Volume 19 Issue 3 September 2010Original Research
Use and utility of a 24-hour Telephone Support Service for
‘high risk’ patients with COPD
Pages 260-265
*John R Hursta,b, Fiona Fitzgerald-Khanb, Jennifer K Quinta, James JP Goldringa, Christine Mikelsonsb, J Paul Dilworthb, Jadwiga A Wedzichaa,b
a
Academic Unit of Respiratory Medicine, Royal Free Campus, UCL Medical School, London, UK
b
Department of Respiratory Medicine, Royal Free Hampstead NHS Trust, London, UK
Received 27 October 2009 • Accepted 2 May 2010 • Online 22 June 2010
Abstract
BACKGROUND: Hospitalisations are important events in COPD, and exacerbation prevention strategies are not completely effective.
Experience with our research cohort suggested that availability of 24-hour telephone advice may reduce hospital admission.
AIM: To examine the use and utility of a 24-hour Telephone Support Service for high-risk NHS COPD patients.
METHOD: 74 patients with ‘high-risk’ COPD had therapy optimised, were educated about exacerbations, given home ‘emergency’
therapy, and had 24-hour access to telephone advice.
RESULTS: Patients had a mean (SD) age of 70.4 (9.1) years and severe disease (mean FEV1 1.00 (0.37) litre; 30% had home oxygen and
46% lived alone). There were 258 telephone calls in 22,074 follow-up days. 76% of calls were received between 0800 and 1700 hours.
The proportion of possible exacerbation (‘appropriate’) calls (overall 56%) was higher at weekends and overnight. Overnight calls (2100-
0800) were rare: to expect one appropriate call per shift would require 2453 patients. A third of appropriate overnight calls could be
managed without further emergency assessment. Mean (SD) length of follow-up was 298 (117) days/patient. Patients completing one year
of follow-up (n=52) demonstrated a 45% reduction in admissions and 37% reduction in bed days. Patient satisfaction was high.
CONCLUSIONS: We report data on the use and utility of a 24-hour Telephone Support Service in COPD. The service was associated with a
reduction in hospital admission. Call volume was low, thus giving information on the size and cost-effectiveness of such service provision.
Keywords
COPD, exacerbation, hospitalisation, telephone support, service development
* Corresponding author. John R Hurst Tel: +44 (0)20 7317 Fax: +44 (0)20 7472 6141 Email: j.hurst@medsch.ucl.ac.uk | |
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