Feasibility of Telephone Follow-up Visits in Primary Care

Study Overview
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Brief Summary
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Doctors frequently speak with their patients over the telephone. Having a visit with a doctor over the telephone rather than face-to-face can be convenient for patients and allow them to save time and money on transportation and missed time from work. However, some patients may prefer seeing the doctor in person. In this study, we will study two groups of patients - some who have their visits with their doctor over the telephone and some who have them face-to-face. Using surveys and interviews, we will study if the groups differ in their satisfaction with their visit with their doctor after participating in the study for 6 months. We will also look at doctor satisfaction with telephone visits, use of clinic resources and if patients received recommended care such as laboratory tests and vaccines during the study period.

Detailed Description
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This two arm randomized controlled trial will evaluate the effect of telephone follow-up versus standard in-person follow-up (usual care) on patient satisfaction among a sample of 360 primary care patients followed at the Gouverneur Ambulatory Care Practice. All primary care patients will be considered eligible at the outset. Providers will determine patient's study eligibility at the baseline visit based on the ability to safely follow-up the patient's health issue over the telephone in subsequent visits. Eligible patients that are randomized to the telephone follow-up arm will have their next medical visit with their primary care provider via a telephone call. Eligible patients that are randomized to the usual care arm will have a standard in-person clinic visit with their primary care provider. In both study arms, the timing and frequency of follow-up appointments will be determined by the patient's primary care provider. Regardless of group assignment, outcomes will be assessed at the baseline and 6-month study visit.

Official Title
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The Feasibility of Replacing Follow-up Visits With Telephone Calls in Primary Care: A Randomized Clinical Trial

Conditions
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No Specific Condition

Intervention / Treatment
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* Other: Telephone Visit


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Have a follow-up issue that can be addressed over the phone (as determined by their provider); 18 years of age or older; Have a working telephone number; and Are English, Spanish, Cantonese or Mandarin-speaking. Exclusion Criteria: Patient refusal or are unable to provide informed consent; Currently participate in another clinical trial; Have significant psychiatric comorbidity or cognitive impairment that would compromise their ability to participate (as determined by their provider); or Plan to discontinue care at the Gouverneur Ambulatory Care Practice within the next 6 months

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Usual Care<br>Eligible patients that are randomized to the usual care arm will have a standard in-person clinic visit with their primary care provider. | |
| Experimental: Telephone visit<br>Eligible patients that are randomized to the telephone follow-up arm will have their next medical visit with their primary care provider via a telephone call. | Other: Telephone Visit<br>* Eligible patients that are randomized to the telephone follow-up arm will have their next medical visit with their primary care provider via a telephone call.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility assessment | Proportion of patients recruited out of the total population and proportion of patients retained at 6 months. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Provider workload | The number of minutes spent in conversation during the telephone visit | 6 months | 
| Provider workload | The total number of scheduled and unscheduled clinic sessions | 6 months | 
| Patient Satisfaction | Patient satisfaction assessed with the CG-CAHPS questionnaire. For the purposes of this study we will only use measures related to provider ratings and communication . Semi-structured in-depth interviews will also be conducted with a subsample of patients in the telephone visit arm to elicit their beliefs on the usefulness and appropriateness of telephone visits for their health care needs as well as suggestions for instituting a telephone visit program, and willingness to participate in future telephone visits. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Telemedicine, Primary Care, Health Services Research