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Outpatient visits versus telephone interviews for postoperative care: a randomized controlled trial.

Authors
  • Thompson, Jennifer C1
  • Cichowski, Sara B2
  • Rogers, Rebecca G3
  • Qeadan, Fares4
  • Zambrano, Julissa1
  • Wenzl, Cynthia1
  • Jeppson, Peter C1
  • Dunivan, Gena C1
  • Komesu, Yuko M1
  • 1 University of New Mexico Department of Obstetrics and Gynecology, Division of Urogynecology, 2211 Lomas Blvd. NE, ACC-4th Floor, Albuquerque, NM, 87131, USA. , (Mexico)
  • 2 University of New Mexico Department of Obstetrics and Gynecology, Division of Urogynecology, 2211 Lomas Blvd. NE, ACC-4th Floor, Albuquerque, NM, 87131, USA. [email protected] , (Mexico)
  • 3 Dell Medical School, The University of Texas at Austin, Austin, TX, USA.
  • 4 University of New Mexico Clinical and Translational Science Center, Albuquerque, NM, USA. , (Mexico)
Type
Published Article
Journal
International urogynecology journal
Publication Date
Oct 01, 2019
Volume
30
Issue
10
Pages
1639–1646
Identifiers
DOI: 10.1007/s00192-019-03895-z
PMID: 30783704
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Our aim was to determine whether postoperative telephone follow-up was noninferior to in-person clinic visits based on patient satisfaction. Secondary outcomes were safety and clinical outcomes. Women scheduled for pelvic surgery were recruited from a single academic institution and randomized to clinic or telephone follow-up. The clinic group returned for visits 2, 6, and 12 weeks postoperatively and the telephone group received a call from a nurse at the same time intervals. Women completed the Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS) questionnaire, Pelvic Floor Distress Inventory (PFDI)-20, and pain scales prior to and 3 months postoperatively. Randomized patients who completed the S-CAHPS at 3 months were included for analysis. Sample size calculations, based on a 15% noninferiority limit in the S-CAHPS global assessment surgeon rating, required 100 participants, with power = 80% and alpha = 0.025. From October 2016 to November 2017, 100 participants were consented, underwent surgery, were randomized, and included in the final analysis (clinic group n = 50, telephone group n = 50). Mean age was 58.5 ± 12.2 years. Demographic data and surgery type, dichotomized into outpatient and inpatient, did not differ between groups. The S-CAHPS global assessment surgeon rating from patients in the telephone group was noninferior to the clinic group (92 vs 88%, respectively, rated their surgeons 9 and10, with a noninferiority limit of 36.1; p = 0.006). Adverse events did not differ between groups (n = 26; 57% fclinic vs 43% telephone; p = 0.36). Patients in the telephone group did not require additional emergency room or primary care visits. Clinical outcome measures improved in both groups, with no differences (all p > 0.05). Telephone follow-up after pelvic floor surgery results in noninferior patient satisfaction, without differences in clinical outcomes or adverse events. Telephone follow-up may improve healthcare quality and decrease patient and provider burden for postoperative care. ClinicalTrials.gov , www.clinicaltrials.gov , NCT02891187.

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