N008. Audit into patient opinion of an inflammatory bowel disease nurse led virtual telephone follow-up clinic
G. Lloyd-Ford, A. Lewis, L. Hook, K. Yearsley, Aneurin Bevan University Health Board, Gastroenterology, Abergavenny, United Kingdom
Due to over-burdened IBD follow-up clinics, a need for more responsive and timely follow-up arrangements was identified. Virtual telephone clinics have been successful in other units for patients with IBD and it was felt appropriate to trial one within this health board. Funding was obtained for the initial set up costs and the trial set up on one site within the health board (Nevill Hall Hospital) where the majority of IBD patients are under the care of one consultant.
Patients aged 18 or over were identified retrospectively via the Consultant and Nurse Led follow up waiting lists as being appropriate for a telephone review; they were also identified prospectively during clinic visits. Patients broadly fell into two groups: (a) patients with UC on 5-ASA therapy only and no flare ups for at least a year; and (b) patients with all IBD types on immunomodulator or anti-TNF therapy under 6-monthly routine reviews previously undertaken in an outpatient clinic. Five patients were reviewed fortnightly by telephone during the pilot. Following the consultation each patient was asked to feed back on the service by means of a questionnaire.
Questionnaires were sent to the first 50 patients reviewed in the virtual clinic; 34 (68%) were returned. There were more female respondents (20–58%) and most were in the age range of 61–80 years. The majority (23–68%) had ulcerative colitis. There were 9 with Crohn's (26%) and 2 with indeterminate colitis (6%). All but three patients were happy with the nurse led telephone clinic stating it met their needs. Following the initial telephone consultation, 27 patients continued under the telephone clinic, two patients required a consultant review, and five chose nurse specialist follow-up.
The telephone clinic proved popular and appropriate for patients with quiescent disease those requiring monitoring whilst receiving immunomodulator or anti-TNF therapy. Most patients were happy to be reviewed in this way in the future. Offering telephone follow-up to these groups increases clinic capacity for patients requiring traditional outpatient review. The pilot will be extended to all sites within the health board with the hope it will benefit patients and service delivery on all sites.