Telephone communication is common between healthcare providers and patients with inflammatory bowel disease (IBD).
Dr David Binion and colleagues analyzed telephone activity at an IBD care center to identify disease and patient characteristics associated with high levels of telephone activity.
In addition, the team determined if call volume could identify individuals at risk for future visits to the emergency department (ED) or hospitalization.
The research team performed a prospective observational study in which they categorized telephone calls received by nursing staff over 2 years at a tertiary care IBD clinic.
The researchers analyzed data on 21,979 ingoing and outgoing calls in 2009, and 32,667 calls in 2010 and assessed associations between clinical factors and logged telephone encounters, and between patterns of telephone encounters and future visits to the ED or hospitalization.
Telephone encounters occurred twice as frequently as office visits.
|42% of patients with more than 8 telephone encounters within 30 days were seen in the ED |
|Clinical Gastroenterology & Hepatology|
The team found that 15% of the patients generated more than 10 telephone encounters per year, and were responsible for half of all telephone encounters.
A higher percentage of these high telephone encounter patients were female, had Crohn's disease, received steroid treatment, had increased levels of C-reactive protein and rates of erythrocyte sedimentation, had psychiatric comorbidities, and had chronic abdominal pain than patients with lower telephone encounters.
The high telephone encounter patients were also more frequently seen in the ED or hospitalized over the same time period and in subsequent years.
The research team noted that 42% of patients with more than 8 telephone encounters within 30 days were seen in the ED or hospitalized within the subsequent 12 months.
Dr Binion's team commented, "Based on an analysis of telephone records at an IBD clinic, 15% of patients account for half of all calls."
"These high telephone encounter patients are a heterogeneous group with refractory disease who are likely to visit the ED or be hospitalized."