Association Between Telephone Activity and Features of Patients With Inflammatory Bowel Disease

Abstract

Background & Aims Telephone communication is common between health care providers and patients with inflammatory bowel disease (IBD). We analyzed telephone activity at an IBD care center to identify disease and patient characteristics associated with high levels of telephone activity and determine if call volume could identify individuals at risk for future visits to the emergency department (ED) or hospitalization. Methods We performed a prospective observational study in which we categorized telephone calls received by nursing staff over 2 years at a tertiary care IBD clinic (2475 patients in 2009 and 3118 in 2010). We 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. Results Telephone encounters occurred twice as frequently as office visits; 15% of the patients generated >10 telephone encounters/y, and were responsible for half of all telephone encounters. A higher percentage of these high telephone encounter (HTE) patients were female, had Crohn's disease, received steroid treatment, had increased levels of C reactive protein and rates of erythrocyte sedimentation, had psychiatric co-morbidities, and had chronic abdominal pain than patients with lower telephone encounters. The HTE patients were also more frequently seen in the ED or hospitalized over the same time period and in subsequent years. Forty-two percent of patients with >8 telephone encounters within 30 days were seen in the ED or hospitalized within the subsequent 12 months. Conclusions Based on an analysis of phone records at an IBD clinic, 15% of patients account for half of all calls. These HTE patients are a heterogeneous group with refractory disease who are likely to visit the ED or be hospitalized.

The Influence of Anti–tumor Necrosis Factor Agents on Hemoglobin Levels of Patients with Inflammatory Bowel Disease

“…The characteristics of the consented, prospective, longitudinal, natural history registry of patients with IBD at University of Pittsburgh Medical Center have been previously described (11). This registry includes demographic, clinical, endoscopic, pathological, radiological, laboratory, and other clinical data of enrolled patients and is updated routinely through Information Technology support.…”

Impact of Obesity on the Management and Clinical Course of Patients with Inflammatory Bowel Disease

“…16 The most recent dose of IBD maintenance immunosuppressants (methotrexate, azathioprine, and 6-mercaptopurine ) and biologic anti-tumor necrosis factor (anti-TNF) agents (infliximab, adalimumab, and certolizumab pegol) were determined to calculate milligrams per kilogram drug dose. Drug dosing was also calculated using ideal body weight (IBW) for each patient using the Devine's formula.…”

How is inflammatory bowel disease managed in Spanish gastroenterology departments? The results of the GESTIONA-EII survey

“…Some aspects are highly positive: most centers provide emergency care, have telephone visits available, and have nurses in their units, all of which is highly beneficial for patient-doctor interactions (16,17). However, other aspects are negative, including the fact that nearly 40% have no surgeon specialist in IBD, which is clearly non-beneficial for patients as, the higher the number of annual surgeries for IBD, the lower the number of complications (18).…”