences between the regimens. Many patients saw themselves as fit as their contemporaries. [Table: see text]


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
A. M. Charnell ◽  
E. Hannon ◽  
D. Burke ◽  
M. R. Iredale ◽  
J. R. Sutcliffe

Abstract Background The COVID-19 pandemic has resulted in many changes to clinical practice, including the introduction of remote clinics. Those familiar with remote clinics have reported benefits to their use, such as patient satisfaction and cost benefits; however, ongoing challenges exist, including delivering optimal patient-centred care. As a tertiary paediatric surgery unit in the UK, completing remote clinics was a new experience for most of our surgical team. We completed a service evaluation early into the COVID-19 pandemic aiming to define and address issues when delivering remote clinics in paediatric surgery. Remote clinics were observed (telephone and video), with follow-up calls to families following the consultations. Results Eight paediatric surgeons were observed during their remote clinics (telephone n = 6, video n = 2). Surgeons new to remote clinics felt their consultations took longer and were reluctant to discharge patients. The calls did not always occur at the appointed time, causing some upset by parents. Prescription provision and outpatient investigations led to some uncertainty within the surgical team. Families (n = 11) were called following their child’s appointment to determine how our remote clinics could be optimised. The parents all liked remote clinics, either as an intermediate until a face-to-face consultation or for continued care if appropriate. Our findings, combined by discussions with relevant managers and departments, led to the introduction of recommendations for the surgical team. An information sheet was introduced for the families attending remote clinics, which encouraged them to take notes before and during their consultations. Conclusions There must be strong support from management and appropriate departments for successful integration of remote clinics. Surgical trainees and their training should be considered when implementing remote clinics. Our learning from the pandemic may support those considering integrating remote clinics in the future.


2021 ◽  
Author(s):  
Felix Ndashimye ◽  
Oumarou Hebie ◽  
Jasper Tjaden

Phone surveys have increasingly become important data collection tools in developing countries, particularly in the context of sudden contact restrictions due to the COVID-19 pandemic. Phone surveys offer particular potential for migration scholars aiming to study cross-border migration behavior. Geographic change of location over time complicates the logistics of face-to-face surveys and heavily increases costs. There is, however, limited evidence of the effectiveness of the phone survey modes in different geographic settings more generally, and in migration research more specifically. In this field experiment, we compared the response rates between WhatsApp—a relatively new but increasingly important survey mode—and interactive voice response (IVR) modes, using a sample of 8446 contacts in Senegal and Guinea. At 12%, WhatsApp survey response rates were nearly eight percentage points lower than IVR survey response rates. However, WhatsApp offers higher survey completion rates, substantially lower costs and does not introduce more sample selection bias compared to IVR. We discuss the potential of WhatsApp surveys in low-income contexts and provide practical recommendations for field implementation.


2008 ◽  
Vol 7 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Geraldine A. Lee

Background: The number of individuals undergoing Coronary Artery Bypass Graft Surgery (CABGS) to treat coronary artery disease is steadily increasing. Aim: The purpose of the study was to describe the cohort's characteristics, their angina and breathless symptoms and report health-related quality of life (HRQoL) five years after CABGS. Methods: One hundred and twenty-eight patients participated in the follow-up study using the quality of life Short-Form 36 (SF-36) questionnaire. Angina and breathless symptoms were also recorded. Results: One hundred and nine patients were interviewed (face-to-face) and 19 completed postal questionnaires. The SF-36 component summaries of the face-to-face patients indicated that their physical (PCS) and mental (MCS) health was relatively good (45.8 and 53.6, respectively, with 0 = worst health and 100 = best health and 50 being the mean score), compared to the postal patients' mean PCS of 30.8 ( p < .001). The postal MCS was also lower but not statistically significant (49.6, p = .081). At follow-up, the majority of patients were asymptomatic in terms of angina and breathlessness compared to their pre-operative status. Conclusion: The findings demonstrate that patient perceived HRQoL five years after CABGS is generally good and patients remain relatively asymptomatic although data collection methods highlight differences in physical HRQoL.


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A Hoyle ◽  
K Iqbal ◽  
J Henry ◽  
L Hughes ◽  
D Johnson

Abstract Background In anticipation of the UK coronavirus pandemic peak, BOA published new pandemic-specific guidance (“COVID BOAST”) in April 2020. We describe our experience implementing this restructured T&O service in a busy DGH setting during the pandemic peak. Method A rapid retrospective audit was conducted of all patients presenting to our T&O service in April 2020, with particular emphasis compliance with COVID BOAST. Results Our service conducted 511 outpatient reviews, and 95 operative procedures. 94% of outpatients were treated non-operatively. We provided telephone appointments to 12.8% of follow-up patients, and 39% of new patients. 82% of patients were treated with removable casts/splints/boots. 23% of patients were discharged direct from VFC or after one face-to-face fracture clinic review. Residual deformity was consciously accepted in 13% of patients. Theatre throughput fell significantly due to pandemic precautions however, femoral neck fracture volumes remained constant. Conclusions We demonstrate broad compliance with COVID BOAST guidance. The majority of patients were treated non-operatively, including conscious acceptance of residual deformity. Our pre-existing VFC allowed us to provide a significant number of telephone consultations, although despite the practice shift towards removable splintage, face-to-face consultations were required for clinical and/or radiological assessment. The impact of increased conservative management on patients’ long-term outcomes needs further evaluation.


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