N43 the "help-line telephone" form: a new telemedical support for managing patients with ibd
Authors: Povoli A , Grubissa S , Molino L , Marino M , Berretti D 
Published: January 2025

Abstract

Background
In the current healthcare economy, the implementation of telemedicine is rapidly evolving.The rationale for development and advancement in this area seems to be dual: first, to improve speed and efficiency in the supply of health counseling and decision making, and second, to provide access to patients in rural areas.IBD has a significant medical, social and financial impact considering the constant increasing worldwide in its incidence and prevalence.Our study aims to determine how much the "Help-line telephone" form that supports phone call could become a useful tool to the IBD nurse and physician to ensure a better and a faster patient care

Methods
A retrospective observational 12 months study was conducted in 2024.All phone calls were recorded on the help-line telephone card in 12 months were included.Descriptive statistics has been used to categorize the number of phone calls received and splitted into several categories: request for visit/change visit/reminder; requests for other investigations/blood tests/calprotectin/histology; colonoscopy request; worsening;improvement; biologic therapy; topical therapy;os therapy; covid

Results
A total of 1465 phone calls were recorded from November 2023 to October 2024.The average number of phone calls per month is 122.1.We present the percentage of the different items considered:32.6% "Request/Change Visit + Reminder",7.3% were for hematology and/or fecal calprotectin tests, 4.1% were for other investigations, and 0.8% were for histological reports and 4.6% for colonscopy. It emerges that worsening reporting of the patient's health status are about 4 times higher than calls for improvement. Calls regarding biologic therapy amounted to18.0% followed by topical therapy(3.5%)and oral therapy(4.6%).Calls to report Covid, flu and joint pain(6.6%) appear to be more frequent in cold months such as November 2023(n=17)and October 2024 (n=19)and almost absent in warm months such as May and June 2024(n=1)tracing a cyclical pattern.

Conclusion
Despite the fact that this service was adopted as an emergency measure during the pandemic period of SARS-COVID-19, it is still widely used in our Centre on daily basis. Beyond limiting the number of outpatient visits, it is essential for the day-to-day follow-up.The support of the ‘help-line telephone’ form is important for the internal management of the outpatient clinic as it enables the healthcare professionals to provide adequate answers to specific patient requests within a short period of time. In addition, it is proven to be effective in managing needs in order to eliminate any possible oversights.A continuation of the study is suggested for further data collection in order to optimize the form by further orienting it towards patients' needs.

References
DeBlois, D., Millefoglie, M. (2015). Telehealth: enhancing collaboration, improving care coordination. Nursing Management; 46:10–12.
Huang, V., Reich, K., Fedorak, R. (2014). Distance management of inflammatory bowel disease: systematic review and meta-analysis. World Journal of Gastroenterology; 20:829–42.Win, A. (2015) Telehealth can bridge the gap for rural, disabled, and elderly patients. J Am Med Dir Assoc; 16:268–9.
Turner, D., Ricciuto, A., Lewis, A., D'Amico, F., Dhaliwal, J., Griffiths, A.M., Bettenworth, D., Sandborn, W.J., Sands, B.E., Reinisch, W., Schölmerich, J., Bemelman, W., Danese, S., Mary, J.Y., Rubin, D.,
Colombel, J.F., Peyrin-Biroulet, L., Dotan, I., Abreu, M.T., Dignass, A. (2021). STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology; 160: 1570-1583.
Jackson, C.A., Clatworthy, J., Robinson, A., Horne, R. (2010). Factors associated with non-adherence to oral medication for inflammatory bowel disease: a systematic review. Am J Gastroenterol; 105: 525-539.
Del Hoyo, J., Millán, M., Garrido-Marín, A., Aguas, M. (2010). Are we ready for telemonitoring inflammatory bowel disease? A review of advances, enablers, and barriers. World journal of gastroenetology; 29(7):1139-1156.